1
|
Atuheire CGK, Okwee-Acai J, Taremwa M, Terence O, Ssali SN, Mwiine FN, Kankya C, Skjerve E, Tryland M. Descriptive analyses of knowledge, attitudes, and practices regarding rabies transmission and prevention in rural communities near wildlife reserves in Uganda: a One Health cross-sectional study. Trop Med Health 2024; 52:48. [PMID: 39030649 PMCID: PMC11264860 DOI: 10.1186/s41182-024-00615-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/06/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Despite urban (domestic dog) rabies cycles being the main target for rabies elimination by 2030, sylvatic (wildlife) rabies cycles can act as rabies spillovers especially in settlements contiguous to wildlife reserves. Rural communities next to wildlife reserves are characterized by unique socio-demographic and cultural practices including bat consumption, hunting for bushmeat, and non-vaccination of hunting dogs against rabies among others. This study aimed to compare the knowledge, attitudes, and practices (KAPs) related to rabies transmission and prevention in the three districts of Uganda; (1) Nwoya, neighboring Murchison Falls National Park (MFNP) in the north, (2) Kamwenge neighboring Kibaale National Park (KNP), Queen Elizabeth National Park (QENP) and Katonga Game Reserve (KGR) in the west, and (3) Bukedea, neighboring Pian Upe Game Reserve (PUGR) in the east of Uganda. METHODS A community-based cross-sectional survey was conducted in settlements contiguous to these wildlife reserves. Using a semi-structured questionnaire, data were collected from 843 households owning dogs and livestock. Data were collected between the months of January and April 2023. Stratified univariate analyses by district were carried out using the Chi-square test for independence and Fisher's exact test to compare KAPs in the three study districts. RESULTS The median age of study participants was 42 years (Q1, Q3 = 30, 52) with males comprising the majority (67%, n = 562). The key findings revealed that participants from the Nwoya district in the north (MFNP) had little knowledge about rabies epidemiology (8.5%, n = 25), only 64% (n = 187) of them knew its signs and symptoms such as a rabid dog presenting with aggressiveness and showed negative attitudes towards prevention measures (15.3%, n = 45). Participants in the Kamwenge district-west (KNP, QENP, and KGR) had little knowledge and negative attitude towards wildlife-human interaction pertaining to rabies transmission and prevention especially those with no or primary level of education (20.9%, n = 27) while participants from Bukedea in the east (PUGR) had remarkedly poor practices towards rabies transmission, prevention, and control (37.8%, n = 114). CONCLUSIONS Rabies from sylvatic cycles remains a neglected public health threat in rural communities surrounding national parks and game reserves in Uganda. Our study findings highlight key gaps in knowledge, attitudes, and practices related to rabies transmission and prevention among such communities. Communication and action between veterinary services, wildlife authority, public health teams, social science and community leaders through available community platforms is key in addressing rabies among the sympatric at-risk communities in Uganda.
Collapse
Affiliation(s)
- Collins G K Atuheire
- Department of Biosecurity, Ecosystems & Veterinary Public Health, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda.
