The Epidemiology, Economics and Risk Assessment Group, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Roslin EH25 9RG, United Kingdom;
Mission Rabies, Blantyre, Malawi.
Proc Natl Acad Sci U S A. 2021 Feb 2;118(5). doi: 10.1073/pnas.2003722118.
Rabies kills ∼60,000 people per year. Annual vaccination of at least 70% of dogs has been shown to eliminate rabies in both human and canine populations. However, delivery of large-scale mass dog vaccination campaigns remains a challenge in many rabies-endemic countries. In sub-Saharan Africa, where the vast majority of dogs are owned, mass vaccination campaigns have typically depended on a combination of static point (SP) and door-to-door (D2D) approaches since SP-only campaigns often fail to achieve 70% vaccination coverage. However, D2D approaches are expensive, labor-intensive, and logistically challenging, raising the need to develop approaches that increase attendance at SPs. Here, we report a real-time, data-driven approach to improve efficiency of an urban dog vaccination campaign. Historically, we vaccinated ∼35,000 dogs in Blantyre city, Malawi, every year over a 20-d period each year using combined fixed SP (FSP) and D2D approaches. To enhance cost effectiveness, we used our historical vaccination dataset to define the barriers to FSP attendance. Guided by these insights, we redesigned our vaccination campaign by increasing the number of FSPs and eliminating the expensive and labor-intensive D2D component. Combined with roaming SPs, whose locations were defined through the real-time analysis of vaccination coverage data, this approach resulted in the vaccination of near-identical numbers of dogs in only 11 d. This approach has the potential to act as a template for successful and sustainable future urban SP-only dog vaccination campaigns.
狂犬病每年导致约 6 万人死亡。研究表明，对至少 70%的犬进行年度疫苗接种，可以在人类和犬类群体中消除狂犬病。然而，在许多狂犬病流行的国家，开展大规模的大规模犬只疫苗接种运动仍然是一个挑战。在撒哈拉以南非洲，绝大多数犬只都是私人拥有的，大规模疫苗接种运动通常依赖于固定点（SP）和上门（D2D）两种方法的结合，因为仅 SP 方法通常无法实现 70%的疫苗接种覆盖率。然而，D2D 方法成本高、劳动强度大、物流挑战大，因此需要开发能提高 SP 参与度的方法。在这里，我们报告了一种实时的、数据驱动的方法，以提高城市犬只疫苗接种运动的效率。在历史上，我们每年在马拉维布兰太尔市使用固定 SP（FSP）和 D2D 两种方法相结合，在 20 天的时间内为约 35000 只狗接种疫苗。为了提高成本效益，我们利用历史疫苗接种数据来确定 FSP 出勤率的障碍。根据这些见解，我们重新设计了我们的疫苗接种运动，增加了 FSP 的数量，并取消了昂贵且劳动密集型的 D2D 部分。与流动 SP 相结合，其位置是通过对疫苗接种覆盖数据的实时分析来确定的，这种方法仅用 11 天就为几乎相同数量的狗接种了疫苗。这种方法有可能成为未来成功和可持续的城市 SP 犬只疫苗接种运动的模板。
