Prevention of Canine Rabies in Rural Mexico: an Epidemiologic Study of Vaccination Campaigns

Db, Fishbein; Mg, Frontini; Jg, Dobbins; E, Flores Collins; G, Quiroz Huerta; Jj, Gamez Rodriguez; Wooming, Brian; J, Garza Ramos; Aj, Belotto; Jm, Balderas Torres

doi:10.4269/ajtmh.1992.47.317

Cited by 26 publications

(16 citation statements)

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“…Our study discovered that around half (48%) of patients are unsure and only as many as a third (33%) of patients with chronic wounds are up‐to‐date with their vaccination. This is in keeping with other studies that have estimated that when questioned 57% of patients will not correctly know their tetanus status (22). The recent findings have showed that although covered on paper their immunity may be lacking through a decline in postvaccination antibody concentration (23), which has been found to be particularly true in the elderly (>65) and female patients (20,23).…”

Section: Discussionsupporting

confidence: 86%

Tetanus in patients with chronic wounds – are we aware?

Farnworth

Roberts

Rangaraj

et al. 2011

International Wound Journal

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The incidence of tetanus in patients with wounds is unknown; however, recently concern has been raised over the proportion of tetanus cases in which a chronic wound is the portal of entry for Clostridium tetani. Varicose ulcers, dermatosis and necrosed tumours are estimated to be the point of entry for C. tetani spores in 11-14% of three cases. Of diabetic patients in the USA who contracted tetanus, a diabetic foot ulcer was responsible in 25% of cases despite this chronic wounds have yet to be considered as a risk factor for tetanus. An audit was undertaken and a survey devised to form the basis of the data collection to assess if patients with chronic wounds are up-to-date in accordance with the tetanus immunisation programme. Over a 5-day period, the data were prospectively collected and the tetanus status of a 100 patients retrospectively analysed. The status was then compared with general practitioner (GP) records via telephone follow-up. One hundred patients (n = 100) were available in the audit period, with the majority being male (n = 51). The age range was 22-91 years old (median 70 years). Nearly half of the samples (n = 48) were diabetic, with the majority of patients (n = 35) having venous leg ulcers. Only 15% had a biopsy of their wound. The duration of wounds varied from 1 to 480 months. Patients were asked to confirm their tetanus status. Almost half of the patients were unsure of their tetanus status 48% (n = 48), almost a third 30% (n = 30) thought they were not covered and 22% (n = 22) thought they were up-to-date. After confirming with the GP records, the results were as follows: almost half of the patients, 43% (n = 43) were not covered, 33% (n = 33) were up-to-date, 13% had no immunisation records available at the GPs, 10% had no GP contact details and 1% no contact was possible. Currently, tetanus prophylaxis is given based on the vaccination history of the patient but as identified that this can prove to be unreliable. With the burden of chronic wound and ageing population set to increase, levels of protection amplify the risk of tetanus faced by those suffering from chronic wounds. Strict caution should be taken in those patients who were born before the national childhood vaccination programme, implemented in 1961. Moreover, every effort should be made to ensure that such individuals complete their primary course. By ensuring each patient is actively immunised, protection against tetanus, a potential killer, is provided.

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Section: Discussionsupporting

confidence: 86%

Tetanus in patients with chronic wounds – are we aware?

Farnworth

Roberts

Rangaraj

et al. 2011

International Wound Journal

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“…Previous studies in the Philippines have reported household dog ownership ranging from 40% to 69% (Robinson et al, 1996;Estrada et al, 2001). However, the mean number of dogs owned in Bohol (approximately 1.6) is similar to that of the United States (1.7; AVMA, 2007) and lower than that found in many other developing countries (Beran, 1982;Fishbein et al, 1992;Robinson et al, 1996;Kitala et al, 2001;Awoyomi et al, 2007;Knobel et al, 2008).…”

Section: Discussionmentioning

confidence: 60%

Factors Associated with Dog Rabies Vaccination in Bhol, Philippines: Results of a Cross‐Sectional Cluster Survey Conducted Following the Island‐Wide Rabies Elimination Campaign