| | - James Okwee-Acai
- Department of Veterinary Pharmacy, Clinical and Comparative Medicine, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Martha Taremwa
- Department of Biosecurity, Ecosystems & Veterinary Public Health, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Odoch Terence
- Department of Biosecurity, Ecosystems & Veterinary Public Health, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Sarah N Ssali
- School of Women and Gender Studies, College of Humanities, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Frank N Mwiine
- Department of Biomolecular Resources and Bio-Lab Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Clovice Kankya
- Department of Biosecurity, Ecosystems & Veterinary Public Health, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Eystein Skjerve
- Department of Production Animal Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Morten Tryland
- Department of Arctic and Marine Biology, UiT-The Arctic University of Norway, Tromsø, Norway
- Department of Forestry and Wildlife Management, Inland Norway University of Applied Sciences, 2480, Koppang, Norway
| |
Collapse
|
2
|
Nujum ZT, Asaria M, Kurup KK, Mini M, Mazumdar S, Daptardar M, Tiwari H. Cost-effectiveness of One Health interventions for rabies elimination: a systematic review. Trans R Soc Trop Med Hyg 2024; 118:223-233. [PMID: 37903657 DOI: 10.1093/trstmh/trad074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/31/2023] [Accepted: 10/05/2023] [Indexed: 11/01/2023] Open
Abstract
The 'One Health' (OH) approach is the most promising idea in realising the global goal of eliminating canine-mediated human rabies by 2030. However, taking an OH approach to rabies elimination can mean many different things to different people. We conducted a systematic review scrutinizing economic evaluations (EEs) retrieved from MEDLINE OVID, Embase OVID, Global Health OVID, CINAHL EBSCO and ECONLIT EBSCO that used the OH approach with the intent of identifying cost-effective sets of interventions that can be combined to implement an optimal OH-based rabies elimination program and highlight key gaps in the knowledge base. Our review suggests that an optimal OH program to tackle rabies should incorporate mass dog vaccination and integrated bite case management in combination with efficient use of post-exposure prophylaxis along with a shift to a 1-week abbreviated intradermal rabies vaccine regimen in humans. We recommend that future EEs of OH interventions for rabies elimination should be performed alongside implementation research to ensure proposed interventions are feasible and adopt a wider societal perspective taking into account costs and outcomes across both the human health and animal welfare sectors. The systematic review has been registered with PROSPERO.
Collapse
Affiliation(s)
- Zinia T Nujum
- Senior Visiting Fellow, Department of Health Policy, London School of Economics and Political Science, London WC2A2AE, UK
| | - Miqdad Asaria
- Assistant Professor, Department of Health Policy, London School of Economics and Political Science, London WC2A2AE, UK
| | - Karishma Krishna Kurup
- Research Fellow, Center for Universal Health, Chatham House (Royal Institute of International Affairs) London, UK
| | - Malathi Mini
- MSc Global Health Policy Candidate, London School of Economics and Political Science, London WC2A2AE, UK
| | - Sumit Mazumdar
- Research Fellow (Global Health), Centre for Health Economics, University of York Visiting Senior Fellow, Institute for Human Development, New Delhi, India
| | | | - Harish Tiwari
- DBT Wellcome India Alliance CPH Intermediate Fellow, Indian Institute of Technology Guwahati, Assam, India
- Research Affiliate, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
3
|
Duamor CT, Hampson K, Lankester F, Lugelo A, Changalucha J, Lushasi KS, Czupryna A, Mpolya E, Kreppel K, Cleaveland S, Wyke S. Integrating a community-based continuous mass dog vaccination delivery strategy into the veterinary system of Tanzania: A process evaluation using normalization process theory. One Health 2023; 17:100575. [PMID: 37332884 PMCID: PMC10272491 DOI: 10.1016/j.onehlt.2023.100575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/20/2023] Open
Abstract
Abstract Sustained vaccination coverage of domestic dog populations can interrupt rabies transmission. However, challenges remain including low dog owner participation, high operational costs associated with current (centralized and annually delivered (pulse)) approaches and high dog population turnover. To address these challenges an alternative (community-based continuous mass dog vaccination (CBC-MDV)) approach was designed. We investigated the potential for successful normalization of CBC-MDV into routine practice within the context of local communities and the veterinary system of Tanzania. Methods In a process evaluation of a pilot implementation of CBC-MDV, we conducted in-depth interviews with implementers and community leaders (n = 24), focus group discussion with implementers and community members (n = 12), and non-participant observation (n = 157 h) of delivery of the intervention components. We analyzed these data thematically drawing on the normalization process theory, to assess factors affecting implementation and integration. Main findings Implementers and community members clearly understood the values and benefits of the CBC-MDV, regarding it as an improvement over the pulse strategy. They had a clear understanding of what was required to enact CBC-MDV and considered their own involvement to be legitimate. The approach fitted well into routine schedules of implementers and the context (infrastructure, skill sets and policy). Implementers and community members positively appraised CBC-MDV in terms of its perceived impact on rabies and recommended its use across the country. Implementers and community members further believed that vaccinating dogs free of charge was critical and made community mobilization easier. However, providing feedback to communities and involving them in evaluating outcomes of vaccination campaigns were reported to have not been done. Local politics was cited as a barrier to collaboration between implementers and community leaders. Conclusion This work suggests that CBC-MDV has the potential to be integrated and sustained in the context of Tanzania. Involving communities in design, delivery and monitoring of CBC-MDV activities could contribute to improving and sustaining its outcomes.
