IMPACT OF CULLING STRAY DOGS AND VACCINATION ON THE CONTROL OF HUMAN RABIES: A MATHEMATICAL MODELING APPROACH

2011 ◽  
Vol 04 (04) ◽  
pp. 379-397 ◽  
Author(s):  
C. P. BHUNU
Keyword(s):  
Control Strategies ◽  
Developing Nations ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Analytical Results ◽  
Rabies Control ◽  
Animal Control ◽  
To Come ◽  
Exposure Prophylaxis

Human rabies cases are not declining in Africa and Asia even though possible interventions are available. A mathematical model for the transmission dynamics of rabies is presented and analyzed in the presence of intervention strategies (culling, dog vaccinations, pre- and post-exposure vaccinations for humans). The reproduction number is computed and rigorously analyzed. Analytical results suggest that the key to rabies control lies in good animal control and seeking medical advice early, once exposed to a dog bite. Numerical simulations support analytical results obtained. We conclude that the post-exposure prophylaxis might be the best possible way to control rabies in developing nations if it can be made easily accessible to those in need. However, due to costs of vaccines which are beyond the reach of many people in developing nations, it may be best to come up with better animal control strategies to control the spread of rabies.

Challenges facing human rabies control: the Lebanese experience

2013 ◽  
Vol 142 (7) ◽  
pp. 1486-1494 ◽  
Author(s):  
A. BIZRI ◽  
A. ALAWIEH ◽  
N. GHOSN ◽  
A. BERRY ◽  
U. MUSHARRAFIEH
Keyword(s):  
Regional Cooperation ◽  
Public Awareness ◽  
Passive Immunization ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Zoonotic Infections ◽  
Rabies Control ◽  
Animal Bites ◽  
Exposure Prophylaxis

SUMMARYRabies is one of the most important zoonotic infections worldwide. The burden of the disease continues to be significant in countries in the Middle East where the most important vector is stray dogs. Control efforts are hindered by lack of awareness and incomplete post-exposure prophylaxis. The aim of this article is to re-assess the situation of rabies in Lebanon and compare it to other Middle Eastern countries. Eight cases of rabies and 5280 incidents of animal bites to humans were reported to the Lebanese Ministry of Public Health between 2001 and 2012. Dogs were the only vector of infection and were responsible for most reported animal bites to humans. An average of 3·2 doses of vaccine per bite was administered as post-exposure prophylaxis. The status of human and canine rabies control, the risks associated with children's behaviour and the hazards of secondary wild reservoirs are discussed. Our data illustrates the importance of prevention through vector control, public awareness and education, and timely administration of active and passive immunization, as well as the significance of regional cooperation and monitoring the circulation of viral variants in wild animals.

scholarly journals Avaliação dos profissionais de saúde no atendimento antirrábico humano

2018 ◽  
Vol 12 (5) ◽  
pp. 1233
Author(s):  
Maria Elda Alves de Lacerda Campos ◽  
Bruna Coelho De Macedo ◽  
Glenda Katherine Silvetre da Silva ◽  
Flávia Emília Cavalcante Valença Fernandes
Keyword(s):  
Regression Analysis ◽  
Health Professionals ◽  
Control Method ◽  
Epidemiological Surveillance ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Rabies Control ◽  
Vaccine Type ◽  
Exposure Prophylaxis

