Rabies control in rural Africa: Evaluating strategies for effective domestic dog vaccination

• Published in: Vaccine 2009-01, Vol.27 (1), p.152-160
• Main Authors: Kaare, M, Lembo, T, Hampson, K, Ernest, E, Estes, A, Mentzel, C, Cleaveland, S
• Format: Article
• Language: English
• Subjects: Africa; Allergy and Immunology; Animals; Applied microbiology; Biological and medical sciences; Cost-effectiveness; Developing countries; Disease; Dog Diseases - prevention & control; Dogs; Domestic animals; Female; Fundamental and applied biological sciences. Psychology; Herd immunity; Humans; LDCs; Male; Microbiology; Miscellaneous; Population Density; Rabies; Rabies - prevention & control; Rabies - veterinary; Rabies Vaccines - administration & dosage; Rabies Vaccines - economics; Rural areas; Rural Population; Surveys and Questionnaires; Towns; Vaccination - economics; Vaccination - veterinary; Vaccination coverage; Vaccination strategy; Vaccines; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Virology
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2008.09.054

Abstract Effective vaccination campaigns need to reach a sufficient percentage of the population to eliminate disease and prevent future outbreaks, which for rabies is predicted to be 70%, at a cost that is economically and logistically sustainable. Domestic dog rabies has been increasing across most of sub-Saharan Africa indicating that dog vaccination programmes to date have been inadequate. We compare the effectiveness of a variety of dog vaccination strategies in terms of their cost and coverage in different community settings in rural Tanzania. Central-point (CP) vaccination was extremely effective in agro-pastoralist communities achieving a high coverage (>80%) at a low cost (US$5/dog) and inadequate (US$6 and >US$4/dog, respectively). No single vaccination strategy is likely to be effective in all populations and therefore alternative approaches must be deployed under different settings. CP vaccination is cost-effective and efficient for the majority of dog populations in rural Tanzania and potentially elsewhere in sub-Saharan Africa, whereas a combination strategy is necessary in remote pastoralist communities. These results suggest that rabies control is logistically feasible across most of the developing world and that the annual costs of effective vaccination campaigns in Tanzania are likely to be affordable.