Davlin

Lapiz

Miranda

et al. 2012

Zoonoses and Public Health

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Summary The Philippines has a long history of rabies control efforts in their dog populations; however, long-term success of such programmes and the goal of rabies elimination have not yet been realized. The Bohol Rabies Prevention and Elimination Program was developed as an innovative approach to canine rabies control in 2007. The objective of this study was to assess canine rabies vaccination coverage in the owned-dog population in Bohol and to describe factors associated with rabies vaccination two years after implementation of the programme. We utilized a cross-sectional cluster survey based on the World Health Organization’s Expanded Programme on Immunization coverage survey technique. We sampled 460 households and collected data on 539 dogs residing within these households. Seventy-seven percent of surveyed households reported owning at least one dog. The human to dog ratio was approximately 4 : 1, and the mean number of dogs owned per household was 1.6. Based on this ratio, we calculated an owned-dog population of almost 300 000. Overall, 71% of dogs were reported as having been vaccinated for rabies at some time in their lives; however, only 64% of dogs were reported as having been recently vaccinated. Dogs in our study were young (median age = 24 months). The odds of vaccination increased with increasing age. Dogs aged 12 – 23 months had 4.6 times the odds of vaccination compared to dogs aged 3 – 11 months (95% CI 1.8 – 12.0; P = 0.002). Confinement of the dog both day and night was also associated with increased odds of vaccination (OR = 2.1; 95% CI 0.9 – 4.9; P = 0.07), and this result approached statistical significance. While the programme is on track to meet its goal of 80% vaccination coverage, educational efforts should focus on the need to confine dogs and vaccinate young dogs.

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“…Central point vaccination campaigns have been successful in sub-Saharan Africa and Latin America (6,29,30). Our scenario analyses indicated that, if owners are willing to bring their dogs to the campaign team, a higher annual target for canine vaccination becomes optimal.…”

Section: Discussionmentioning

confidence: 99%

“…Mass canine vaccination campaigns in a number of settings require dogs to be brought by their owners to the vaccination teams, avoiding the costs of dog capture (29)(30)(31). If less time is spent catching dogs, campaign teams would be able to vaccinate more dogs each day, and annual targets could potentially be reached with less expense.…”

Section: Resultsmentioning

confidence: 99%

One Health approach to cost-effective rabies control in India

Fitzpatrick

Shah

Pandey

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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Over 20,000 rabies deaths occur annually in India, representing one-third of global human rabies. The Indian state of Tamil Nadu has pioneered a "One Health" committee to address the challenge of rabies in dogs and humans. Currently, rabies control in Tamil Nadu involves postexposure vaccination of humans after dog bites, whereas potential supplemental approaches include canine vaccination and sterilization. We developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu. Integrating local estimates for canine demography and costs, we predicted the impact of canine vaccination and sterilization on human health outcomes and evaluated cost-effectiveness according to the WHO criteria for India, which correspond to thresholds of $1,582 and $4,746 per disability-adjusted life-years (DALYs) for very cost-effective and cost-effective strategies, respectively. We found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 y, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Through integration over parameter uncertainty, we find that, for a cost-effectiveness threshold above $1,400 per DALY, canine interventions are at least 95% likely to be optimal. If owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective. This case study of cost-effective canine interventions in Tamil Nadu may have applicability to other settings in India and beyond. mathematical modeling | cost-effectiveness | rabies | sterilization | vaccination

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Prevention of Canine Rabies in Rural Mexico: an Epidemiologic Study of Vaccination Campaigns

Cited by 26 publications

References 0 publications

Tetanus in patients with chronic wounds – are we aware?

Tetanus in patients with chronic wounds – are we aware?

Factors Associated with Dog Rabies Vaccination in Bhol, Philippines: Results of a Cross‐Sectional Cluster Survey Conducted Following the Island‐Wide Rabies Elimination Campaign

One Health approach to cost-effective rabies control in India

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