Low coverage of central point vaccination against dog rabies in Bamako, Mali

Muthiani, Yvonne; Traoré, Abdallah; Mauti, Stephanie; Zinsstag, Jakob; Hattendorf, Jan

doi:10.1016/j.prevetmed.2015.04.007

Cited by 66 publications

(60 citation statements)

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“…Various theories have been developed to guide assessments of effectiveness of rabies vaccination campaigns [10,52,53]; an important component of this work is examining the perspectives of dog owners and community members, both qualitatively and quantitatively [53]. This article analyzes unique focus group data, and is the first from our ongoing multi-method studies of factors associated with coverage of and participation in mass canine rabies vaccination campaigns.…”

Section: Discussionmentioning

confidence: 99%

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Barriers to dog rabies vaccination during an urban rabies outbreak: Qualitative findings from Arequipa, Peru

et al. 2017

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BackgroundCanine rabies was reintroduced to the city of Arequipa, Peru in March 2015. The Ministry of Health has conducted a series of mass dog vaccination campaigns to contain the outbreak, but canine rabies virus transmission continues in Arequipa’s complex urban environment, putting the city’s 1 million inhabitants at risk of infection. The proximate driver of canine rabies in Arequipa is low dog vaccination coverage. Our objectives were to qualitatively assess barriers to and facilitators of rabies vaccination during mass campaigns, and to explore strategies to increase participation in future efforts.Methodology/Principal findingsWe conducted 8 focus groups (FG) in urban and peri-urban communities of Mariano Melgar district; each FG included both sexes, and campaign participants and non-participants. All FG were transcribed and then coded independently by two coders. Results were summarized using the Social Ecological Model. At the individual level, participants described not knowing enough about rabies and vaccination campaigns, mistrusting the campaign, and being unable to handle their dogs, particularly in peri-urban vs. urban areas. At the interpersonal level, we detected some social pressure to vaccinate dogs, as well as some disparaging of those who invest time and money in pet dogs. At the organizational level, participants found the campaign information to be insufficient and ill-timed, and campaign locations and personnel inadequate. At the community level, the influence of landscape and topography on accessibility to vaccination points was reported differently between participants from the urban and peri-urban areas. Poor security and impermanent housing materials in the peri-urban areas also drives higher prevalence of guard dog ownership for home protection; these dogs usually roam freely on the streets and are more difficult to handle and bring to the vaccination points.ConclusionsA well-designed communication campaign could improve knowledge about canine rabies. Timely messages on where and when vaccination is occurring could increase dog owners’ perception of their own ability to bring their dogs to the vaccination points and be part of the campaign. Small changes in the implementation of the campaign at the vaccination points could increase the public’s trust and motivation. Location of vaccination points should take into account landscape and community concerns.

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Section: Discussionmentioning

confidence: 99%

“…At the individual level, the ability to restrain and handle dogs [10–15]; lack of time to attend vaccination campaigns [12,13,15]; lack of information [10,13–15]; and level of knowledge of rabies [14,16–20] have been shown to influence vaccination uptake. At the interpersonal level, social norms (i.e.…”

Section: Introductionmentioning

confidence: 99%

Barriers to dog rabies vaccination during an urban rabies outbreak: Qualitative findings from Arequipa, Peru

et al. 2017

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“…Transects could be used to identify areas in need of improved vaccination, where delivery was poor (for example in Figure 4). More generally, transects have proven to be effective in measuring the immediate success of vaccination campaigns in settings in both Asia and Africa (12–14, 29, 33). One concern is that transect routes are not pre-defined, which could result in recounting of dogs.…”

Section: Discussionmentioning

confidence: 99%

“…Several methods have been used to estimate coverage including (i) the use of pre-campaign estimates of dog population size through human to dog ratios (HDRs) as the denominator, and the number of dogs vaccinated during the campaign as the numerator (6); (ii) post-vaccination household surveys to estimate the proportion of vaccinated dogs (7–11); and (iii) post-vaccination transects to estimate the proportion of marked (vaccinated) dogs (4, 12–14). However, these methods all have limitations.…”

