Challenges to improved animal rabies surveillance: Experiences from pilot implementation of decentralized diagnostic units in Chad

Naïssengar, Kemdongarti; Oussiguéré, Assandi; Madaye, Enos; Mbaipago, Nodjimbadem; Mindekem, Rolande; Moyengar, Ronelngar; Madjadinan, Alladoumngar; Ngandolo, Richard; Zinsstag, Jakob; Léchenne, Monique

doi:10.1016/j.actatropica.2021.105984

Cited by 14 publications

(19 citation statements)

References 40 publications

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“…To the best of our knowledge, this is the first report comparing the performance of LFD using a simplified sampling method with that of dFAT performed on samples obtained after opening the skull. Several studies performed LFD and dFAT on samples collected by simplified sampling and showed high performance of LFD [ 7 , 12 , 14 , 17 ]. DRIT was also evaluated, and it showed high performance when used for analyzing samples collected by a straw or opening the skull [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, if combined with rapid diagnostic tests, which require minimal equipment, rabies diagnostic tests can be performed in the field or frontline laboratories in remote areas where there are no laboratories equipped with autopsy rooms or microscopes. Direct rapid immunohistochemical tests (DRITs) do not require fluorescent microscopes and have been proven to increase diagnostic capacity in decentralized laboratories [ 5 – 7 ]. Lateral flow devices (LFDs) are quick and easy in comparison with dFAT and DRIT and can be used in areas where neither fluorescent microscopy nor light microscopy is available or practical.…”

Section: Real-world Challengementioning

confidence: 99%

“…To the best of our knowledge, no studies have compared the diagnostic accuracy of LFD using the simplified sampling method with dFAT using samples collected after the skull has been opened. For comparison of the diagnostic accuracy of rapid diagnostics tests and dFAT, most studies have used samples collected by the simplified sampling method for both types of diagnostic test [ 7 , 12 , 14 , 17 ]. Mauti and colleagues described the detailed methodology for simplified sampling and LFD [ 12 ].…”

Section: Real-world Challengementioning

confidence: 99%

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Lateral flow devices for samples collected by straw sampling method for postmortem canine rabies diagnosis

Mananggit¹,

Manalo

Saito

et al. 2021

PLoS Negl Trop Dis

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The direct fluorescent antibody test (dFAT) using brain sample after opening the skull is the standard rabies diagnostic test in animal rabies. However, it is not feasible in many resource-limited settings. Lateral flow devices (LFD) combined with a simple sampling methodology is quicker, simpler, and less hazardous than the standard test and can be a useful tool. We conducted a prospective on-site study to evaluate the diagnostic accuracy of the LFD with the straw sampling method compared with that of the dFAT with the skull opening procedure for post-mortem canine rabies diagnosis. We collected 97 rabies-suspected animals between December 1, 2020 and March 31, 2021. Among the 97 samples, 53 and 50 cases were positive tests for dFAT and LFD, respectively. The sensitivity and specificity of LFD with straw sampling method were 94.3% (95% confidence interval [CI], 84.3–98.8%) and 100% (95% CI, 92.0–100%), respectively. The performance of LFD by the straw sampling method showed relatively high sensitivity and 100% specificity compared with that of dFAT performed on samples collected after opening the skull. This methodology can be beneficial and is a strong tool to overcome limited animal surveillance in remote areas. However, because of our limited sample size, more data using fresh samples on-site and the optimizations are urgently needed for the further implementation in endemic areas.

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Section: Discussionmentioning

confidence: 99%

Section: Real-world Challengementioning

confidence: 99%

Section: Real-world Challengementioning

confidence: 99%

See 1 more Smart Citation

Lateral flow devices for samples collected by straw sampling method for postmortem canine rabies diagnosis

Mananggit¹,

Manalo

Saito

et al. 2021

PLoS Negl Trop Dis

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“…From 2016 to 2018, a project to estimate the burden of rabies and PEP demand in West and Central Africa was conducted with financial support from GAVI ( 20 ). In Chad, this funding has enabled the extension of canine rabies surveillance to four administrative provinces through establishment of decentralized diagnostic units ( 21 ), collection of data on bite exposure on household level and access to PEP on health facility level ( 18 ). The results of the household survey showed that the incidence of dog bites ranged from 2.1 to 9.5 per 1,000 people per year depending on the region, and almost half of the bite victims were under 15 years of age ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

“…The findings from the various quantitative studies of the GAVI project allowed us to assess rabies risk and the need for PEP on the national level and to identify a lack of access to appropriate health and veterinary facilities with well-trained health and veterinary workers ( 18 , 21 , 23 ). However, the purely quantitative data did not allow us a deeper understanding of the mechanism of PEP access and implementation of joint case management by human and veterinary health services.…”

Section: Introductionmentioning

confidence: 99%

“When a dog bites someone”: Community and service provider dynamics influencing access to integrated bite case management in Chad

et al. 2022

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This study aims to identify factors on the community, the human health and the animal health provider level that determine access to Post Exposure Prophylaxis (PEP) and animal rabies diagnosis in the light of a future integrated bite case management (IBCM) approach for rabies control in Chad. The study was embedded in an overall project conducted from 2016 to 2018, to determine rabies burden and vaccine demand in West and Central Africa. Data collection took place during the projects closing workshops with stakeholders organized between August and September 2018 in the three study zones in Chad covering Logone Occidental and Ouaddaï province and parts of Hadjer Lamis and Chari Baguirmi province. A qualitative approach based on focus group discussion and in-depth interviews was used to get insights on access to care and animal investigation after suspected rabies exposure. A total of 96 participants, including 39 from the community (bite victims, dog owners) and 57 human and animal health providers (health center managers, chief veterinary officers, chief district medical officers, chiefs of livestock sectors) contributed to the study. Based on an existing conceptual framework of access to health care, several points of dissatisfaction were identified, in particular the unaffordability of human rabies vaccine for PEP (affordability) and the distance to travel to a health facility in case of a bite (accessibility). In addition, there are unfavorable attitudes observed highlighted by the importance given to traditional or local rabies care practices to the detriment of PEP (acceptability) and a low level of knowledge among Chadian communities regarding bite prevention, coupled with a very inadequate information and awareness system regarding the disease (adequacy). As for human and veterinary health services, both sectors suffer from insufficient resources for PEP on the human health and rabies diagnosis on the veterinary side impacting negatively on availability and accessibility of both these services. Action to improving provision of rabies health services and increasing knowledge about risk and prevention of the disease among the population need to be undertaken to implement IBCM, improve access to PEP and achieve the goal of eliminating dog mediated human rabies by 2030 in Chad.

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Short communication on the use of a free rabies hotline service in Chad

Mbaipago¹,

Mindekem²,

Madjiadinan³

et al. 2020

Acta Tropica

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Challenges to improved animal rabies surveillance: Experiences from pilot implementation of decentralized diagnostic units in Chad

Cited by 14 publications

References 40 publications

Lateral flow devices for samples collected by straw sampling method for postmortem canine rabies diagnosis

Lateral flow devices for samples collected by straw sampling method for postmortem canine rabies diagnosis

“When a dog bites someone”: Community and service provider dynamics influencing access to integrated bite case management in Chad

Short communication on the use of a free rabies hotline service in Chad

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