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Long-range movements coupled with heterogeneous incubation period sustain dog rabies at the national scale in Africa.

ABSTRACT: Dog-transmitted rabies is responsible for more than 98% of human cases worldwide, remaining a persistent problem in developing countries. Mass vaccination targets predominantly major cities, often compromising disease control due to re-introductions. Previous work suggested that areas neighboring cities may behave as the source of these re-introductions. To evaluate this hypothesis, we introduce a spatially explicit metapopulation model for rabies diffusion in Central African Republic. Calibrated on epidemiological data for the capital city, Bangui, the model predicts that long-range movements are essential for continuous re-introductions of rabies-exposed dogs across settlements, eased by the large fluctuations of the incubation period. Bangui's neighborhood, instead, would not be enough to self-sustain the epidemic, contrary to previous expectations. Our findings suggest that restricting long-range travels may be very efficient in limiting rabies persistence in a large and fragmented dog population. Our framework can be applied to other geographical contexts where dog rabies is endemic.

SUBMITTER: Colombi D

PROVIDER: S-EPMC7274467 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Long-range movements coupled with heterogeneous incubation period sustain dog rabies at the national scale in Africa.

Colombi Davide D Poletto Chiara C Nakouné Emmanuel E Bourhy Hervé H Colizza Vittoria V

PLoS neglected tropical diseases 20200526 5

Dog-transmitted rabies is responsible for more than 98% of human cases worldwide, remaining a persistent problem in developing countries. Mass vaccination targets predominantly major cities, often compromising disease control due to re-introductions. Previous work suggested that areas neighboring cities may behave as the source of these re-introductions. To evaluate this hypothesis, we introduce a spatially explicit metapopulation model for rabies diffusion in Central African Republic. Calibrate ...[more]

PMID: 32453756

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Project description:BackgroundDog rabies annually causes 24,000-70,000 deaths globally. We built a spreadsheet tool, RabiesEcon, to aid public health officials to estimate the cost-effectiveness of dog rabies vaccination programs in East Africa.MethodsRabiesEcon uses a mathematical model of dog-dog and dog-human rabies transmission to estimate dog rabies cases averted, the cost per human rabies death averted and cost per year of life gained (YLG) due to dog vaccination programs (US 2015 dollars). We used an East African human population of 1 million (approximately 2/3 living in urban setting, 1/3 rural). We considered, using data from the literature, three vaccination options; no vaccination, annual vaccination of 50% of dogs and 20% of dogs vaccinated semi-annually. We assessed 2 transmission scenarios: low (1.2 dogs infected per infectious dog) and high (1.7 dogs infected). We also examined the impact of annually vaccinating 70% of all dogs (World Health Organization recommendation for dog rabies elimination).ResultsWithout dog vaccination, over 10 years there would a total of be approximately 44,000-65,000 rabid dogs and 2,100-2,900 human deaths. Annually vaccinating 50% of dogs results in 10-year reductions of 97% and 75% in rabid dogs (low and high transmissions scenarios, respectively), approximately 2,000-1,600 human deaths averted, and an undiscounted cost-effectiveness of $451-$385 per life saved. Semi-annual vaccination of 20% of dogs results in in 10-year reductions of 94% and 78% in rabid dogs, and approximately 2,000-1,900 human deaths averted, and cost $404-$305 per life saved. In the low transmission scenario, vaccinating either 50% or 70% of dogs eliminated dog rabies. Results were most sensitive to dog birth rate and the initial rate of dog-to-dog transmission (Ro).ConclusionsDog rabies vaccination programs can control, and potentially eliminate, dog rabies. The frequency and coverage of vaccination programs, along with the level of dog rabies transmission, can affect the cost-effectiveness of such programs. RabiesEcon can aid both the planning and assessment of dog rabies vaccination programs.

Project description:BackgroundRabies still poses a significant human health problem throughout most of Africa, where the majority of the human cases results from dog bites. Mass dog vaccination is considered to be the most effective method to prevent rabies in humans. Our objective was to systematically review research articles on dog rabies parenteral vaccination coverage in Africa in relation to dog accessibility and vaccination cost recovery arrangement (i.e.free of charge or owner charged).Methodology/principal findingsA systematic literature search was made in the databases of CAB abstracts (EBSCOhost and OvidSP), Scopus, Web of Science, PubMed, Medline (EBSCOhost and OvidSP) and AJOL (African Journal Online) for peer reviewed articles on 1) rabies control, 2) dog rabies vaccination coverage and 3) dog demography in Africa. Identified articles were subsequently screened and selected using predefined selection criteria like year of publication (viz. ≥ 1990), type of study (cross sectional), objective(s) of the study (i.e. vaccination coverage rates, dog demographics and financial arrangements of vaccination costs), language of publication (English) and geographical focus (Africa). The selection process resulted in sixteen peer reviewed articles which were used to review dog demography and dog ownership status, and dog rabies vaccination coverage throughout Africa. The main review findings indicate that 1) the majority (up to 98.1%) of dogs in African countries are owned (and as such accessible), 2) puppies younger than 3 months of age constitute a considerable proportion (up to 30%) of the dog population and 3) male dogs are dominating in numbers (up to 3.6 times the female dog population). Dog rabies parenteral vaccination coverage was compared between "free of charge" and "owner charged" vaccination schemes by the technique of Meta-analysis. Results indicate that the rabies vaccination coverage following a free of charge vaccination scheme (68%) is closer to the World Health Organization recommended coverage rate (70%) than the achieved coverage rate in owner-charged dog rabies vaccination schemes (18%).Conclusions/significanceMost dogs in Africa are owned and accessible for parenteral vaccination against rabies if the campaign is performed "free of charge".

Project description:Australia is currently canine rabies free. However, communities located on the northern coastline-such as the Northern Peninsula Area (NPA), Queensland-are at risk of an incursion due to their large populations of susceptible free-roaming dogs and proximity to rabies-infected Indonesian islands. A rabies-spread model was used to simulate potential outbreaks and evaluate various disease control strategies. A heterogeneous contact structure previously described in the population of interest-explorer dogs, roamer dogs and stay-at-home dogs-was incorporated into the model using six spatial kernels describing contacts between dog roaming categories. Twenty-seven vaccination strategies were investigated based on a complete block design of 50%, 70% and 90% coverage for each of the three roaming categories to simulate various targeted vaccination strategies. The 27 strategies were implemented in four population structures in which the proportion of dogs in each category varied-explorer dominant, roamer dominant, stay-at-home dominant and a field population (based on field estimates of population structure). The overall vaccination coverage varied depending on the subpopulation targeted for vaccination and the population structure modelled. A total of 108 scenarios were simulated 2000 times and the model outputs (outbreak size and duration) were compared to Strategy 14 (a standard recommended overall 70% vaccination coverage). In general, targeting explorer dogs-and to a lesser extent roamer dogs-produced similar outbreaks to Strategy 14 but with a lower overall vaccination coverage. Similarly, strategies that targeted stay-at-home dogs required a higher vaccination coverage to produce significantly smaller and shorter outbreaks. This study provides some theoretical evidence that targeting subpopulations of dogs for vaccination based on their roaming behaviours (and therefore risk of rabies transmission) could be more efficient than blanket 70% vaccination campaigns. Such information can be used in preparedness planning to help improve control of a potential rabies incursion in Australia.

Dataset Information

Long-range movements coupled with heterogeneous incubation period sustain dog rabies at the national scale in Africa.

Publications

Long-range movements coupled with heterogeneous incubation period sustain dog rabies at the national scale in Africa.

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