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Kaburi BB, Harries M, Hauri AM, Kenu E, Wyss K, Silenou BC, Klett-Tammen CJ, Ressing C, Awolin J, Lange B, Krause G. Availability of published evidence on coverage, cost components, and funding support for digitalisation of infectious disease surveillance in Africa, 2003-2022: a systematic review. BMC Public Health 2024; 24:1731. [PMID: 38943132 PMCID: PMC11214246 DOI: 10.1186/s12889-024-19205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 06/19/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND The implementation of digital disease surveillance systems at national levels in Africa have been challenged by many factors. These include user applicability, utility of IT features but also stable financial support. Funding closely intertwines with implementations in terms of geographical reach, disease focus, and sustainability. However, the practice of evidence sharing on geographical and disease coverage, costs, and funding sources for improving the implementation of these systems on the continent is unclear. OBJECTIVES To analyse the key characteristics and availability of evidence for implementing digital infectious disease surveillance systems in Africa namely their disease focus, geographical reach, cost reporting, and external funding support. METHODS We conducted a systematic review of peer-reviewed and grey literature for the period 2003 to 2022 (PROSPERO registration number: CRD42022300849). We searched five databases (PubMed, MEDLINE over Ovid, EMBASE, Web of Science, and Google Scholar) and websites of WHO, Africa CDC, and public health institutes of African countries. We mapped the distribution of projects by country; identified reported implementation cost components; categorised the availability of data on cost components; and identified supporting funding institutions outside Africa. RESULTS A total of 29 reports from 2,033 search results were eligible for analysis. We identified 27 projects implemented in 13 countries, across 32 sites. Of these, 24 (75%) were pilot projects with a median duration of 16 months, (IQR: 5-40). Of the 27 projects, 5 (19%) were implemented for HIV/AIDs and tuberculosis, 4 (15%) for malaria, 4 (15%) for all notifiable diseases, and 4 (15%) for One Health. We identified 17 cost components across the 29 reports. Of these, 11 (38%) reported quantified costs for start-up capital, 10 (34%) for health personnel compensation, 9 (31%) for training and capacity building, 8 (28%) for software maintenance, and 7(24%) for surveillance data transmission. Of 65 counts of external funding sources, 35 (54%) were governmental agencies, 15 (23%) foundations, and 7 (11%) UN agencies. CONCLUSIONS The evidence on costing data for the digitalisation of surveillance and outbreak response in the published literature is sparse in quantity, limited in detail, and without a standardised reporting format. Most initial direct project costs are substantially donor dependent, short lived, and thus unsustainable.
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Affiliation(s)
- Basil Benduri Kaburi
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- PhD Programme "Epidemiology" Braunschweig-Hannover, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- Hannover Medical School, Hannover, Germany.
| | - Manuela Harries
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Anja M Hauri
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Accra, Ghana
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bernard Chawo Silenou
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Cordula Ressing
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Jannis Awolin
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Center for Infection Research partner site, Hannover-Braunschweig, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Center for Infection Research partner site, Hannover-Braunschweig, Germany
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Moh’d AZ, Coetzer A, Malan AJ, Scott TP, Ramadhan RJ, Wright N, Nel LH. Investigating the Impact That Diagnostic Screening with Lateral Flow Devices Had on the Rabies Surveillance Program in Zanzibar, Tanzania. Microorganisms 2024; 12:1314. [PMID: 39065083 PMCID: PMC11279036 DOI: 10.3390/microorganisms12071314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
With the global impetus for the elimination of canine-mediated human rabies, the need for robust rabies surveillance systems has become ever more important. Many countries are working to improve their rabies surveillance programs and, as a result, the reported use of lateral flow devices (LFDs) is increasing. Despite their known diagnostic limitations, previous studies have hypothesised that the benefits associated with LFDs could make them potentially quite useful towards improving the overall robustness of surveillance programs. To test this, a best practice standard operating procedure was developed which was used to guide the implementation of the ADTEC LFD as a diagnostic screening tool in Zanzibar. Over the course of the first 22 months of this investigation, 83 samples were subjected to in-field diagnostic screening, coupled with subsequent laboratory confirmation, and only one false-negative result was detected. Furthermore, the findings of our investigation indicated that the routine use of LFDs as a diagnostic screening tool resulted in a four-fold increase in the number of samples subjected to rabies diagnosis per month and a three-fold increase in the number of wards where samples were collected per year. Our findings suggest that LFDs could play a noteworthy role in improving the robustness of surveillance systems by increasing the number of samples tested and promoting diagnostic screening in areas distant from laboratories. Their implementation would, however, need to be carefully controlled through standardised protocols that align with the international best practices to ensure their judicious use.