Collapse
Affiliation(s)
- Christian Tetteh Duamor
- Department of Global Health and Biomedical Sciences, Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
- Environmental Health and Ecological Sciences Thematic Group, Ifakara Health Institute – Tanzania, Ifakara, Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Katie Hampson
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Felix Lankester
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, USA
- Global Animal Health Tanzania, Arusha, Tanzania
| | - Ahmed Lugelo
- Environmental Health and Ecological Sciences Thematic Group, Ifakara Health Institute – Tanzania, Ifakara, Tanzania
- Global Animal Health Tanzania, Arusha, Tanzania
- Sokoine University of Agriculture, Morogoro, Tanzania
| | - Joel Changalucha
- Environmental Health and Ecological Sciences Thematic Group, Ifakara Health Institute – Tanzania, Ifakara, Tanzania
- Global Animal Health Tanzania, Arusha, Tanzania
| | - Kennedy Selestin Lushasi
- Department of Global Health and Biomedical Sciences, Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
- Environmental Health and Ecological Sciences Thematic Group, Ifakara Health Institute – Tanzania, Ifakara, Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Anna Czupryna
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Global Animal Health Tanzania, Arusha, Tanzania
| | - Emmanuel Mpolya
- Department of Global Health and Biomedical Sciences, Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Katharina Kreppel
- Department of Global Health and Biomedical Sciences, Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
4
|
Duamor CT, Lankester F, Mpolya E, Ferguson EA, Johnson PCD, Wyke S, Cleaveland S, Hampson K, Kreppel K. Participation in mass dog vaccination campaigns in Tanzania: Benefits of community engagement. Front Public Health 2022; 10:971967. [PMID: 36311637 PMCID: PMC9616113 DOI: 10.3389/fpubh.2022.971967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023] Open
Abstract
Background Canine rabies causes about 59,000 human deaths each year globally but the disease can be eliminated by sustaining sufficient dog vaccination coverage over several consecutive years. A challenge to achieving high coverage is low participation of dog owners in vaccination campaigns. We explored whether and how previously identified contributory factors to low participation can be addressed through community engagement activities. Methods We engaged communities in two wards in Tanzania on dog behavior and handling, safe ways of interacting with dogs, and their perceptions of dog vaccination. We shared and elicited information from them through village meetings, video screenings, posters and leaflets and involved the leadership of one of the wards in planning and implementing a dog vaccination exercise to explore the feasibility of their participation. We assessed the impact of engagement activities with household surveys, meeting reports, observations and focus group discussions. We used a generalized linear mixed-effects model to identify predictors of knowledge and perceptions and compared knowledge amongst respondents before and after engagement activities. Qualitative data was analyzed inductively to explore perceptions of dog handling and vaccination and feasibility, opportunities and barriers to community leadership participation in organizing mass dog vaccination. Main findings Knowledge of dog behavior, dog handling, and safe ways of interacting with dogs was positively associated with age (p < 0.0001), dog ownership (p = 0.0203), training (p = 0.0010) and previous experience of a dog bite (p = 0.0002); and was negatively associated with being afraid of dogs (p = 0.0061) and participation in a recent dog vaccination campaign (p = 0.0077). Knowledge was low before and significantly improved after engagement activities. The majority (92%) of respondents believed dog vaccination has no negative effects on dogs. Respondents perceived lack of bonding with their dog as a limitation to the ability to restrain a dog for vaccination. The community performed most roles assigned to them in the dog vaccination exercise, but barriers such as lack of motivation for volunteering exist. Conclusion Engaging communities regularly on dog vaccination can improve their knowledge of dog behavior and dog handling techniques, and may help improve owner participation in dog vaccination campaigns.
