Towards the elimination of dog-mediated rabies: development and application of an evidence-based management tool
| Autor: | Jesus F. Gonzalez Roldan, Silene Manrique Rocha, Victor J. Del Rio Vilas, André Peres Barbosa de Castro, Rebecca Mancy, Lúcia R. Montebello, Kristyna Rysava, Marco Antonio Natal Vigilato, Eduardo Pacheco de Caldas, Katie Hampson, Daniel T. Haydon, Veronica Gutierrez, Paul C. D. Johnson, Mary Freire de Carvalho, Tamara Mancero |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Management recommendations Decision support tool Vaccination Coverage Rabies Program management 030231 tropical medicine medicine.disease_cause Mass Vaccination lcsh:Infectious and parasitic diseases 03 medical and health sciences Dogs 0302 clinical medicine medicine Interruption of transmission Animals Humans lcsh:RC109-216 Dog Diseases Scientific guidance Disease Eradication Mexico Environmental planning Retrospective Studies Infection Control Surveillance Case detection Freedom from disease Rabies virus Evidence-based management Genomics medicine.disease Mass dog vaccination Latin America 030104 developmental biology Infectious Diseases Geography Vaccination coverage Simulated data Rabies control Canine rabies Algorithms Brazil Research Article |
| Zdroj: | BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-14 (2020) BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/s12879-020-05457-x |
| Popis: | Background International organizations advocate for the elimination of dog-mediated rabies, but there is only limited guidance on interpreting surveillance data for managing elimination programmes. With the regional programme in Latin America approaching elimination of dog-mediated rabies, we aimed to develop a tool to evaluate the programme’s performance and generate locally-tailored rabies control programme management guidance to overcome remaining obstacles. Methods We developed and validated a robust algorithm to classify progress towards rabies elimination within sub-national administrative units, which we applied to surveillance data from Brazil and Mexico. The method combines criteria that are easy to understand, including logistic regression analysis of case detection time series, assessment of rabies virus variants, and of incursion risk. Subjecting the algorithm to robustness testing, we further employed simulated data sub-sampled at differing levels of case detection to assess the algorithm’s performance and sensitivity to surveillance quality. Results Our tool demonstrated clear epidemiological transitions in Mexico and Brazil: most states progressed rapidly towards elimination, but a few regressed due to incursions and control lapses. In 2015, dog-mediated rabies continued to circulate in the poorest states, with foci remaining in only 1 of 32 states in Mexico, and 2 of 27 in Brazil, posing incursion risks to the wider region. The classification tool was robust in determining epidemiological status irrespective of most levels of surveillance quality. In endemic settings, surveillance would need to detect less than 2.5% of all circulating cases to result in misclassification, whereas in settings where incursions become the main source of cases the threshold detection level for correct classification should not be less than 5%. Conclusion Our tool provides guidance on how to progress effectively towards elimination targets and tailor strategies to local epidemiological situations, while revealing insights into rabies dynamics. Post-campaign assessments of dog vaccination coverage in endemic states, and enhanced surveillance to verify and maintain freedom in states threatened by incursions were identified as priorities to catalyze progress towards elimination. Our finding suggests genomic surveillance should become increasingly valuable during the endgame for discriminating circulating variants and pinpointing sources of incursions. |
| Databáze: | OpenAIRE |
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