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Taylor E, Aguilar-Ancori EG, Banyard AC, Abel I, Mantini-Briggs C, Briggs CL, Carrillo C, Gavidia CM, Castillo-Neyra R, Parola AD, Villena FE, Prada JM, Petersen BW, Falcon Perez N, Cabezas Sanchez C, Sihuincha M, Streicker DG, Maguina Vargas C, Navarro Vela AM, Vigilato MAN, Wen Fan H, Willoughby R, Horton DL, Recuenco SE. The Amazonian Tropical Bites Research Initiative, a hope for resolving zoonotic neglected tropical diseases in the One Health era. Int Health 2023; 15:216-223. [PMID: 35896028 PMCID: PMC9384559 DOI: 10.1093/inthealth/ihac048] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/19/2022] [Accepted: 06/23/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) disproportionately affect populations living in resource-limited settings. In the Amazon basin, substantial numbers of NTDs are zoonotic, transmitted by vertebrate (dogs, bats, snakes) and invertebrate species (sand flies and triatomine insects). However, no dedicated consortia exist to find commonalities in the risk factors for or mitigations against bite-associated NTDs such as rabies, snake envenoming, Chagas disease and leishmaniasis in the region. The rapid expansion of COVID-19 has further reduced resources for NTDs, exacerbated health inequality and reiterated the need to raise awareness of NTDs related to bites. METHODS The nine countries that make up the Amazon basin have been considered (Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Peru, Surinam and Venezuela) in the formation of a new network. RESULTS The Amazonian Tropical Bites Research Initiative (ATBRI) has been created, with the aim of creating transdisciplinary solutions to the problem of animal bites leading to disease in Amazonian communities. The ATBRI seeks to unify the currently disjointed approach to the control of bite-related neglected zoonoses across Latin America. CONCLUSIONS The coordination of different sectors and inclusion of all stakeholders will advance this field and generate evidence for policy-making, promoting governance and linkage across a One Health arena.
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Affiliation(s)
- Emma Taylor
- University of Surrey, School of Veterinary Medicine, Daphne Jackson Road, Guildford, GU2 7AL, UK
| | - Elsa Gladys Aguilar-Ancori
- Instituto Universitario de Enfermedades Tropicales y Biomedicina de Cusco - Universidad Nacional de San Antonio Abad del Cusco, Cusco, 08003, Peru
| | - Ashley C Banyard
- Animal and PlantHealth Agency, WoodhamLane, New Haw, Weybridge, Surrey, KT15 3NB, United Kingdom
| | - Isis Abel
- Laboratório de Epidemiologia e Geoprocessamento, Instituto de MedicinaVeterinária, Universidade Federal do Pará, Castanhal, Pará, 68743-970, Brasil
| | - Clara Mantini-Briggs
- Berkeley Center for Social Medicine and the Institute for the Study of Societal Issues, University of California, Berkeley, 94720-5670, USA
| | - Charles L Briggs
- Berkeley Center for Social Medicine and the Department of Anthropology, University of California, Berkeley, 94720-5670, USA
| | - Carolina Carrillo
- Instituto de Ciencia y Tecnología Dr. Cesar Milstein, Fundación Pablo Cassará - ConsejoNacional de InvestigacionesCientíficas y Técnicas, Saladillo 2468 (C1440FFX) Ciudad de Buenos Aires, Argentina
| | - Cesar M Gavidia
- Facultad de MedicinaVeterinaria, Universidad Nacional Mayor de San Marcos, Lima, 15021, Perú
| | - Ricardo Castillo-Neyra
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, 19104-6021, USA
- One Health Unit, School of Public Health and Administration, Universidad PeruanaCayetano Heredia, Lima, 15102, Peru
| | - Alejandro D Parola
- Fundación Pablo Cassará. Instituto de Ciencia y Tecnología Dr. Cesar Milstein, Saladillo 2468 (C1440FFX) Ciudad de Buenos Aires, Argentina
| | - Fredy E Villena
- Asociaciónpara el Empleo y Bienestar Animal en Investigación y Docencia (ASOPEBAID), Lima, 15072, Peru
| | - Joaquin M Prada
- University of Surrey, School of Veterinary Medicine, Daphne Jackson Road, Guildford, GU2 7AL, UK
| | - Brett W Petersen
- Poxvirus and Rabies Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, 30333, USA
| | - Nestor Falcon Perez