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Affiliation(s)
- Ali Z. Moh’d
- Department of Livestock Development, Ministry of Agriculture, Irrigation, Natural Resources and Livestock, Zanzibar P.O. Box 159, Tanzania
| | - Andre Coetzer
- Global Alliance for Rabies Control, Manhattan, KS 66502, USA; (A.C.); (T.P.S.)
| | - Ayla J. Malan
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa
| | - Terence P. Scott
- Global Alliance for Rabies Control, Manhattan, KS 66502, USA; (A.C.); (T.P.S.)
| | - Ramadhan J. Ramadhan
- Department of Livestock Development, Ministry of Agriculture, Irrigation, Natural Resources and Livestock, Zanzibar P.O. Box 159, Tanzania
| | - Nicolette Wright
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa
| | - Louis H. Nel
- Global Alliance for Rabies Control, Manhattan, KS 66502, USA; (A.C.); (T.P.S.)
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa
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Omar KN, Coetzer A, Hamdu M, Malan AJ, Moh’d AZ, Suleiman TS, Nel LH. The Use of Dog Collars Offers Significant Benefits to Rabies Vaccination Campaigns: The Case of Zanzibar, Tanzania. Trop Med Infect Dis 2023; 8:421. [PMID: 37624359 PMCID: PMC10459019 DOI: 10.3390/tropicalmed8080421] [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: 07/27/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023] Open
Abstract
Tools and resources that could increase dog vaccination coverage have become increasingly critical towards progressing the goal to eliminate dog-mediated human rabies by 2030. In this regard, dog collars that are fitted during vaccination campaigns could potentially enhance owner participation. The use of dog collars will, however, increase the cost per dog vaccinated and the impact and benefit of this practice should be elucidated. This study evaluated the impact of dog collars by testing the perception and related behavioural influences in communities in Zanzibar. In this cross-sectional investigation-conducted approximately two months after the implementation of a mass dog vaccination (MDV) where dog collars were provided to vaccinated dogs-data were collected from 600 respondents in 56 municipal wards in Zanzibar. Descriptive analyses and logistic regressions were undertaken to determine the impact the collars had on respondents with regards to (i) engaging with the community dogs, (ii) health seeking behaviour after exposure, and (iii) overall participation during dog vaccination campaigns. From the data, it was evident that the collars had a positive impact on the community's perception of dogs, with 57% of the respondents feeling safer around a dog with a collar, while 66% of the respondents felt less safe around a dog without a collar. Furthermore, the collars had a positive impact on participation during dog vaccination campaigns. Of the 142 respondents who owned dogs, 64% reported that the collars made them more likely to take their dogs for vaccination, and 95% felt that the collar was an important sign of the dog's vaccination status. This study demonstrated that dog collars could not only improve participation during dog vaccination campaigns, but that they could also play a significant role in the community's perception of rabies vaccination campaigns and vaccinated dogs in general.
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Affiliation(s)
- Khadija N. Omar
- Zanzibar Livestock Research Institute, Zanzibar P.O. Box 104, Tanzania
| | - Andre Coetzer
- Global Alliance for Rabies Control South Africa Non-Profit Company, Pretoria 0181, South Africa
| | - Maulid Hamdu
- Zanzibar Livestock Research Institute, Zanzibar P.O. Box 104, Tanzania
| | - Ayla J. Malan
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa
| | - Ali Z. Moh’d
- Department of Livestock Development, Ministry of Agriculture, Irrigation, Natural Resources and Livestock, Zanzibar P.O. Box 159, Tanzania
| | - Talib S. Suleiman
- Zanzibar Livestock Research Institute, Zanzibar P.O. Box 104, Tanzania
| | - Louis H. Nel
- Global Alliance for Rabies Control South Africa Non-Profit Company, Pretoria 0181, South Africa
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa
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Schrodt CA, Dilius P, Gibson AD, Crowdis K, Fénelon N, Ross Y, Bonaparte S, Joseph HC, Wallace RM. Electronic application for rabies management improves surveillance, data quality, and investigator experience in Haiti. Front Vet Sci 2023; 10:1052349. [PMID: 37065250 PMCID: PMC10103903 DOI: 10.3389/fvets.2023.1052349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundIntegrated bite case management (IBCM) is a multi-sectoral response to animal-bites which reduces human and canine rabies mortality through animal quarantine, bite-victim counseling, and vaccination tracking. Haiti's national rabies surveillance program was established in 2013 using paper-based IBCM (pIBCM) with adoption of an electronic smartphone application (eIBCM) in 2018.MethodsWe evaluated the feasibility of implementing the electronic app in Haiti and compared pIBCM and eIBCM data quality collected January 2013–August 2019. Deaths prevented, cost-per-death averted, and cost-per-investigation during use of pIBCM and eIBCM were estimated