Collapse
Affiliation(s)
- Christian Tetteh Duamor
- Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
- Environmental Health and Ecological Sciences Thematic Group, Ifakara Health Institute, Dar-es-Salaam, Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Felix Lankester
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, United States
- Global Animal Health Tanzania, Arusha, Tanzania
| | - Emmanuel Mpolya
- Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Elaine A. Ferguson
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Paul CD. Johnson
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sally Wyke
- School of Social and Political Sciences, School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Katie Hampson
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Katharina Kreppel
- Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| |
Collapse
|
5
|
Duamor CT, Hampson K, Lankester F, Lugelo A, Mpolya E, Kreppel K, Cleaveland S, Wyke S. Development, feasibility and potential effectiveness of community-based continuous mass dog vaccination delivery strategies: Lessons for optimization and replication. PLoS Negl Trop Dis 2022; 16:e0010318. [PMID: 36067231 PMCID: PMC9481168 DOI: 10.1371/journal.pntd.0010318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 09/16/2022] [Accepted: 08/22/2022] [Indexed: 12/25/2022] Open
Abstract
Objectives Dog vaccination can eliminate rabies in dogs, but annual delivery strategies do not sustain vaccination coverage between campaigns. We describe the development of a community-based continuous mass dog vaccination (CBC-MDV) approach designed to improve and maintain vaccination coverage in Tanzania and examine the feasibility of delivering this approach as well as lessons for its optimization. Methods We developed three delivery strategies of CBC-MDV and tested them against the current annual vaccination strategy following the UK Medical Research Council’s guidance: i) developing an evidence-based theoretical framework of intervention pathways and ii) piloting to test feasibility and inform optimization. For our process evaluation of CBC-MDV we collected data using non-participant observations, meeting reports and implementation audits and in-depth interviews, as well as household surveys of vaccination coverage to assess potential effectiveness. We analyzed qualitative data thematically and quantitative data descriptively. Results The final design included delivery by veterinary teams supported by village-level one health champions. In terms of feasibility, we found that less than half of CBC-MDV’s components were implemented as planned. Fidelity of delivery was influenced by the strategy design, implementer availability and appreciation of value intervention components, and local environmental and socioeconomic events (e.g. elections, funerals, school cycles). CBC-MDV activities decreased sharply after initial campaigns, partly due to lack of supervision. Community engagement and involvement was not strong. Nonetheless, the CBC-MDV approaches achieved vaccination coverage above the critical threshold (40%) all-year-round. CBC-MDV components such as identifying vaccinated dogs, which village members work as one health champions and how provision of continuous vaccination is implemented need further optimization prior to scale up. Interpretation CBC-MDV is feasible to deliver and can achieve good vaccination coverage. Community involvement in the development of CBC-MDV, to better tailor components to contextual situations, and improved supervision of activities are likely to improve vaccination coverage in future. Annual mass dog vaccination campaigns that reach at least 70% of the dog population, should maintain sufficient herd immunity (sustain vaccination coverage above 40%) between campaigns to interrupt rabies transmission. However, it is often challenging to reach 70% of the dog population with annual vaccination campaigns. We hypothesized that a community-based continuous approach to dog vaccination could better maintain high levels of vaccination coverage all-year-round. We describe the development of a community-based continuous approach to dog vaccination in Tanzania, and assessed the feasibility of delivering its components, its potential effectiveness and lessons for its optimization. We found that the approach was well accepted, as its development involved key stakeholders. Although less than half of the components of the community-based continuous approach were delivered exactly as planned, over 70% of dogs were vaccinated and the approach maintained coverage above the critical vaccination threshold throughout the year. We conclude that it is feasible to deliver a community-based continuous approach to dog vaccination, but that some components need further improvement; more supervision and community involvement should lead to better outcomes.