- Facultad de MedicinaVeterinaria y Zootecnia, Universidad Peruana Cayetano Heredia, Lima, 15102, Perú
| | - Cesar Cabezas Sanchez
- Centro de InvestigacionesTecnologicas, Biomedicas y Medioambientales-CITBM, Universidad Nacional Mayor de San Marcos, Lima, 15081, Peru
| | | | - Daniel G Streicker
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK
- MRC-University of Glasgow Centre for Virus Research, Glasgow, G61 1QH, UK
| | - Ciro Maguina Vargas
- Instituto de Medicina Tropical Alexander Von Humbolt, Universidad Peruana Cayetano Heredia, Lima, 15102, Perú
| | | | - Marco A N Vigilato
- Pan American Center for Foot and Mouth Disease and Veterinary Public Health, Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization, Rio de Janeiro, 25040-004, Brazil
| | - Hui Wen Fan
- Bioindustrial Center, InstitutoButantan, São Paulo, 05503-900, Brazil
| | | | - Daniel L Horton
- University of Surrey, School of Veterinary Medicine, Daphne Jackson Road, Guildford, GU2 7AL, UK
| | - Sergio E Recuenco
- Centro de InvestigacionesTecnologicas, Biomedicas y Medioambientales-CITBM, Universidad Nacional Mayor de San Marcos, Lima, 15081, Peru
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Quezada-Nolasco JL, Galarde-López M, Sánchez-Zamorano LM, Serrano-Márquez JM, Arvizu-Tovar LO, Reyna-Sevilla A, Alanis-Gallardo VM, Soberanis-Ramos O. Spatial patterns and risk of aggression of dogs and cats in a central township of Mexico City. Acta Trop 2023; 239:106814. [PMID: 36603802 DOI: 10.1016/j.actatropica.2023.106814] [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: 06/13/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 01/04/2023]
Abstract
Dog and cat aggressions are public health concerns associated with rabies transmission to the human population. The social and environmental conditions of marginalized and urban areas stand a risk due to people's contact with dogs. This study aimed to identify spatial patterns related to dog and cat aggression in a densely populated area in the center of Mexico City, analyzing the risk of aggression at the census unit level in the 2018-2020 triennium. This cross-sectional study was carried out in Coyoacán, in the south-central area of Mexico City's urbanized region. The total number of cases (n = 1,078) was obtained from monthly records of aggressions by dogs and cats, from the Control and Prevention of Zoonoses-Rabies Program of the Coyoacán Sanitary Jurisdiction. The information collected was related to the victims and the aggressors. Associations between the occurrence of bites and the characteristics of the victim were evaluated using a geographic information system (GIS), as well as the spatio-temporal distribution of the aggressions to the census unit level. Out of 1,078 cases reported, 977 (90.6%) were caused by dogs and 101 (9.4%) by cats, 55.1% (n = 587) occurred within the same household, and 13.7% (n = 148) were categorized as severe injuries. Adult men were the most affected group. Attacks on the street had a higher risk of resulting in a severe injury, compared to those that occurred at home (OR 1.63, 95CI 1.15 - 2.31, p <0.006). According to the standardized rate of the triennium, the values ranged between 54.1 and 619 aggressions per 100,000 inhabitants, and summer was the season with a higher probability of occurrence. These results provide a basis for the analytical investigation of the spatial patterns of dog and cat aggression, highlighting the need to implement efficient surveillance systems and public health strategies.
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Affiliation(s)
| | - Miguel Galarde-López
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Morelos 62100, Mexico
| | | | - Juan Manuel Serrano-Márquez
- Programa de control y prevención de las zoonosis, Jurisdicción Sanitaria de Coyoacán, Mexico City 03660, Mexico
| | - Laura Olivia Arvizu-Tovar
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Antonio Reyna-Sevilla
- Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, Mexico City 06400, Mexico
| | - Valeria María Alanis-Gallardo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Orbelín Soberanis-Ramos
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico.
