Abstract
Rabies has been eliminated in some Asian countries including Japan, Singapore, Maldives, and Hong Kong. Sri Lanka is close to joining that group: human rabies cases declined from 288 in 1975 to 23 in 2017, due largely to intradermal post-exposure prophylaxis. The weakest link in rabies elimination in Sri Lanka is inconsistent prevention at the source due in part to insufficient institutional capacity to achieve the goal of 70% dog vaccination coverage.Obstacles to rabies control identified through focus groups and in-depth interviews with stakeholders, government officials, non-government agents, and community residents include insufficient motivation for disease reporting and development of a clear protocol for disease reporting by the public, lack of awareness in some areas of the importance of disease reporting exacerbated by logistical issues, uneven vaccination coverage due to insufficient communication regarding government vaccination campaigns, and incomplete implementation of government policies. Other issues included a need for more responsible dog ownership and better understanding of rabies disease risks amongst dog owners. Dog-associated factors included the need for improved understanding of drivers of variation in dog population size, for lower sterilization cost to owners, and for monitoring of post-surgical complications.An integrated national dog rabies monitoring and reporting system based on effective partnerships among relevant institutions plus additional decentralized dog rabies diagnosis laboratories plus additional local veterinary and medical government staff are needed.
Highlights
IntroductionDifferences exist among countries in implementing dog rabies vaccination campaigns aimed at reaching the World Health Organization (WHO) recommended 70% coverage with coverage being a key indicator of ability to carry out mass dog vaccination [1]
This study identified and assessed important obstacles in overcoming known challenges of rabies control and will help to develop effective strategies that can support the country on its way to elimination, if supported by a legal framework
Differences exist among countries in implementing dog rabies vaccination campaigns aimed at reaching the World Health Organization (WHO) recommended 70% coverage with coverage being a key indicator of ability to carry out mass dog vaccination [1]
Summary
Differences exist among countries in implementing dog rabies vaccination campaigns aimed at reaching the World Health Organization (WHO) recommended 70% coverage with coverage being a key indicator of ability to carry out mass dog vaccination [1]. Local socio-cultural context influences perceptions of rabies and dog-keeping practices, e.g., responsible dog ownership, dog population management, and vaccination. Poor community participation in local rabies control programs together with technical, intersectoral, organizational, and monetary obstacles slow progress toward preventing human rabies through control of the disease in its dog populations [5] even though elimination of dogmediated human rabies is technically feasible through a combination of dog vaccination and post-exposure prophylaxis for humans [6,7]. Requirements for successful elimination of dog-mediated rabies include prevention by vaccination of dogs, education of the public, cost-effective and high-quality human rabies vaccines, sufficient local capacity for rabies diagnosis, effective disease reporting and surveillance, and responsible dog ownership [5]
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