Collapse
Affiliation(s)
- Christian Tetteh Duamor
- Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha–Tanzania
- Environmental Health and Ecological Sciences Thematic Group, Ifakara Health Institute–Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- * E-mail:
| | - Katie Hampson
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Felix Lankester
- Paul G. Allen School for Global Health, Washington State University, Pullman, Washington, United States of America
- Global Animal Health Tanzania, Arusha, Tanzania
| | - Ahmed Lugelo
- Sokoine University of Agriculture, Morongoro–Tanzania
| | - Emmanuel Mpolya
- Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha–Tanzania
| | - Katharina Kreppel
- Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha–Tanzania
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sally Wyke
- School of Social and Political Sciences, School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| |
Collapse
|
6
|
Duamor CT, Hampson K, Lankester F, Sambo M, Kreppel K, Wyke S, Cleaveland S. Use of lay vaccinators in animal vaccination programmes: A scoping review. PLoS Negl Trop Dis 2021; 15:e0009691. [PMID: 34375325 PMCID: PMC8378730 DOI: 10.1371/journal.pntd.0009691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/20/2021] [Accepted: 07/28/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The human resource gap in veterinary sectors, particularly in low-income countries, imposes limitations on the delivery of animal healthcare in hard-to-reach populations. Lay animal health workers have been deployed in these settings to fill the gap though there are mixed views about the benefits of doing this and whether they can deliver services safely. We mapped evidence on the nature and extent of roles assigned to lay animal vaccinators, and identified lessons useful for their future deployment. METHODOLOGY/PRINCIPAL FINDINGS Following the PRISMA Extension for Scoping Reviews guidelines, we searched seven bibliographic databases for articles published between 1980 and 2021, with the search terms lay OR community-based OR volunteer AND "animal health worker" OR vaccinator*, and applied an a priori exclusion criteria to select studies. From 30 identified studies, lay vaccinators were used by non-government developmental (n = 12, 40%), research (n = 10, 33%) and government (n = 5, 17%) programmes to vaccinate domestic animals. The main reason for using lay vaccinators was to provide access to animal vaccination in the absence of professional veterinarians (n = 12, 40%). Reported positive outcomes of programmes included increased flock and herd sizes and farmer knowledge of best practice (n = 13, 43%); decreased disease transmission, outbreaks and mortality (n = 11, 37%); higher vaccination coverage (10, 33%); non-inferior seroconversion and birth rates among vaccinated herds (n = 3, 10%). The most frequently reported facilitating factor of lay vaccinator programmes was community participation (n = 14, 47%), whilst opposition from professional veterinarians (n = 8, 27%), stakeholders seeking financial gains to detriment of programmes goals (n = 8, 27%) and programming issues (n = 8, 27%) were the most frequently reported barriers. No study reported on cost-effectiveness and we found no record from a low and middle-income country of lay vaccinator programmes being integrated into national veterinary services. CONCLUSION Although the majority of included studies reported more benefits and positive perceptions of lay vaccinator programmes than problems and challenges, regularization will ensure the programmes can be designed and implemented to meet the needs of all stakeholders.
Collapse
Affiliation(s)
- Christian Tetteh Duamor
- Department of Global Health, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
- Environmental Health and Ecological Sciences Thematic Group, Ifakara Health Institute, Ifakara, Tanzania
| | - Katie Hampson
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Felix Lankester
- Paul G. Allen School for Global Health, Washington State University, Pullman, Washington, United States of America
- Global Animal Health Tanzania, Arusha, Tanzania
| | - Maganga Sambo
- Environmental Health and Ecological Sciences Thematic Group, Ifakara Health Institute, Ifakara, Tanzania
| | - Katharina Kreppel
- Department of Global Health, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| |
Collapse
|
7
|
Changalucha J, Hampson K, Jaswant G, Lankester F, Yoder J. Human rabies: prospects for elimination. CAB REVIEWS : PERSPECTIVES IN AGRICULTURE, VETERINARY SCIENCE, NUTRITION AND NATURAL RESOURCES 2021; 16:039. [PMID: 34765015 PMCID: PMC8580373 DOI: 10.1079/pavsnnr202116039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Almost half of all countries in the world are effectively free of human deaths from dog-mediated rabies. But the disease still affects people in low- and middle-income countries, especially the rural poor, and children. Successful regional elimination of human rabies is attributable to advances in significant and sustained investment in dog vaccination, post-exposure vaccination and surveillance, illustrated by productive efforts to reduce human rabies in Latin America over the last 35 years. Nonetheless, countries still facing endemic rabies face significant barriers to elimination. Using the 2017 Global Strategic Plan to end human rabies deaths from dog-mediated rabies by 2030 as a reference point and an organizing framework, we assess progress toward global rabies elimination by examining the characteristics of successful regional control efforts and barriers to elimination. Although substantive barriers exist for countries where rabies remains endemic, advances in knowledge, technology, institutions, and economics provide a basis for optimism.