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Swedberg C, Mazeri S, Mellanby RJ, Hampson K, Chng NR. Implementing a One Health Approach to Rabies Surveillance: Lessons From Integrated Bite Case Management. FRONTIERS IN TROPICAL DISEASES 2022; 3:829132. [PMID: 36945698 PMCID: PMC7614337 DOI: 10.3389/fitd.2022.829132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As part of the 'Zero by 30' strategy to end human deaths from dog-mediated rabies by 2030, international organizations recommend a One Health framework that includes Integrated Bite Case Management (IBCM). However, little is understood about the implementation of IBCM in practice. This study aims to understand how IBCM is conceptualized, exploring how IBCM has been operationalized in different contexts, as well as barriers and facilitators to implementation. Semi-structured interviews were conducted with seventeen practitioners and researchers with international, national, and local expertise across Africa, Asia, and the Americas. Thematic analysis was undertaken using both inductive and deductive approaches. Four main themes were identified: 1) stakeholders' and practitioners' conceptualization of IBCM and its role in rabies elimination; 2) variation in how IBCM operates across different contexts; 3) barriers and facilitators of IBCM implementation in relation to risk assessment, PEP provisioning, animal investigation, One Health collaboration, and data reporting; and 4) the impact of the COVID-19 pandemic on IBCM programs. This study highlights the diversity within experts' conceptualization of IBCM, and its operationalization. The range of perspectives revealed that there are different ways of organizing IBCM within health systems and it is not a one-size-fits-all approach. The issue of sustainability remains the greatest challenge to implementation. Contextual features of each location influenced the delivery and the potential impact of IBCM. Programs spanned from highly endemic settings with limited access to PEP charged to the patient, to low endemicity settings with a large patient load associated with free PEP policies and sensitization. In practice, IBCM was tailored to meet the demands of the local context and level of rabies control. Thus, experts' experiences did not necessarily translate across contexts, affecting perceptions about the function, motivation for, and implementation of IBCM. To design and implement future and current programs, guidance should be provided for health workers receiving patients on assessing the history and signs of rabies in the biting animal. The study findings provide insights in relation to implementation of IBCM and how it can support programs aiming to reach the Zero by 30 goal.
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Affiliation(s)
- Catherine Swedberg
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Stella Mazeri
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, United Kingdom
| | - Richard J. Mellanby
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, United Kingdom
| | - Katie Hampson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Nai Rui Chng
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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Rupprecht CE, Mani RS, Mshelbwala PP, Recuenco SE, Ward MP. Rabies in the Tropics. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:28-39. [PMID: 35371908 PMCID: PMC8960221 DOI: 10.1007/s40475-022-00257-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2022] [Indexed: 11/25/2022]
Abstract
Purpose of Review Rabies is an ancient yet still neglected tropical disease (NTD). This review focuses upon highlights of recent research and peer-reviewed communications on the underestimated tropical burden of disease and its management due to the complicated dynamics of virulent viral species, diverse mammalian reservoirs, and tens of millions of exposed humans and animals – and how laboratory-based surveillance at each level informs upon pathogen spread and risks of transmission, for targeted prevention and control. Recent Findings While both human and rabies animal cases in enzootic areas over the past 5 years were reported to PAHO/WHO and OIE by member countries, still there is a huge gap between these “official” data and the need for enhanced surveillance efforts to meet global program goals. Summary A review of the complex aspects of rabies perpetuation in human, domestic animal, and wildlife communities, coupled with a high fatality rate despite the existence of efficacious biologics (but no therapeutics), warrants the need for a One Health approach toward detection via improved laboratory-based surveillance, with focal management at the viral source. More effective methods to prevent the spread of rabies from enzootic to free zones are needed.
