Abstract
To control and prevent rabies in Latin America, mass dog vaccination campaigns (MDVC) are implemented mainly through fixed-location vaccination points: owners have to bring their dogs to the vaccination points where they receive the vaccination free of charge. Dog rabies is still endemic in some Latin-American countries and high overall dog vaccination coverage and even distribution of vaccinated dogs are desired attributes of MDVC to halt rabies virus transmission. In Arequipa, Peru, we conducted a door-to-door post-campaign survey on >6,000 houses to assess the placement of vaccination points on these two attributes. We found that the odds of participating in the campaign decreased by 16% for every 100 m from the owner’s house to the nearest vaccination point (p = 0.041) after controlling for potential covariates. We found social determinants associated with participating in the MDVC: for each child under 5 in the household, the odds of participating in the MDVC decreased by 13% (p = 0.032), and for each decade less lived in the area, the odds of participating in the MDVC decreased by 8% (p<0.001), after controlling for distance and other covariates. We also found significant spatial clustering of unvaccinated dogs over 500 m from the vaccination points, which created pockets of unvaccinated dogs that may sustain rabies virus transmission. Understanding the barriers to dog owners’ participation in community-based dog-vaccination programs will be crucial to implementing effective zoonotic disease preventive activities. Spatial and social elements of urbanization play an important role in coverage of MDVC and should be considered during their planning and evaluation.
Highlights
The city of Arequipa is in the midst of a sustained dog rabies outbreak
Author summary In Peru and other dog rabies-affected countries, mass dog vaccination campaigns (MDVC) are implemented primarily through fixed-location vaccination points: owners have to bring their dogs to the vaccination points where they receive the vaccination
When comparing dog owners with similar characteristics, we found that the odds of participating in the MDVC was reduced by 16% for every 100 m distance from the nearest vaccination point
Summary
The city of Arequipa is in the midst of a sustained dog rabies outbreak. The introduction of rabies virus into the city has been ascribed to the unintentional transport of rabid dogs from the rabies-endemic state of Puno during human migration [1,2,3], and the persistence of transmission is likely due to low coverage in the annual city-wide dog vaccination campaigns [3]. Following the detection of the outbreak in Arequipa city in 2015, the Ministry of Health of Peru (MOH) initiated additional vaccination campaigns in the city with varying intensity [4] These additional efforts have not quelled the epidemic: more than 160 rabid dogs have been detected as of 2019. In most rabies-affected countries, government health entities (e.g. MOH) organize annual mass dog vaccination campaigns (MDVC) that are held in outdoor settings. These campaigns are usually free of charge and voluntary [8,16] and campaign promotion varies greatly in format, content and intensity [1,17,18]
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