Collapse
Affiliation(s)
- Joel Changalucha
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 78373, Dar es salaam, 14112, Tanzania
- Boyd Orr Centre for Population and ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12, 8QQ, UK
- College of Veterinary Medicine and Biomedical Science, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, 23, Tanzania
| | - Katie Hampson
- Boyd Orr Centre for Population and ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12, 8QQ, UK
| | - Gurdeep Jaswant
- Boyd Orr Centre for Population and ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12, 8QQ, UK
- University of Nairobi Institute of Tropical and Infectious Diseases (UNITID), P.O. Box 30197, Nairobi, 00202, Kenya
- Tanzania Industrial Research Development Organisation (TIRDO), P.O. Box 23235, Dar es salaam, Tanzania
| | - Felix Lankester
- Global Animal Health Tanzania, Ngorongoro Conservation Area Authority Building, P.O. Box 1642, Arusha, Tanzania
- Paul G. Allen School for Global Animal Health, Washington state University, P.O. Box 647090, Pullman, Washington, WA 99164 United States of America
| | - Jonathan Yoder
- Paul G. Allen School for Global Animal Health, Washington state University, P.O. Box 647090, Pullman, Washington, WA 99164 United States of America
- School of Economic Sciences, Washington State University, P.O. Box 646210, Pullman, Washington, WA 99164-6210, United States of America
| |
Collapse
|
8
|
Gold S, Donnelly CA, Woodroffe R, Nouvellet P. Modelling the influence of naturally acquired immunity from subclinical infection on outbreak dynamics and persistence of rabies in domestic dogs. PLoS Negl Trop Dis 2021; 15:e0009581. [PMID: 34283827 PMCID: PMC8330898 DOI: 10.1371/journal.pntd.0009581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 08/03/2021] [Accepted: 06/21/2021] [Indexed: 12/04/2022] Open
Abstract
A number of mathematical models have been developed for canine rabies to explore dynamics and inform control strategies. A common assumption of these models is that naturally acquired immunity plays no role in rabies dynamics. However, empirical studies have detected rabies-specific antibodies in healthy, unvaccinated domestic dogs, potentially due to immunizing, non-lethal exposure. We developed a stochastic model for canine rabies, parameterised for Laikipia County, Kenya, to explore the implications of different scenarios for naturally acquired immunity to rabies in domestic dogs. Simulating these scenarios using a non-spatial model indicated that low levels of immunity can act to limit rabies incidence and prevent depletion of the domestic dog population, increasing the probability of disease persistence. However, incorporating spatial structure and human response to high rabies incidence allowed the virus to persist in the absence of immunity. While low levels of immunity therefore had limited influence under a more realistic approximation of rabies dynamics, high rates of exposure leading to immunizing non-lethal exposure were required to produce population-level seroprevalences comparable with those reported in empirical studies. False positives and/or spatial variation may contribute to high empirical seroprevalences. However, if high seroprevalences are related to high exposure rates, these findings support the need for high vaccination coverage to effectively control this disease.