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Affiliation(s)
- Charles E. Rupprecht
- LYSSA LLC, Atlanta, GA USA
- School of Forestry and Wildlife Sciences, Auburn University, Auburn, AL USA
| | - Reeta S. Mani
- Department of Neurovirology, WHO Collaborating Centre for Reference and Research in Rabies, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka India
| | - Philip P. Mshelbwala
- School of Veterinary Science, The University of Queensland, Brisbane, Australia
- Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Sergio E. Recuenco
- Facultad de Medicina San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Michael P. Ward
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW Australia
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Premashthira S, Suwanpakdee S, Thanapongtharm W, Sagarasaeranee O, Thichumpa W, Sararat C, Wiratsudakul A. The Impact of Socioeconomic Factors on Knowledge, Attitudes, and Practices of Dog Owners on Dog Rabies Control in Thailand. Front Vet Sci 2021; 8:699352. [PMID: 34490393 PMCID: PMC8416909 DOI: 10.3389/fvets.2021.699352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/12/2021] [Indexed: 12/25/2022] Open
Abstract
Rabies is a deadly zoonotic disease responsible for almost 60,000 deaths each year, especially in Africa and Asia including Thailand. Dogs are the major reservoirs for rabies virus in these settings. This study thus used the concept of knowledge, attitudes, and practices (KAP) to identify socioeconomic factors that contribute to the differences in the canine rabies occurrences in high and low-risk areas which were classified by a Generalized Additive Model (GAM). Multistage sampling was then applied to designate the study locations and a KAP-based questionnaire was used to retrieve data and relevant perspectives from the respondents. Based on the responses from 476 participants living across four regions of Thailand, we found that the knowledge of the participants was positively correlated with their behaviors but negatively associated with the attitudes. Participants who are male, younger, educated at the level of middle to high school, or raising more dogs are likely to have negative attitudes but good knowledge on rabies prevention and control whereas farmers with lower income had better attitudes regardless of their knowledge. We found that people in a lower socioeconomic status with a lack of knowledge are not willing to pay at a higher vaccine price. Public education is a key to change dog owners' behaviors. Related authorities should constantly educate people on how to prevent and control rabies in their communities. Our findings should be applicable to other countries with similar socioeconomic statuses.
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Affiliation(s)
| | - Sarin Suwanpakdee
- Department of Clinical Sciences and Public Health, and the Monitoring and Surveillance Center for Zoonotic Diseases in Wildlife and Exotic Animals, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | | | | | - Weerakorn Thichumpa
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chayanin Sararat
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Anuwat Wiratsudakul
- Department of Clinical Sciences and Public Health, and the Monitoring and Surveillance Center for Zoonotic Diseases in Wildlife and Exotic Animals, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
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Mathematical modelling and phylodynamics for the study of dog rabies dynamics and control: A scoping review. PLoS Negl Trop Dis 2021; 15:e0009449. [PMID: 34043640 PMCID: PMC8189497 DOI: 10.1371/journal.pntd.0009449] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 06/09/2021] [Accepted: 05/05/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Rabies is a fatal yet vaccine-preventable disease. In the last two decades, domestic dog populations have been shown to constitute the predominant reservoir of rabies in developing countries, causing 99% of human rabies cases. Despite substantial control efforts, dog rabies is still widely endemic and is spreading across previously rabies-free areas. Developing a detailed understanding of dog rabies dynamics and the impact of vaccination is essential to optimize existing control strategies and developing new ones. In this scoping review, we aimed at disentangling the respective contributions of mathematical models and phylodynamic approaches to advancing the understanding of rabies dynamics and control in domestic dog populations. We also addressed the methodological limitations of both approaches and the remaining issues related to studying rabies spread and how this could be applied to rabies control. METHODOLOGY/PRINCIPAL FINDINGS We reviewed how mathematical modelling of disease dynamics and phylodynamics have been developed and used to characterize dog rabies dynamics and control. Through a detailed search of the PubMed, Web of Science, and Scopus databases, we identified a total of n = 59 relevant studies using mathematical models (n = 30), phylodynamic inference (n = 22) and interdisciplinary approaches (n = 7). We found that despite often relying on scarce rabies epidemiological data, mathematical models investigated multiple aspects of rabies dynamics and control. These models confirmed the overwhelming efficacy of massive dog vaccination campaigns in all settings and unraveled the role of dog population structure and frequent introductions in dog rabies maintenance. Phylodynamic approaches successfully disentangled the evolutionary and environmental determinants of rabies dispersal and consistently reported support for the role of reintroduction events and human-mediated transportation over long distances in the maintenance of rabies in endemic areas. Potential biases in data collection still need to be properly accounted for in most of these analyses. Finally, interdisciplinary studies were determined to provide the most comprehensive assessments through hypothesis generation and testing. They also represent new avenues, especially concerning the reconstruction of local transmission chains or clusters through data integration. CONCLUSIONS/SIGNIFICANCE Despite advances in rabies knowledge, substantial uncertainty remains regarding the mechanisms of local spread, the role of wildlife in dog rabies maintenance, and the impact of community behavior on the efficacy of control strategies including vaccination of dogs. Future integrative approaches that use phylodynamic analyses and mechanistic models within a single framework could take full advantage of not only viral sequences but also additional epidemiological information as well as dog ecology data to refine our understanding of rabies spread and control. This would represent a significant improvement on past studies and a promising opportunity for canine rabies research in the frame of the One Health concept that aims to achieve better public health outcomes through cross-sector collaboration.