RESUMOObjetivo: avaliar a conduta dos profissionais de saúde no atendimento antirrábico humano. Método: estudo quantitativo, descritivo, com 2.789 casos que sofreram agressão por cão ou gato para a profilaxia antirrábica humana pós-exposição, no período de 2013 a 2015, notificados no Sinan. Os dados foram analisados pelo programa Stata 12.0 e realizou-se análise de regressão logística para a avaliação da adequação da conduta. Resultados: a mordedura representou maior proporção dos casos (85,6%). Os cães e gatos representaram 98,4% das espécies agressoras. Desses, 81,8% foram referidos como sadios. Dos tratamentos indicados, 68% foram do tipo observação e vacina. Constatou-se que, das condutas indicadas, 70,1% foram adequadas. Conclusão: a partir da avaliação das condutas dos profissionais de saúde no atendimento antirrábico humano, pôde-se verificar que a maioria delas foi realizada da forma correta e de acordo com as normas ministeriais. No entanto, constatou-se um número considerável de condutas inadequadas refletindo a necessidade constante de qualificação dos profissionais para a instituição da profilaxia antirrábica. Descritores: Raiva; Profilaxia Pós-Exposição; Vigilância Epidemiológica; Educação em Saúde; Políticas Públicas; Pessoal de Saúde.ABSTRACTObjective: to evaluate the behavior of health professionals in human rabies control. Method: a descriptive, quantitative study with 2,789 cases of dog or cat aggression for post-exposure human rabies prophylaxis in the period from 2013 to 2015, reported in Sinan. The data was analyzed by the Stata 12.0 program and a logistic regression analysis was performed to assess the suitability of the conduct. Results: the bite represented a higher proportion of cases (85.6%). Dogs and cats accounted for 98.4% of the aggressor species. Of these, 81.8% were referred to as healthy. Of the treatments indicated, 68% were of the observation and vaccine type. It was found that 70.1% of the behaviors indicated were adequate. Conclusion: based on the evaluation of the health professionals' conduct in the human rabies control, it was verified that most of them were performed correctly and in accordance with ministerial norms. However, a considerable number of inadequate behaviors were observed reflecting the constant need to qualify professionals for the institution of anti-rabies prophylaxis. Descriptors: Rabies; Post-Exposure Prophylaxis; Epidemiological Surveillance; Health Education; Public Policies; Health Personnel.RESUMENObjetivo: evaluar la conducta de los profesionales de salud en la atención antirrábica humana. Método: estudio cuantitativo, descriptivo, con 2.789 casos que sufrieron agresión por perro o gato para la profilaxis antirrábica humana post-exposición, en el período de 2013 a 2015, notificados en el Sinan. Los datos fueron analizados por el programa Stata 12.0 y se realizó un análisis de regresión logística para evaluar la adecuación de la conducta. Resultados: la mordedura representó mayor proporción de los casos (85.6%). Los perros y gatos representaron el 98.4% de las especies agresoras. De los 81.8% fueron referidos como sanos. De los tratamientos indicados, el 68% fueron del tipo observación y vacuna. Se constató que, de las conductas indicadas, el 70.1% fueron adecuadas. Conclusión: a partir de la evaluación de la conducta de los profesionales de salud en la atención antirrábica humana se puede verificar que la mayoría de ellas fueron realizadas de la forma correcta y de acuerdo con las normas ministeriales. Sin embargo, se constató un número considerable de conductas inadecuadas, reflejando la necesidad constante de calificación de los profesionales para la institución de la profilaxis antirrábica. Descriptores: Rabia; Profilaxis Post-Exposición; Vigilancia Epidemiológica; Educación en Salud; Políticas Públicas; Personal de Salud.

scholarly journals Post-exposure prophylaxis vaccination rate and risk factors of human rabies in mainland China: a meta-analysis

2018 ◽  
Vol 147 ◽  
Author(s):  
D. L. Wang ◽  
X. F. Zhang ◽  
H. Jin ◽  
X. Q. Cheng ◽  
C. X. Duan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Meta Analysis ◽  
Mainland China ◽  
Vaccination Rate ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Eastern Region ◽  
Post Exposure ◽  
Exposure Prophylaxis

AbstractRabies is one of the major public health problems in China, and the mortality rate of rabies remains the highest among all notifiable infectious diseases. A meta-analysis was conducted to investigate the post-exposure prophylaxis (PEP) vaccination rate and risk factors for human rabies in mainland China. The PubMed, Web of Science, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical and Wanfang databases were searched for articles on rabies vaccination status (published between 2007 and 2017). In total, 10 174 human rabies cases from 136 studies were included in this meta-analysis. Approximately 97.2% (95% confidence interval (CI) 95.1–98.7%) of rabies cases occurred in rural areas and 72.6% (95% CI 70.0–75.1%) occurred in farmers. Overall, the vaccination rate in the reported human rabies cases was 15.4% (95% CI 13.7–17.4%). However, among vaccinated individuals, 85.5% (95% CI 79.8%–83.4%) did not complete the vaccination regimen. In a subgroup analysis, the PEP vaccination rate in the eastern region (18.8%, 95% CI 15.9–22.1%) was higher than that in the western region (13.3%, 95% CI 11.1–15.8%) and this rate decreased after 2007. Approximately 68.9% (95% CI 63.6–73.8%) of rabies cases experienced category-III exposures, but their PEP vaccination rate was 27.0% (95% CI 14.4–44.9%) and only 6.1% (95% CI 4.4–8.4%) received rabies immunoglobulin. Together, these results suggested that the PEP vaccination rate among human rabies cases was low in mainland China. Therefore, standardised treatment and vaccination programs of dog bites need to be further strengthened, particularly in rural areas.