using a previously validated rabies cost-effectiveness tool that accounted for bite-victim demographics; probability of acquiring rabies; post-exposure prophylaxis; and costs including training, supplies, and salaries. We compared pIBCM and eIBCM based on data comprehensiveness, completeness, and reporting efficiency. Surveys were administered to IBCM staff to evaluate the usefulness, simplicity, flexibility, and acceptability of eIBCM.ResultsOf 15,526 investigations, 79% were paper-based and 21% electronic. IBCM prevented 241 (estimated) human rabies deaths. Using pIBCM, cost-per-death averted was $2,692 and the cost-per-investigation was $21.02; up to 55 data variables were collected per investigation; data transmission took 26 days to reach national staff, and 180 days until analysis. Using eIBCM, the cost-per-death averted was $1,247 and the cost-per-investigation was $22.70; up to 174 data variables were collected per investigation; data transmission took 3 days to reach national staff, and 30 days until analysis. Among 12,194 pIBCM investigations, 55% were mappable by commune, compared to 100% of eIBCM investigations mappable by GPS. Animal case definitions were incorrectly ascribed by investigators in 5.5% of pIBCM investigations and zero for eIBCM; typically, errors were in determining probable vs. suspect case assignments. Overall, eIBCM was well-accepted by staff, who reported the app is easy-to-use, facilitates investigations, and compared to pIBCM hastens data reporting.DiscussionIn Haiti, eIBCM showed improved data completeness, data quality, and shorter notification times with minimal increase in operational cost. The electronic app is simple-to-use and facilitates IBCM investigations. Rabies endemic countries could refer to eIBCM in Haiti as a cost-effective means to reduce human rabies mortality and improve surveillance capacity.
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Affiliation(s)
- Caroline A. Schrodt
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
- Epidemic Intelligence Service, CDC, Atlanta, GA, United States
- *Correspondence: Caroline A. Schrodt
| | - Pierre Dilius
- Haiti Ministry of Agriculture, Rural Development and Natural Resources, Port au Prince, Haiti
| | - Andrew D. Gibson
- Mission Rabies, Cranborne, Dorset, United Kingdom
- The Royal Dick School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | | | - Yasmeen Ross
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sarah Bonaparte
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Haïm C. Joseph
- Epidemic Intelligence Service, CDC, Atlanta, GA, United States
| | - Ryan M. Wallace
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Sambo M, Ferguson EA, Abela-Ridder B, Changalucha J, Cleaveland S, Lushasi K, Mchau GJ, Nanai A, Nonga H, Steenson R, Johnson PCD, Hampson K. Scaling-up the delivery of dog vaccination campaigns against rabies in Tanzania. PLoS Negl Trop Dis 2022; 16:e0010124. [PMID: 35143490 PMCID: PMC8865671 DOI: 10.1371/journal.pntd.0010124] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 02/23/2022] [Accepted: 12/27/2021] [Indexed: 11/18/2022] Open
Abstract
An increasing number of countries are committing to meet the global target to eliminate human deaths from dog-mediated rabies by 2030. Mass dog vaccination is central to this strategy. To interrupt rabies transmission from dogs to humans, the World Health Organization recommends that vaccination campaigns should be carried out every year in all dog-owning communities vaccinating 70% of their susceptible dogs. Monitoring and evaluation of dog vaccination campaigns are needed to measure progress towards elimination. In this study, we measured the delivery performance of large-scale vaccination campaigns implemented in 25 districts in south-east Tanzania from 2010 until 2017. We used regression modelling to infer the factors associated with, and potentially influencing the successful delivery of vaccination campaigns. During 2010-2017, five rounds of vaccination campaigns were carried out, vaccinating in total 349,513 dogs in 2,066 administrative vaccination units (rural villages or urban wards). Progressively more dogs were vaccinated over the successive campaigns. The campaigns did not reach all vaccination units each year, with only 16-28% of districts achieving 100% campaign completeness (where all units were vaccinated). During 2013-2017 when vaccination coverage was monitored, approximately 20% of vaccination units achieved the recommended 70% coverage, with average coverage around 50%. Campaigns were also not completed at annual intervals, with the longest interval between campaigns being 27 months. Our analysis revealed that districts with higher budgets generally achieved higher completeness, with a twofold difference in district budget increasing the odds of a vaccination unit being reached by a campaign by slightly more than twofold (OR: 2.29; 95% CI: 1.69-3.09). However, higher budgets did not necessarily result in higher coverage within vaccination units that were reached. We recommend national programs regularly monitor and evaluate the performance of their vaccination campaigns, so as to identify factors hindering their effective delivery and to guide remedial action.