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How geographic access to care shapes disease burden: The current impact of post-exposure prophylaxis and potential for expanded access to prevent human rabies deaths in Madagascar. PLoS Negl Trop Dis 2021; 15:e0008821. [PMID: 33901194 PMCID: PMC8102000 DOI: 10.1371/journal.pntd.0008821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 05/06/2021] [Accepted: 02/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background Post-exposure prophylaxis (PEP) is highly effective at preventing human rabies deaths, however access to PEP is limited in many rabies endemic countries. The 2018 decision by Gavi to add human rabies vaccine to its investment portfolio should expand PEP availability and reduce rabies deaths. We explore how geographic access to PEP impacts the rabies burden in Madagascar and the potential benefits of improved provisioning. Methodology & principal findings We use spatially resolved data on numbers of bite patients seeking PEP across Madagascar and estimates of travel times to the closest clinic providing PEP (N = 31) in a Bayesian regression framework to estimate how geographic access predicts reported bite incidence. We find that travel times strongly predict reported bite incidence across the country. Using resulting estimates in an adapted decision tree, we extrapolate rabies deaths and reporting and find that geographic access to PEP shapes burden sub-nationally. We estimate 960 human rabies deaths annually (95% Prediction Intervals (PI): 790–1120), with PEP averting an additional 800 deaths (95% PI: 640–970) each year. Under these assumptions, we find that expanding PEP to one clinic per district (83 additional clinics) could reduce deaths by 19%, but even with all major primary clinics provisioning PEP (1733 additional clinics), we still expect substantial rabies mortality. Our quantitative estimates are most sensitive to assumptions of underlying rabies exposure incidence, but qualitative patterns of the impacts of travel times and expanded PEP access are robust. Conclusions & significance PEP is effective at preventing rabies deaths, and in the absence of strong surveillance, targeting underserved populations may be the most equitable way to provision PEP. Given the potential for countries to use Gavi funding to expand access to PEP in the coming years, this framework could be used as a first step to guide expansion and improve targeting of interventions in similar endemic settings where PEP access is geographically restricted and baseline data on rabies risk is lacking. While better PEP access should save many lives, improved outreach, surveillance, and dog vaccination will be necessary, and if rolled out with Gavi investment, could catalyze progress towards achieving zero rabies deaths. Canine rabies causes an estimated 60,000 deaths each year across the world, primarily in low- and middle-income countries where people have limited access to both human vaccines (post-exposure prophylaxis or PEP) and dog rabies vaccines. Given that we have the tools to prevent rabies deaths, a global target has been set to eliminate deaths due to canine rabies by 2030, and recently, Gavi, a multilateral organization that aims to improve access to vaccines in the poorest countries, added human rabies vaccine to it’s portfolio. In this study, we estimated reported incidence of patients seeking PEP in relation to travel times to clinics provisioning PEP and extrapolate human rabies deaths in Madagascar. We find that PEP currently averts around 800 deaths each year, but that the burden remains high (1000 deaths/year), particularly in remote, hard-to-reach areas. We show that expanding PEP availability to more clinics could significantly reduce rabies deaths in Madagascar, but our results reaffirm that expansion alone is will not achieve the global goal of zero human deaths from dog-mediated rabies by 2030. Combining PEP expansion with outreach, surveillance, and mass dog vaccination programs will be necessary to move Madagascar, and other Low- and Middle-Income countries, forward on the path to rabies elimination.
