1
|
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
|
2
|
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
|
3
|
Drawert B, Flies AS, Matthew S, Powell M, Rumsey B. Saving the Devils Is in the Details: Tasmanian Devil Facial Tumor Disease Can Be Eliminated with Interventions. LETTERS IN BIOMATHEMATICS 2022; 9:121-140. [PMID: 37655234 PMCID: PMC10470821 DOI: 10.30707/lib9.1.1681913305.269822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Tasmanian Devils facial tumor disease (DFTD) is severely impacting the population of this wild animal. We developed a computational model of the population of Tasmanian Devils, and the change induced by DFTD. We use this model to test possible intervention strategies Tasmanian conservationists could do. We investigate bait drop vaccination programs, diseased animal removals programs, and evolution of natural immunity. We conclude that a combination of intervention strategies gives the most favorable outcome. An additional goal of this paper is reproducibility of our results. Our StochSS software platform features the ability to share and reproduce the computational notebooks that created all of the results in the paper. We endeavor that all readers should be able to reproduce our results with minimum effort.
Collapse
Affiliation(s)
- Brian Drawert
- National Environmental Modeling and Analysis Center, University of North Carolina Asheville, Asheville, NC, USA
| | - Andrew S. Flies
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Sean Matthew
- National Environmental Modeling and Analysis Center, University of North Carolina Asheville, Asheville, NC, USA
| | - Megan Powell
- Department of Mathematics and Statistics, University of North Carolina Asheville, Asheville, NC, USA
| | - Bryan Rumsey
- National Environmental Modeling and Analysis Center, University of North Carolina Asheville, Asheville, NC, USA
| |
Collapse
|