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Affiliation(s)
- Maganga Sambo
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Ifakara, 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
| | - 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
| | | | - Joel Changalucha
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Ifakara, Tanzania
| | - 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
| | - Kennedy Lushasi
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Ifakara, Tanzania
- Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Geofrey Joseph Mchau
- Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Alphoncina Nanai
- Department of Neglected Tropical Diseases, World Health Organization, Country Office of Tanzania, Dar es Salaam, Tanzania
| | - Hezron Nonga
- Directorate of Veterinary Services, Ministry of Livestock Development and Fisheries, Dodoma, Tanzania
| | - Rachel Steenson
- 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
| | - 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
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Fasina FO, Fasanmi OG, Makonnen YJ, Bebay C, Bett B, Roesel K. The one health landscape in Sub-Saharan African countries. One Health 2021; 13:100325. [PMID: 34584927 PMCID: PMC8455361 DOI: 10.1016/j.onehlt.2021.100325] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/06/2021] [Accepted: 09/06/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES One Health is transiting from multidisciplinary to transdisciplinary concepts and its viewpoints should move from 'proxy for zoonoses', to include other topics (climate change, nutrition and food safety, policy and planning, welfare and well-being, antimicrobial resistance (AMR), vector-borne diseases, toxicosis and pesticides issues) and thematic fields (social sciences, geography and economics). This work was conducted to map the One Health landscape in Africa. METHODS An assessment of existing One Health initiatives in Sub-Saharan African (SSA) countries was conducted among selected stakeholders using a multi-method approach. Strengths, weaknesses, opportunities and threats to One Health initiatives were identified, and their influence, interest and impacts were semi-quantitatively evaluated using literature reviews, questionnaire survey and statistical analysis. RESULTS One Health Networks and identified initiatives were spatiotemporally spread across SSA and identified stakeholders were classified into four quadrants. It was observed that imbalance in stakeholders' representations led to hesitation in buying-in into One Health approach by stakeholders who are outside the main networks like stakeholders from the policy, budgeting, geography and sometimes, the environment sectors. CONCLUSION Inclusion of theory of change, monitoring and evaluation frameworks, and tools for standardized evaluation of One Health policies are needed for a sustained future of One Health and future engagements should be outputs- and outcomes-driven and not activity-driven. National roadmaps for One Health implementation and institutionalization are necessary, and proofs of concepts in One Health should be validated and scaled-up. Dependence on external funding is unsustainable and must be addressed in the medium to long-term. Necessary policy and legal instruments to support One Health nationally and sub-nationally should be implemented taking cognizance of contemporary issues like urbanization, endemic poverty and other emerging issues. The utilization of current technologies and One Health approach in addressing the ongoing pandemic of COVID-19 and other emerging diseases are desirable. Finally, One Health implementation should be anticipatory and preemptive, and not reactive in containing disease outbreaks, especially those from the animal sources or the environment before the risk of spillover to human.
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Key Words
- ACDC, Africa Centres for Disease Control and Prevention
- AFROHUN, Africa One Health University Network
- AMR, Antimicrobial resistance
- AMU, Arab Maghreb Union
- AU, African Union
- AU-IBAR, African Union Inter-African Bureau for Animal Resources
- Africa
- Animal health
- Antimicrobial resistance
- BMGF, Bill and Melinda Gates Foundation
- BSL-3, Biosafety level 3 laboratory
- CEMAC, Economic and Monetary Community of Central Africa
- CILSS, Permanent Inter-State Committee for Drought Control in the Sahel
- COCTU, Control of Trypanosomiasis in Uganda
- COMESA, Common Market for Eastern and Southern Africa
- COVID-19, Coronavirus (SARS CoV 2) disease 2019
- EAC, East African Community
- ECCAS, Economic Community of Central African States
- ECOWAS, Economic Community of West African States
- Emerging and re-emerging diseases
- Environment health
- FAO, Food and Agriculture Organization of the United Nations
- FELTP, Field Epidemiology & Laboratory Training Program
- Food safety
- GARC, Global Alliance for Rabies Control
- GHSA-ZDAH, Global Health Security Agenda's Zoonotic Diseases and Animal Health in Africa
- GIS, Geographic information system
- HPAI H5N1, Highly pathogenic avian influenza subtype H5N1
- IGAD, Intergovernmental Authority on Development
- ILRI, International Livestock Research Institute
- IRA, Institute for Resource Assessment
- ISAVET, Frontline In-Service Applied Veterinary Epidemiology Training
- KEMRI, Kenya Medical Research Institute
- M & E, monitoring and evaluation
- MALF, Ministry of Agriculture, Livestock, and Fisheries
- MRU, Mano River Union
- MoH, Ministry of Health
- NISCAI, National Inter-Ministerial Steering Committee on Avian Influenza
- NTCAI, National Technical Committee on Avian Influenza
- OH, One Health
- OIE, World Organization for Animal Health
- One health (OH)
- PMP, Progressive Management Pathway
- Public health
- RECs, regional economic commissions
- RVF, Rift Valley fever
- SACIDS, Southern African Centre for Infectious Disease Surveillance
- SACU, South African Customs Union
- SADC, South African Development Community
- SSA, Sub-Saharan Africa
- SWOT, Strengths, weaknesses, opportunities and threats
- Toxicosis
- UNICEF, United Nations Children's Fund
- UNSIC, United Nations System Influenza Coordination
- USAID, United States Agency for International Development
- WAEMU, West African Economic and Monetary Union
- WHO, World Health Organization
- ZDU, Zoonotic Disease Unit.