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Barrios CL, Bustos-López C, Pavletic C, Parra A, Vidal M, Bowen J, Fatjó J. Epidemiology of Dog Bite Incidents in Chile: Factors Related to the Patterns of Human-Dog Relationship. Animals (Basel) 2021; 11:E96. [PMID: 33419043 PMCID: PMC7825333 DOI: 10.3390/ani11010096] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 01/18/2023] Open
Abstract
Dog bites are one of the main public health problems. They produce important consequences for those who suffer them (physical and psychological injuries, secondary infections, sequelae, risk of transmission of zoonoses and surgeries, among others). The objective of this study was to characterize epidemiologically the incidents of bites in Chile and the patterns of human-dog relationship involved. The records analyzed in this article were obtained from bitten patients who attended the main public health facilities in Chile during the period 17 September 2017 and 17 September 2018: In the period studied, 17,299 animal bites were recorded; however, only 7220 (41.74%) cases were analyzed in which the offending species could be identified. Of the bites analyzed, 6533 were caused by dogs (90.48%). Of these, 41.05% were caused by medium-sized dogs. Most bites were caused by dogs of mixed breeds (55.99%), followed by dogs of the German Shepherd breed (8.50%). Most of the dogs that bit were known to the victim (99.95%) and most of the attacks occurred indoors (57.48%). Although dog bite records have improved in Chile, it would be useful to also include background information on the context in which the incident occurred, which would be very useful for developing effective bite prevention programs.
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Affiliation(s)
- Carmen Luz Barrios
- Cátedra Fundación Affinity Animales y Salud, Universitat Autónoma de Barcelona, Parque de Investigación Biomédica de Barcelona, C/Dr. Aiguader 88, 08003 Barcelona, Spain;
- Escuela de Medicina Veterinaria, Facultad de Ciencias, Universidad Mayor, Camino La Pirámide 5750, Huechuraba, Región Metropolitana 8580745, Chile;
| | - Carlos Bustos-López
- Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad Santo Tomás, Santiago, Chile, Av. Ejército Libertador 146, Santiago, Región Metropolitana 8320000, Chile;
| | - Carlos Pavletic
- Departamento de Zoonosis y Vectores, Ministerio de Salud, Enrique Mac Iver 541, Santiago, Región Metropolitana 8320064, Chile; (C.P.); (A.P.)
| | - Alonso Parra
- Departamento de Zoonosis y Vectores, Ministerio de Salud, Enrique Mac Iver 541, Santiago, Región Metropolitana 8320064, Chile; (C.P.); (A.P.)
| | - Macarena Vidal
- Escuela de Medicina Veterinaria, Facultad de Ciencias, Universidad Mayor, Camino La Pirámide 5750, Huechuraba, Región Metropolitana 8580745, Chile;
| | - Jonathan Bowen
- Queen Mother Hospital for Small Animals, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA, UK;
| | - Jaume Fatjó
- Cátedra Fundación Affinity Animales y Salud, Universitat Autónoma de Barcelona, Parque de Investigación Biomédica de Barcelona, C/Dr. Aiguader 88, 08003 Barcelona, Spain;
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Rocha F. Control of Rabies as a Victim of Its Own Success: Perception of Risk within a Latin American Population. Am J Trop Med Hyg 2020; 103:929-930. [PMID: 32662393 PMCID: PMC7470575 DOI: 10.4269/ajtmh.20-0728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Felipe Rocha
- Pan American Center for Foot-and-Mouth Disease and Veterinary Public Health, Pan American Health Organization/World Health Organization (PANAFTOSA-PAHOWHO)
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10
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Raynor B, Díaz EW, Shinnick J, Zegarra E, Monroy Y, Mena C, Castillo-Neyra R. The impact of the COVID-19 pandemic on rabies reemergence in Latin America: the case of Arequipa, Peru. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.08.06.20169581. [PMID: 32817966 PMCID: PMC7430610 DOI: 10.1101/2020.08.06.20169581] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Over the past decades, there has been tremendous progress towards eliminating canine rabies in Latin America. Major components of rabies prevention programs in Latin America leading to these successes have been constant and intense surveillance for rabid dogs and uninterrupted yearly mass dog vaccination campaigns. However, vital measures to control COVID-19 in Latin America have had the negative trade-off of jeopardizing these rabies elimination and prevention activities. In this paper, we aimed to assess the effect of interrupting canine rabies surveillance and mass dog vaccination campaigns on rabies trends. We built a deterministic compartment model of dog rabies dynamics parameterized for conditions found in Arequipa, Peru, where there is an ongoing dog rabies epidemic. Our model suggests that a decrease in canine vaccination coverage as well as decreased surveillance leading to an increased length of survival of infected dogs could lead to a sharp rise in canine rabies and, subsequently, human rabies risk. We examined our results over the best estimate of the basic reproductive number in Arequipa (R0 = 1.44) and a range of plausible values for R0 (1.36 - 2). The rising trend was consistent. It is very possible that COVID-19 will continue to challenge our public health departments in the short- and medium-term. Innovative strategies to conduct dog vaccination and rabies surveillance during these trying times should be considered to safeguard the achievements made in Latin America towards the elimination of dog-mediated human rabies.