CROSS- SECTIONAL STUDY OF ANIMAL BITE VICTIMS AND RABIES POST EXPOSURE PROPHYLAXIS UNDER NRCP (NATIONAL RABIES CONTROL PROGRAMME) AT A RURAL HOSPITAL OF NORTH 24 PARGANAS OF WEST BENGAL, INDIA.

2021 ◽  
pp. 4-6
Author(s):  
Chinmay Nandi ◽  
Saikat Bhattacharya ◽  
Soumitra Mondal ◽  
Shibasish Banerjee
Keyword(s):  
Cross Sectional Study ◽  
Control Programme ◽  
Post Exposure Prophylaxis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Case Record ◽  
Post Exposure ◽  
Rabies Control ◽  
Animal Bites ◽  
Exposure Prophylaxis

Objectives -Rabies, an Endemic disease, is responsible for extensive morbidity and mortality in India. About 96% of the mortality and morbidity is associated with dog bites. The aim of the study was to estimate the prevalence and pattern of animal bites and rabies post exposure prophylaxis under National Rabies Control Programme Methodology – It was a Record cross sectional study where complete enumeration of all animal bite victims were done. Total 2940 such cases were found in that year. Data of 42 cases was excluded due to incomplete records. Data was analysed using MS Excel. Animal Bite Exposure register under National Rabies Control Programme, Patient Treatment cards, Consolidated reports were evaluated as study tools. Results - Majority of the wounds were found in limbs in 2695 (93%) cases. It is followed by wound in other areas like face 104(3.6%) and back 95 (3.3%). In a few cases site of wound was not mentioned in the case record. Children were most commonly affected (28.2%).Cat -bite is most common (49.3%). Around 84.9% were Category II bite and rest are category III. Conclusion - Dogs and cats are mostly responsible of animal bites in this part of the country. There is need to control stray dogs .Children are found to be most vulnerable for animal bites. There is gap between eligible candidates for vaccine and those who actually received it both in Category II and III animal bite victims.

scholarly journals Human rabies post-exposure prophylaxis relative to the disease epidemiological status

2019 ◽  
Vol 24 (1) ◽  
pp. 315-322 ◽  
Author(s):  
Bruno Fonseca Martins da Costa Andrade ◽  
Taísa Santos de Melo Andrade ◽  
Luzia Helena Queiroz
Keyword(s):  
Rabies Vaccine ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Paulo State ◽  
Technical Manual ◽  
Prophylactic Measures ◽  
Exposure Prophylaxis ◽  
Main City ◽  
Technical Recommendations

Abstract This study evaluated the prophylactic measures adopted after attacks by dogs and cats in the main city of Northwester São Paulo State, based on the technical manual for post-exposure treatment, considering the not controlled (1990-1996) and controlled (1997-2010) rabies status. A retrospective analysis was done using the data from the SINAN records (W64-CID10) between 1990 and 2010. In most cases, the accidents were mild (76.9%), and biting animals were healthy (75.4%); therefore, no treatment was needed in 53.3% of the cases. In 64.6% of cases, the prescribed PEP treatment was inappropriate. The most indicated PEP treatments consisted of vaccine and RIG (43.4%), and either three doses of mouse brain vaccine or two doses of cell culture vaccine (76.5%), during the not controlled and controlled rabies periods, respectively. The treatment was more appropriate and followed the technical recommendations during controlled rabies periods compared to not controlled (p < 0.0001) periods. However, excessive application of RIG and rabies vaccine was observed in both periods.

scholarly journals Human rabies post exposure prophylaxis at the Pasteur Institute of Dakar, Senegal: trends and risk factors

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mamadou Korka Diallo ◽  
Alpha Oumar Diallo ◽  
Anta Dicko ◽  
Vincent Richard ◽  
Emmanuelle Espié
Keyword(s):  
Risk Factors ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Pasteur Institute ◽  
Post Exposure ◽  
Exposure Prophylaxis