Collapse
Affiliation(s)
- Susannah Gold
- Institute of Zoology, Zoological Society of London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - Christl A. Donnelly
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- Department of Statistics, University of Oxford, Oxfordshire, United Kingdom
| | - Rosie Woodroffe
- Institute of Zoology, Zoological Society of London, London, United Kingdom
| | - Pierre Nouvellet
- School of Life Sciences, University of Sussex, Falmer, Brighton, United Kingdom
| |
Collapse
|
9
|
Filla C, Rajeev M, Randriana Z, Hanitriniana C, Rafaliarison RR, Edosoa GT, Andriamananjara M, Razafindraibe NP, Nely J, Ferreira A, Yang AL, Daniel F, Clarke TA, Farris Z, Stone T, Lastdrager J, Rajaonarivelo T, Hampson K, Metcalf CJE, Valenta K. Lessons Learned and Paths Forward for Rabies Dog Vaccination in Madagascar: A Case Study of Pilot Vaccination Campaigns in Moramanga District. Trop Med Infect Dis 2021; 6:tropicalmed6020048. [PMID: 33921499 PMCID: PMC8167587 DOI: 10.3390/tropicalmed6020048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/25/2022] Open
Abstract
Canine rabies causes an estimated 60,000 human deaths per year, but these deaths are preventable through post-exposure prophylaxis of people and vaccination of domestic dogs. Dog vaccination campaigns targeting 70% of the population are effective at interrupting transmission. Here, we report on lessons learned during pilot dog vaccination campaigns in the Moramanga District of Madagascar. We compare two different vaccination strategies: a volunteer-driven effort to vaccinate dogs in two communes using static point vaccination and continuous vaccination as part of routine veterinary services. We used dog age data from the campaigns to estimate key demographic parameters and to simulate different vaccination strategies. Overall, we found that dog vaccination was feasible and that most dogs were accessible to vaccination. The static-point campaign achieved higher coverage but required more resources and had a limited geographic scope compared to the continuous delivery campaign. Our modeling results suggest that targeting puppies through community-based vaccination efforts could improve coverage. We found that mass dog vaccination is feasible and can achieve high coverage in Madagascar; however, context-specific strategies and an investment in dog vaccination as a public good will be required to move the country towards elimination.
Collapse
Affiliation(s)
- Caitlynn Filla
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; (C.F.); (K.V.)
| | - Malavika Rajeev
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; (A.L.Y.); (C.J.E.M.)
- Correspondence: mailto:
| | - Zoavina Randriana
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Chantal Hanitriniana
- Mention Zoologie et Biodiversité Animale, Faculté des Sciences, Université d’Antananarivo, Antananarivo 101, Madagascar;
| | - Radoniaina R. Rafaliarison
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Glenn Torrencelli Edosoa
- Chargé des Maladies Tropicales Négligées Organisation Mondiale de la Santé Madagascar, Antananarivo 101, Madagascar;
| | - Mamitiana Andriamananjara
- Direction des Services Vétérinaires Ministère Chargé de l’Agriculture et de l’Élevage, Antananarivo 101, Madagascar; (M.A.); (N.P.R.)
| | - Nivohanitra P. Razafindraibe
- Direction des Services Vétérinaires Ministère Chargé de l’Agriculture et de l’Élevage, Antananarivo 101, Madagascar; (M.A.); (N.P.R.)
| | - José Nely
- Service contre les Maladies Endémo-épidémiques et Tropicales Négligées Ministère de la Santé Publique, Antananarivo 101, Madagascar;
| | - Angelique Ferreira
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
- Travelling Animal Doctors, Newark, DE 19711-2916, USA; (T.S.); (J.L.)
| | - Annie L. Yang
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; (A.L.Y.); (C.J.E.M.)
| | - Fenomanana Daniel
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Tara A. Clarke
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
- Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC 27695-8107, USA
| | - Zachary Farris
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
- Department of Health and Exercise Science, Appalachian State University, Boone, NC 28608, USA
| | - Terry Stone
- Travelling Animal Doctors, Newark, DE 19711-2916, USA; (T.S.); (J.L.)
| | - Jochem Lastdrager
- Travelling Animal Doctors, Newark, DE 19711-2916, USA; (T.S.); (J.L.)
| | - Tsiky Rajaonarivelo
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Katie Hampson
- Boyd Orr Centre for Population and Ecosystem Health Institute of Biodiversity, Animal Health and Comparative Medicine University of Glasgow, Glasgow G12 8QQ, UK;
| | - C. Jessica E. Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; (A.L.Y.); (C.J.E.M.)
| | - Kim Valenta
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; (C.F.); (K.V.)
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| |
Collapse
|