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Affiliation(s)
- Brinkley Raynor
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
| | - Elvis W. Díaz
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Julianna Shinnick
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
| | - Edith Zegarra
- Gerencia Regional de Salud de Arequipa, Ministerio de Salud, Arequipa 04002, Peru
| | - Ynes Monroy
- Gerencia Regional de Salud de Arequipa, Ministerio de Salud, Arequipa 04002, Peru
| | - Claudia Mena
- Red de Salud Arequipa Caylloma, Ministerio de Salud, Arequipa 04001, Peru
| | - Ricardo Castillo-Neyra
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
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Castillo-Neyra R, Buttenheim AM, Brown J, Ferrara JF, Arevalo-Nieto C, Borrini-Mayorí K, Levy MZ, Becerra V, Paz-Soldan VA. Behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in Arequipa, Peru, during a canine rabies epidemic. PLoS Negl Trop Dis 2020; 14:e0008478. [PMID: 32692739 PMCID: PMC7394441 DOI: 10.1371/journal.pntd.0008478] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/31/2020] [Accepted: 06/12/2020] [Indexed: 02/01/2023] Open
Abstract
A canine rabies epidemic started in early 2015 in Arequipa, Peru and the rabies virus continues to circulate in the dog population. Some city residents who suffer dog bites do not seek care or do not complete indicated post-exposure prophylaxis (PEP) regimens, increasing the risk of human rabies. The objectives of our study are to qualitatively assess knowledge about rabies, and preventive practices, such as rabies vaccine administration, following a dog bite. We conduct eight focus group discussions in peri-urban and urban communities with 70 total participants. In our results, we observe low awareness of rabies severity and fatality, and different practices following a dog bite, depending on the community type: for example, whereas participants in the urban communities report cleaning the wound with hydrogen peroxide rather than soap and water, participants in peri-urban areas cover the wound with herbs and hair from the dog that bit them. Misconceptions about rabies vaccines and mistreatment at health centers also commonly prevent initiating or completing PEP. We identify important behavioral and structural barriers and knowledge gaps that limit evidence-based preventive strategies against rabies and may threaten successful prevention of dog-mediated human rabies in this setting. The city of Arequipa, Peru has been experiencing an outbreak of dog rabies since 2015. The Peruvian Ministry of Health has implemented measures to prevent human infection, including no-cost rabies vaccinations for people bitten by dogs, but health posts report that many people do not utilize the service or complete treatment. We conduct focus groups in urban and peri-urban areas of Arequipa to examine community perceptions and attitudes towards PEP, and organizational and behavioral barriers to initiate and complete the PEP regimen. We observe low awareness of rabies severity, and different practices following a dog bite depending on the community type. Misconceptions about rabies vaccines and mistreatment at health centers also commonly prevent participants from initiating or completing PEP. We identify important behavioral and structural barriers and knowledge gaps that limit preventive strategies against rabies and may threaten successful prevention of dog-mediated human rabies in this setting. Finally, disparate landscapes and topography seem to have different effects on urban and peri-urban participants’ use of healthcare resources. Thus, strategies should target the specific needs of each population.
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Affiliation(s)
- Ricardo Castillo-Neyra
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - Alison M. Buttenheim
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States of America
| | - Joanna Brown
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - James F. Ferrara
- School of Veterinary Medicine, University of Pennsylvania, Pennsylvania, United States of America
| | - Claudia Arevalo-Nieto
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Katty Borrini-Mayorí
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Michael Z. Levy
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Victor Becerra
- Microred Mariano Melgar, Ministerio de Salud, Arequipa, Peru
| | - Valerie A. Paz-Soldan
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
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