Recurrent Temporary Paralysis Reported After Human Rabies Post-Exposure Prophylaxis

2014 ◽  
Vol 62 (3) ◽  
pp. 222-227 ◽  
Author(s):  
V. M. Dato ◽  
E. R. Campagnolo ◽  
D. U. Shah ◽  
M. J. Bellush ◽  
C. E. Rupprecht
Keyword(s):  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

Problems in human rabies post-exposure prophylaxis management

2007 ◽  
Vol 5 (3) ◽  
pp. 189-193 ◽  
Author(s):  
Saowaluck Tepsumethanon ◽  
Veera Tepsumethanon ◽  
Thanphet Tantawichien ◽  
Kanitta Suwansrinon ◽  
Henry Wilde
Keyword(s):  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

scholarly journals How geographic access to care shapes disease burden: the current impact of post-exposure prophylaxis and potential for expanded access to prevent human rabies deaths in Madagascar

2020 ◽  
Author(s):  
Malavika Rajeev ◽  
Hélène Guis ◽  
Glenn Edosoa ◽  
Chantal Hanitriniaina ◽  
Anjasoa Randrianarijaona ◽  
...  
Keyword(s):  
Rabies Vaccine ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Travel Times ◽  
Middle Income ◽  
Geographic Access ◽  
Post Exposure ◽  
Canine Rabies ◽  
Middle Income Countries ◽  
Exposure Prophylaxis

AbstractBackgroundPost-exposure prophylaxis (PEP) is highly effective at preventing human rabies deaths, however access to PEP is limited in many rabies endemic countries. The 2018 decision by Gavi to add human rabies vaccine to its investment portfolio should expand PEP availability and reduce rabies deaths. We explore how geographic access to PEP impacts the rabies burden in Madagascar and the potential benefits of improved provisioning.Methodology & Principal FindingsWe use travel times to the closest clinic providing PEP (N=31) as a proxy for access. We find that travel times strongly predict reported bite incidence across the country. Using resulting estimates in an adapted decision tree framework we extrapolate rabies deaths and reporting and find that geographic access to PEP shapes burden sub-nationally. We estimate 960 human rabies deaths annually (95% Prediction Intervals (PI):790 - 1120), with PEP averting an additional 800 deaths (95% PI: 800 (95% PI: 640 - 970) each year. Under these assumptions, we find that expanding PEP to one clinic per district could reduce deaths by 19%, but even with all major health centers provisioning PEP (1733 additional clinics), we still expect substantial rabies mortality. Our quantitative estimates are most sensitive to assumptions of underlying rabies exposure incidence, but qualitative patterns of the impacts of travel times and expanded PEP access are robust.Conclusions & SignificancePEP is effective at preventing rabies deaths, and in the absence of strong surveillance, targeting underserved populations may be the most equitable way to provision PEP. Our framework could be used to guide PEP expansion and improve targeting of interventions in similar endemic settings where PEP access is geographically restricted. While better PEP access should save many lives, improved outreach and surveillance is needed and if rolled out with Gavi investment could catalyze progress towards achieving zero rabies deaths.Author SummaryCanine rabies causes an estimated 60,000 deaths each year across the world, primarily in low- and middle-income countries where people have limited access to both human vaccines (post-exposure prophylaxis or PEP) and dog rabies vaccines. Given that we have the tools to prevent rabies deaths, a global target has been set to eliminate deaths due to canine rabies by 2030, and recently, Gavi, a multilateral organization that aims to improve access to vaccines in the poorest countries, added human rabies vaccine to it’s portfolio. In this study, we estimated reported bite incidence in relation to travel times to clinics provisioning PEP, and extrapolate human rabies deaths in Madagascar. We find that PEP currently averts around 800 deaths each year, but that the burden remains high (1000 deaths/ year), particularly in remote, hard-to-reach areas. We show that expanding PEP availability to more clinics could significantly reduce rabies deaths in Madagascar, but our results suggest that expansion alone will not eliminate deaths. Combining PEP expansion with outreach, surveillance, and mass dog vaccination programs will be necessary to move Madagascar, and other Low- and Middle-Income countries, forward on the path to rabies elimination.

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