A research agenda to reinforce rabies control: A qualitative and quantitative prioritization

Abstract

BackgroundDespite the existence of safe and effective vaccines, rabies disease still causes an estimated 59,000 human deaths a year in the endemic areas in Asia and Africa. These numbers reflect severe drawbacks regarding the implementation of PrEP and PEP in endemic settings, such as lack of political will and low priority given to rabies. Since these contextual factors have proven to be persistent, there is an urgency to improve current strategies or develop novel approaches in order to control rabies disease in the future.Methods/FindingsThis study aimed to identify and systematically prioritize the research needs, through interviews and questionnaires with key-opinion-leaders (KOLs). A total of 46 research needs were identified and prioritized. The top research needs are considered very high priority based on both importance for rabies control and need for improvement. KOLs agree that animal rabies control remains most important for rabies control, while research on human host, agent (rabies virus) and the environment should be prioritized in terms of need for improvement. A wide variety in perceptions is observed between and within the disciplines of virology, public health and veterinary health and between KOLs with more versus those with less experience in the field.Conclusion/SignificanceThe results of this study give well-defined, prioritized issues that stress the drawbacks that are experienced by KOLs in daily practice. The most important research domains are: 1) cheap and scalable production system for RIG 2) efficacy of dog mass vaccination programs and 3) cheap human vaccines. Addressing these research needs should exist next to and may reinforce current awareness and mass vaccination campaigns. The differences in perspectives between actors revealed in this study are informative for effective execution of the One Health research agenda.

Development of an efficient veterinary rabies vaccine production process in the avian suspension cell line AGE1.CR.pIX

“…Dog vaccination coverage should be maintained continuously above the threshold of 70% over years to achieve the interruption of canine rabies transmission to humans. This challenge is beyond the capacity of most developing countries mainly due to the lack of resources [5,10,26]. A robust and transportable production process may improve local production of rabies vaccines, which in turn may facilitate access to a vaccine and enhance its availability.…”

“…Such inadvertent changes to the ecology of reservoir and vector may thus further complicate control of the virus [8,9]. However, the vaccination rate of dogs in many developing countries remains far below the threshold of 70%, which is the WHO recommended vaccination coverage rate to break the cycle of virus transmission to humans [3,10]. Limited resources and economic constraints in developing countries are among the main hurdles that impede canine rabies control [11].…”

Development of an efficient veterinary rabies vaccine production process in the avian suspension cell line AGE1.CR.pIX

“…However, the vaccination rate of dogs in many developing countries remains far below the threshold of 70%, which is the WHO recommended vaccination coverage rate to break the cycle of virus transmission to humans [ 3 , 10 ]. Limited resources and economic constraints in developing countries are among the main hurdles that impede canine rabies control [ 11 ].…”

A cointegration analysis of rabies cases and weather components in Davao City, Philippines from 2006 to 2017

“…According to Tohma and colleagues [9], control interventions are complicated by dog migration between neighboring islands and by the difficulty of achieving the minimum required 70% vaccination coverage. Furthermore, rabies is considered as one of the lowest priority diseases by the local health authorities [10], i.e., a neglected tropical disease.…”