- Zoonosis
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Affiliation(s)
- Folorunso O. Fasina
- Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), Dar es Salaam, United Republic of Tanzania
- Department of Veterinary Tropical Diseases, University of Pretoria, Onderstepoort, South Africa
| | - Olubunmi G. Fasanmi
- Department of Veterinary Laboratory Technology, Federal College of Animal Health & Production Technology, Ibadan, Oyo State, Nigeria
| | - Yilma J. Makonnen
- FAO Sub-Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations, Addis Ababa, Ethiopia
| | - Charles Bebay
- Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), Nairobi, Kenya
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya &ILRI/BMZ One Health Research, Education, Outreach and Awareness Centre (OHRECA), Kenya
| | - Kristina Roesel
- International Livestock Research Institute, Nairobi, Kenya &ILRI/BMZ One Health Research, Education, Outreach and Awareness Centre (OHRECA), Kenya
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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.
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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
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8
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Cai L, Wang L, Guan X, Wang L, Hu X, Wu Y, Tong Y, Wang P. Epidemiological Analysis of Rabies in Central China from 2013 to 2018. Infect Drug Resist 2021; 14:2753-2762. [PMID: 34305400 PMCID: PMC8297554 DOI: 10.2147/idr.s314881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/02/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The study aimed to timely grasp the epidemiologic status of rabies in Central China from 2013 to 2018 and provide scientific evidence for the implementation of follow-up prevention and control measures. Methods We initiated a retrospective observational and descriptive study of bite-related injuries data and rabies disease data in Hubei province from 2013 to 2018, managed by the Center for Disease Control and Prevention. Results A total of 2,028,691 individuals were exposed to bites from 2013 to 2018, of which 221 were diagnosed with rabies and deceased. Among those cases, the incubation periods of rabies varied from 3 days to 18,406 days, which has been shown to be statistically associated with where the infected person was exposed and whether the wound care has been conducted. Conclusion Epidemiological studies have shown that from 2013 to 2018, the current situation of rabies in Central China is still severe. The case fatality rate keeps virtually 100%. The rural population is still the most vulnerable group to rabies, characterized by a high exposure ratio and low treatment rate as well as poor vaccination compliance. Hoewever, larger populations are warranted to validate our findings.
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Affiliation(s)
- Li Cai
- School of Health Sciences, Wuhan University, Wuhan, 430071, People's Republic of China.,Wuhan Center for Disease Control and Prevention, Wuhan, 430015, People's Republic of China
| | - Lixian Wang
- Xiaonan Center for Disease Control and Prevention, Xiaogan, 432100, People's Republic of China
| | - Xuhua Guan
- Hubei Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Lei Wang
- Hubei Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Xinyi Hu
- Global Study Institute, University of Geneva, Geneva, Switzerland
| | - Yang Wu
- Hubei Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Yeqing Tong
- Hubei Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Peigang Wang
- School of Health Sciences, Wuhan University, Wuhan, 430071, People's Republic of China
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9
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Rabies in the Middle East, Eastern Europe, Central Asia and North Africa: Building evidence and delivering a regional approach to rabies elimination. J Infect Public Health 2021; 14:787-794. [PMID: 34022738 DOI: 10.1016/j.jiph.2021.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 02/07/2021] [Accepted: 02/18/2021] [Indexed: 12/25/2022] Open
Abstract
The Middle East, Eastern Europe, Central Asia and North Africa Rabies Control Network (MERACON), is built upon the achievements of the Middle East and Eastern Europe Rabies Expert Bureau (MEEREB). MERACON aims to foster collaboration among Member States (MS) and develop shared regional objectives, building momentum towards dog-mediated rabies control and elimination. Here we assess the epidemiology of rabies and preparedness in twelve participating MS, using case and rabies capacity data for 2017, and compare our findings with previous published reports and a predictive burden model. Across MS, the number of reported cases of dog rabies per 100,000 dog population and the number of reported human deaths per 100,000 population as a result of dog-mediated rabies appeared weakly associated. Compared to 2014 there has been a decrease in the number of reported human cases in five of the twelve MS, three MS reported an increase, two MS continued to report zero cases, and the remaining two MS were not listed in the 2014 study and therefore no comparison could be drawn. Vaccination coverage in dogs has increased since 2014 in half (4/8) of the MS where data are available. Most importantly, it is evident that there is a need for improved data collection, sharing and reporting at both the national and international levels. With the formation of the MERACON network, MS will be able to align with international best practices, while also fostering international support with other MS and international organisations.
