Where and when to vaccinate? Interdisciplinary design and evaluation of the 2018 Tanzanian anti-rabies campaign. (June 2020)

• Record Type: Journal Article
• Authors: Fasina, Folorunso O.; Mtui-Malamsha, Niwael; Mahiti, Gladys R.; Sallu, Raphael; OleNeselle, Moses; Rubegwa, Bachana; Makonnen, Yilma J.; Kafeero, Fred; Ruheta, Martin; Nonga, Hezron E.; Swai, Emmanuel; Makungu, Selemani; Killewo, Japhet; Otieno, Edward G.; Lupindu, Athumani M.; Komba, Erick; Mdegela, Robinson; Assenga, Justine K.; Bernard, Jubilate; Hussein, Mohamed; Marandu, Walter; Warioba, James; Kaaya, Eliona; Masanja, Pius; Francis, Gundelinda; Kessy, Violet M.; Savy, Janique; Choyo, Hija; Ochieng, Justus; Hoogesteijn, Almira L.; Fasina, Margaret M.; Rivas, Ariel L.;
• Is Part Of: International journal of infectious diseases. Volume 95(2020)
• Page Start: 352
• Page End: 360
• Publication Date: 2020-06
• Subjects: Rabies -- Vaccination -- One health -- Geo-epidemiology -- Dog -- Human health -- Health economics; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2020.03.037
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: A two-phase vaccination against rabies was designed and executed in northern Tanzania, in 2018, which included geo-epidemiological and economic perspectives. It had faster implementation: more people and larger areas were protected from rabies in less time. Lower costs: by decreasing the time involved in the implementation and increasing the number of people and areas protected, the cost per person and animal protected decreased. Longer prevention: prevention may have lasted longer because the geographical density of virus carriers – dogs – decreased earlier. Abstract: Objectives: Hoping to improve health-related effectiveness, a two-phase vaccination against rabies was designed and executed in northern Tanzania in 2018, which included geo-epidemiological and economic perspectives. Methods: Considering the local bio-geography and attempting to rapidly establish a protective ring around a city at risk, the first phase intervened on sites surrounding that city, where the population density was lower than in the city at risk. The second phase vaccinated a rural area. Results: No rabies-related case has been reported in the vaccinated areas for over a year post-immunisation; hence, the campaign is viewed as highly cost-effective. Other metrics included: rapid implementation (concluded in half the time spent on other campaigns) and the estimated cost per protected life, which was 3.28 times lower than in similar vaccinations. Conclusions: The adopted design emphasised local bio-geographical dynamics: it prevented the occurrence of an epidemic in a city with a higher demographic density than its surrounding area and it also achieved greater effectiveness than average interventions. These interdisciplinary, policy-oriented experiences have broad and immediate applications in settings of limited and/or time-sensitive (expertise, personnel, and time available to intervene) resources and conditions.