Abstract
The elimination of canine rabies through the implementation of high coverage mass dog vaccination campaigns is a complex task, particularly in the resource-limited countries of the rabies endemic world. Here we demonstrated the feasibility of applying targeted rabies vaccination campaigns to deliver more impactful intervention campaigns in resource-limited settings using evidence and lessons learnt from other diseases. With the use of strategic rabies intervention programs, we demonstrate the noteworthy reduction of rabies cases in two very different African settings. The strategic intervention was most significantly aided by the use of a custom-developed vaccination tracking device (the Global Alliance for Rabies Control (GARC) Data Logger) and an integrated rabies surveillance system (the Rabies Epidemiological Bulletin). Our first case study, an island-wide strategic dog vaccination on Tanzania’s Unguja island, reduced the incidence of rabies by 71% in the first 16 months of implementation. In the second case study, a similar approach was applied in the metropolitan capital city of Zimbabwe and the incidence of rabies declined by 13% during the first 13 months of implementation. The methodologies and results presented here suggest that, in resource-limited settings, an optimal approach towards the elimination of dog rabies would revolve around strategic interventions, subject to the use of appropriate planning, surveillance, and vaccination tools.
Highlights
Rabies is one of the oldest known zoonotic diseases [1]
Despite the identification of rabies as a priority disease in many African countries [57,58], a distinct lack of successful rabies elimination programmes from here suggests that African countries are not getting the government funding and support required to implement mass dog vaccination (MDV) campaigns of the scale and intensity needed to reach an adequate proportion of the total dog population [15]
Lessons learned from other diseases that have either been eliminated or successfully controlled, include the validation of strategic interventions as a viable approach to rabies elimination in resource-limited countries
Summary
Rabies is one of the oldest known zoonotic diseases [1]. Despite the fact that the first vaccine for Rabies lyssavirus (RABV)—the type species for the Lyssavirus genus—was developed as far back as the. The control and elimination of dog-mediated human rabies through the vaccination of dogs has been demonstrated in countries and regions with different social and political conditions across the world [3,5,6,7] In these successful interventions, it has been shown that the vaccination of 70% of the total dog population is sufficient to interrupt disease transmission to the extent that elimination can be achieved [3]. When considering strategies that have been implemented successfully for other diseases, one key element was paramount in all the cases that we have investigated This commonality was a strategic intervention approach that relied on prioritized targeting of the at-risk population as opposed to the total population. Malaria is briefly discussed below to highlight the effectiveness of the strategic approach and use this information to make a clear case for its use in rabies elimination
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