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10
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Spargo RM, Coetzer A, Makuvadze FT, Chikerema SM, Chiwerere V, Bhara E, Nel LH. Knowledge, attitudes and practices towards rabies: A survey of the general population residing in the Harare Metropolitan Province of Zimbabwe. PLoS One 2021; 16:e0246103. [PMID: 33508028 PMCID: PMC7842990 DOI: 10.1371/journal.pone.0246103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/13/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Rabies remains endemic to the Harare Metropolitan Province of Zimbabwe, with a lack of public participations potentially contributing to the limited success in eliminating the disease. We hypothesized that rabies intervention campaigns were less successful than they could be as a result of poor understanding of the disease at the community level, and thus aimed to identify the knowledge, attitudes, and practices towards rabies in the province. METHODS A cross-sectional survey, using a semi-structured questionnaire, was implemented between January 2017 and June 2018 across the province and data were collected from 798 respondents. Frequency distributions and logistic regressions were undertaken to determine the factors associated with the adequacy of the prevailing rabies knowledge, pet ownership characteristics and the existing preventative practices. RESULTS The results of our study suggested that the majority of the respondents (92%) had heard of rabies. However, the level of rabies knowledge could be classified as "adequate" in only 36% of respondents. The multivariate logistic regression analysis indicated that pet ownership and type of occupation were statistically associated with a better understanding and knowledge of the disease. Off all the respondents, 49% owned at least one dog or cat and suburb density and occupation were statistically associated with owning a pet. Amongst the pet owners, 57% consulted an animal health practitioner at least once a year and 75% were aware of a rabies vaccine for their pets. The multivariate logistic regression analysis indicated that age, education and gender were statistically associated with pet owners taking their pet(s) to an animal clinic. CONCLUSION This study showed that the majority of the respondents lacked comprehensive knowledge about rabies, with the knowledge pertaining to health seeking behaviour and the importance of rabies vaccination being the most lacking. Additional public education relying on key messages, aimed at the different target audiences, is required in the province.
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Affiliation(s)
- Reverend M. Spargo
- Division of Epidemiology and Disease Control, Department of Veterinary Services, Harare, Zimbabwe
| | - Andre Coetzer
- Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
- Global Alliance for Rabies Control SA NPC, Pretoria, South Africa
| | - Francis T. Makuvadze
- Department of Paraclinical Veterinary Studies, University of Zimbabwe, Harare, Zimbabwe
| | | | - Vaida Chiwerere
- Department of Clinical Veterinary Studies, University of Zimbabwe, Harare, Zimbabwe
| | - Esnath Bhara
- Department of Clinical Veterinary Studies, University of Zimbabwe, Harare, Zimbabwe
| | - Louis H. Nel
- Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
- Global Alliance for Rabies Control SA NPC, Pretoria, South Africa
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11
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Athingo R, Tenzin T, Coetzer A, Hikufe EH, Peter J, Hango L, Haimbodi T, Lipinge J, Haufiku F, Naunyango M, Kephas M, Shilongo A, Shoombe KK, Khaiseb S, Letshwenyo M, Pozzetti P, Nake L, Nel LH, Freuling CM, Müller T, Torres G. Application of the GARC Data Logger-a custom-developed data collection device-to capture and monitor mass dog vaccination campaigns in Namibia. PLoS Negl Trop Dis 2020; 14:e0008948. [PMID: 33370285 PMCID: PMC7793283 DOI: 10.1371/journal.pntd.0008948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 01/08/2021] [Accepted: 11/05/2020] [Indexed: 12/30/2022] Open
Abstract
Domestic dogs are responsible for 99% of all cases of human rabies and thus, mass dog vaccination has been demonstrated to be the most effective approach towards the elimination of dog-mediated human rabies. Namibia demonstrated the feasibility of this approach by applying government-led strategic rabies vaccination campaigns to reduce both human and dog rabies incidences in the Northern Communal Areas of Namibia since 2016. The lessons learnt using paper-based form for data capturing and management of mass dog vaccination campaign during the pilot and roll out phase of the project (2016–2018) led to the implementation of a simple and accurate data collection tool in the second phase (2019–2022) of the rabies elimination program. In this paper, we describe the implementation of such custom-developed vaccination tracking device, i.e. the Global Alliance for Rabies Control (GARC) Data Logger (GDL), and the integration of the collected data into a website-based rabies surveillance system (Rabies Epidemiological Bulletin—REB) during 2019 and 2020 campaigns. A total of 10,037 dogs and 520 cats were vaccinated during the 2019 campaign and 13,219 dogs and 1,044 cats during the 2020 campaign. The vaccination data were recorded with the GDL and visualized via REB. Subsequent GIS-analysis using gridded population data revealed a suboptimal vaccination coverage in the great majority of grid cells (82%) with a vaccination coverage below 50%. Spatial regression analysis identified the number of schools, estimated human density, and adult dog population were associated with the