Section: Introductionmentioning

confidence: 99%

Comparing Methods of Assessing Dog Rabies Vaccination Coverage in Rural and Urban Communities in Tanzania

et al. 2017

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Rabies can be eliminated by achieving comprehensive coverage of 70% of domestic dogs during annual mass vaccination campaigns. Estimates of vaccination coverage are, therefore, required to evaluate and manage mass dog vaccination programs; however, there is no specific guidance for the most accurate and efficient methods for estimating coverage in different settings. Here, we compare post-vaccination transects, school-based surveys, and household surveys across 28 districts in southeast Tanzania and Pemba island covering rural, urban, coastal and inland settings, and a range of different livelihoods and religious backgrounds. These approaches were explored in detail in a single district in northwest Tanzania (Serengeti), where their performance was compared with a complete dog population census that also recorded dog vaccination status. Post-vaccination transects involved counting marked (vaccinated) and unmarked (unvaccinated) dogs immediately after campaigns in 2,155 villages (24,721 dogs counted). School-based surveys were administered to 8,587 primary school pupils each representing a unique household, in 119 randomly selected schools approximately 2 months after campaigns. Household surveys were conducted in 160 randomly selected villages (4,488 households) in July/August 2011. Costs to implement these coverage assessments were $12.01, $66.12, and $155.70 per village for post-vaccination transects, school-based, and household surveys, respectively. Simulations were performed to assess the effect of sampling on the precision of coverage estimation. The sampling effort required to obtain reasonably precise estimates of coverage from household surveys is generally very high and probably prohibitively expensive for routine monitoring across large areas, particularly in communities with high human to dog ratios. School-based surveys partially overcame sampling constraints, however, were also costly to obtain reasonably precise estimates of coverage. Post-vaccination transects provided precise and timely estimates of community-level coverage that could be used to troubleshoot the performance of campaigns across large areas. However, transects typically overestimated coverage by around 10%, which therefore needs consideration when evaluating the impacts of campaigns. We discuss the advantages and disadvantages of these different methods and make recommendations for how vaccination campaigns can be better monitored and managed at different stages of rabies control and elimination programs.

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“…To successfully eliminate rabies, vaccination must reach at least 70% of a dog population over consecutive years, yet, despite the feasibility of elimination, programs in Africa struggle with reaching high levels of coverage (16); vaccination rates lower than 30% are considered a “waste of resources” (5). Despite good quality vaccines for dogs, a genuine science of rabies elimination is needed (17) to understand complex social–ecological determinants of vaccination effectiveness (18).…”

Section: Introductionmentioning

confidence: 99%

Rabies Control: Could Innovative Financing Break the Deadlock?

2017

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The neglected zoonotic diseases (NZDs) have been all but eradicated in wealthier countries but remain major causes of ill-health and mortality in over 80 countries across Africa, Asia, and Latin America. The nature of neglect for the NZDs has been ascribed, in part, to underreporting resulting in an underestimation of their global burden that, together with a lack of advocacy, downgrades their relevance to policy-makers and funding agencies. While this may be the case for many NZDs, for rabies this is not the case. The global burden estimates for rabies (931,600 DALYs) more than justify prioritizing rabies control building on the strong advocacy platforms, functioning at local, regional, and global levels (including the Global Alliance for Rabies Control), and commitments from WHO, OIE, and FAO. Simple effective tools for rabies control exist together with blueprints for operationalizing control, yet, despite elimination targets being set, no global affirmative action has been taken. Rabies control demands activities both in the short term and over a long period of time to achieve the desired cumulative gains. Despite the availability of effective vaccines and messaging tools, rabies will not be sustainably controlled in the near future without long-term financial commitment, particularly as disease incidence decreases and other health priorities take hold. While rabies control is usually perceived as a public good, public private partnerships could prove equally effective in addressing endemic rabies through harnessing social investment and demonstrating the cost-effectiveness of control. It is acknowledged that greater attention to navigating local realities in planning and implementation is essential to ensuring that rabies, and other neglected diseases, are controlled sustainably. In the shadows of resource and institutional limitations in the veterinary sector in low- and middle-income countries, sufficient funding is required so that top-down interventions for rabies can more explicitly engage with local project organization capacity and affected communities in the long term. Development Impact Bonds have the potential to secure the financing required to deliver effective rabies control.

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Low coverage of central point vaccination against dog rabies in Bamako, Mali

Cited by 66 publications

References 15 publications

Barriers to dog rabies vaccination during an urban rabies outbreak: Qualitative findings from Arequipa, Peru

Barriers to dog rabies vaccination during an urban rabies outbreak: Qualitative findings from Arequipa, Peru

Comparing Methods of Assessing Dog Rabies Vaccination Coverage in Rural and Urban Communities in Tanzania

Rabies Control: Could Innovative Financing Break the Deadlock?

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