Surveillance to Establish Elimination of Transmission and Freedom from Dog-mediated Rabies
| Autor: | Lúcia R. Montebello P Dourado, J. F. Gonzalez Roldan, Ahmed Lugelo, Daniel T. Haydon, S. Tamara M. Bucheli, Victor J. Del Rio Vilas, Kristyna Rysava, Kennedy Lushasi, Anthony R. Fooks, Bernadette Abela-Ridder, Denise A. Marston, Marco Antonio Natal Vigilato, Eduardo Pacheco de Caldas, Katie Hampson, Malavika Rajeev, Veronica Gutierrez, Mary Freire de Carvalho, Lwitiko Sikana, Silene Manrique Rocha, Sarah Cleaveland, Karen Hotopp, Rebecca Mancy, Joel Changalucha, Maganga Sambo, Jonathan Dushoff, Kirstyn Brunker, Zac Mtema |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
0303 health sciences
medicine.medical_specialty education.field_of_study biology Transmission (medicine) business.industry Public health 030231 tropical medicine Population biology.organism_classification medicine.disease Triage 3. Good health 03 medical and health sciences 0302 clinical medicine Tanzania Epidemiology medicine Rabies Medical emergency business education Contact tracing 030304 developmental biology |
| DOI: | 10.1101/096883 |
| Popis: | BackgroundWith a global target set for zero human deaths from dog-mediated rabies by 2030 and some regional programmes close to eliminating canine rabies, there is an urgent need for enhanced surveillance strategies suitable for declaring freedom from disease and elimination of transmission with known confidence.MethodsUsing exhaustive contact tracing across settings in Tanzania we generated detailed data on rabies incidence, rabid dog biting behaviour and health-seeking behaviour of bite victims. Using these data we compared case detection of sampling-based and enhanced surveillance methodologies and investigated elimination verification procedures.FindingsWe demonstrate that patients presenting to clinics with bite injuries are sensitive sentinels for identifying dog rabies cases. Triage of patients based on bite history criteria and investigation of suspicious incidents can confirm >10% of dog rabies cases and is an affordable approach that will enable validation of disease freedom following two years without case detection. Approaches based on sampling the dog population without using bite-injury follow-up were found to be neither sensitive nor cost-effective.InterpretationThe low prevalence of rabies, and short window in which disease can be detected, preclude sampling-based surveillance. Instead, active case finding guided by bite-patient triage is needed as elimination is approached. Our proposed methodology is affordable, practical and supports the goal of eliminating human rabies deaths by improving administration of lifesaving post-exposure prophylaxis for genuinely exposed but untreated contacts. Moreover, joint investigations by public health and veterinary workers will strengthen intersectoral partnerships and capacity for control of emerging zoonoses. |
| Databáze: | OpenAIRE |
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