vaccination performance. However, there was an inverse correlation to human densities. Nonetheless, the use of the GDL improved data capturing and monitoring capacity of the campaign, enabling the Namibian government to improve strategies for the vaccination of at-risk areas towards achieving adequate vaccination coverage which would effectively break the transmission of rabies. We used a custom-developed vaccination tracking device—the Global Alliance for Rabies Control (GARC) Data Logger—to capture dog rabies vaccination data during the 2019 and 2020 mass vaccination campaign in the Northern Communal Areas of Namibia, and then integrated the collected data into the web-based Rabies Epidemiological Bulletin, a rabies-specific disease surveillance platform for rabies-endemic countries. This approach allowed automatic collation, analysis and, visualization of data and drastically improved the data capturing and monitoring capacity of the Namibian government led campaign. Additionally, subsequent GIS analysis enabled a better estimation of vaccination coverage at a much higher spatial resolution, thus identifying areas where improvements in the vaccination strategy are needed to ensure long-term success of the project.
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Affiliation(s)
- Rauna Athingo
- Animal Disease Control, Sub-division, North-West, Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Ongwediva, Namibia
| | - Tenzin Tenzin
- World Organisation for Animal Health (OIE), Sub-Regional Representation for Southern Africa, Gaborone, Botswana
- * E-mail: ,
| | - Andre Coetzer
- Global Alliance for Rabies Control (GARC), Pretoria, South Africa
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, South Africa
| | - Emmanuel H. Hikufe
- Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Windhoek, Namibia
| | - Josephat Peter
- Outapi State Veterinary Office, Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Omusati region, Outapi, Namibia
| | - Laina Hango
- Outapi State Veterinary Office, Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Omusati region, Outapi, Namibia
| | - Tangeni Haimbodi
- Ondangwa State Veterinary Office, Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Oshana region, Ondangwa, Namibia
| | - Johannes Lipinge
- Ondangwa State Veterinary Office, Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Oshana region, Ondangwa, Namibia
| | - Frenada Haufiku
- Omuthiya State Veterinary Office, Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Oshikoto region, Omuthiya, Namibia
| | - Matias Naunyango
- Eenhana State Veterinary Office, Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Ohangwena region, Eenhana, Namibia
| | - Magano Kephas
- Eenhana State Veterinary Office, Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Ohangwena region, Eenhana, Namibia
| | - Albertina Shilongo
- Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Windhoek, Namibia
| | - Kenneth K. Shoombe
- Animal Disease Control, Sub-division, North-West, Directorate of Veterinary Services (DVS), Ministry of Agriculture, Water and Land Reform, Ongwediva, Namibia
| | - Siegfried Khaiseb
- Central Veterinary Laboratory, Directorate of Veterinary Services (DVS), Ministry of Agriculture Water and Land Reform, Windhoek, Namibia
| | - Moetapele Letshwenyo
- World Organisation for Animal Health (OIE), Sub-Regional Representation for Southern Africa, Gaborone, Botswana
| | | | - Lorenz Nake
- World Organisation for Animal Health (OIE), Paris, France
| | - Louis H. Nel
- Global Alliance for Rabies Control (GARC), Pretoria, South Africa
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, South Africa
| | - Conrad M. Freuling
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institute, Greifswald—Insel Riems, Germany
| | - Thomas Müller
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institute, Greifswald—Insel Riems, Germany
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12
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Evaluation of the Worldwide Occurrence of Rabies in Dogs and Cats Using a Simple and Homogenous Framework for Quantitative Risk Assessments of Rabies Reintroduction in Disease-Free Areas through Pet Movements. Vet Sci 2020; 7:vetsci7040207. [PMID: 33353001 PMCID: PMC7766548 DOI: 10.3390/vetsci7040207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/11/2020] [Accepted: 12/18/2020] [Indexed: 12/31/2022] Open
Abstract
Dog and cat rabies cases imported from rabies enzootic countries represent a major threat for areas that have acquired rabies-free status and quantitative risk analyses (QRAs) are developed in order to assess this risk of rabies reintroduction through dog and cat movements. Herein we describe a framework to evaluate dog and cat rabies incidence levels in exporting countries along with the associated uncertainty for such QRAs. For enzootic dog rabies areas (EDRAs), we extended and adapted a previously published method to specify the relationship between dog rabies vaccination coverage and canine rabies incidence; the relationship between dog and cat rabies incidences; and then to predict annual dog and cat rabies incidences. In non-enzootic dog rabies areas (nEDRAs), we provided annual incidence based on declared dog and cat rabies cases. For EDRAs, we predicted an annual incidence potentially greater than 1.5% in dogs and about ten times lower in cats with a high burden in Africa and Asia but much lower in Latin America. In nEDRAs, the occurrence of rabies was lower and of similar magnitude in dogs and cats. However, wildlife could still potentially infect dogs and cats through spillover events. This framework can directly be incorporated in QRAs of rabies reintroduction.
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13
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Kimitsuki K, Saito N, Yamada K, Park CH, Inoue S, Suzuki M, Saito-Obata M, Kamiya Y, Manalo DL, Demetria CS, Mananggit MR, Quiambao BP, Nishizono A. Evaluation of the diagnostic accuracy of lateral flow devices as a tool to diagnose rabies in post-mortem animals. PLoS Negl Trop Dis 2020; 14:e0008844. [PMID: 33151941 PMCID: PMC7671516 DOI: 10.1371/journal.pntd.0008844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/17/2020] [Accepted: 09/28/2020] [Indexed: 11/19/2022] Open
Abstract
Implementation of lateral flow devices (LFDs) for rabies antigen detection is expected to improve surveillance through the efficient detection of rabid animals in resource-limited settings; however, the use of LFDs for diagnosis remains controversial because some commercially available kits show low sensitivity. Therefore, we compared the diagnostic efficacy of three LFDs (ADTEC, Bionote, and Elabscience kits) paralleled with the direct fluorescent antibody test (dFAT) using fresh samples and investigated the diagnostic accuracies. To do so, we evaluated rabies-suspected samples submitted to the Regional Animal Disease Diagnostic Laboratory III, Philippines. Furthermore, we conducted real-time RT-PCR and sequencing to measure the accuracy of field laboratory diagnosis. The total number of animals submitted during this study period was 184 cases, including negative control samples. Of these, 53.9% (84 cases) were positive in the dFAT. Dogs were the most common rabies-suspected animal (n = 135). The sensitivities of the ADTEC and Bionote kits were 0.88 (74 cases) and 0.95 (80 cases), respectively. The specificity of both kits was 1.00 (100 cases). Furthermore, the sensitivity and specificity of the ADTEC kit after directly homogenizing the samples in assay buffer without dilution in phosphate-buffered saline (ADTEC kit DM) were 0.94 (79 cases) and 1.00 (100 cases), respectively. By contrast, there were no positive results using the Elabscience kit among all dFAT-positive samples. The sensitivity and specificity of LFDs make these tests highly feasible if properly used. Therefore, LFD tests can be used to strengthen the surveillance of rabies-infected animals in endemic and resource-limited settings.
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Affiliation(s)
- Kazunori Kimitsuki
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Nobuo Saito
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Kentaro Yamada
- Laboratory of Veterinary Public Health, Department of Veterinary Medical Science, Faculty of Agriculture, University of Miyazaki, Miyazaki, Miyazaki, Japan
| | - Chun-Ho Park
- Department of Veterinary Pathology, School of Veterinary Medicine, Kitasato University, Towada, Aomori, Japan
| | - Satoshi Inoue
- National Institute of Infectious Disease, Tokyo, Japan
| | - Motoi Suzuki
- National Institute of Infectious Disease, Tokyo, Japan
| | | | - Yasuhiko Kamiya
- School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Daria L. Manalo
- Research Institute for Tropical Medicine, Muntinlupa City, Metro Manila, Philippines
| | - Catalino S. Demetria
- Research Institute for Tropical Medicine, Muntinlupa City, Metro Manila, Philippines
| | - Milagros R. Mananggit
- Regional Animal Disease Diagnostic Laboratory, Department of Agriculture Field Office III, San Fernando, Pampanga, Philippines
| | - Beatriz P. Quiambao
- Research Institute for Tropical Medicine, Muntinlupa City, Metro Manila, Philippines
| | - Akira Nishizono
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Oita, Japan
- * E-mail:
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