Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France.
Sorbonne Université, Paris, France.
PLoS Negl Trop Dis. 2021 May 27;15(5):e0009449. doi: 10.1371/journal.pntd.0009449. eCollection 2021 May.
Rabies is a fatal yet vaccine-preventable disease. In the last two decades, domestic dog populations have been shown to constitute the predominant reservoir of rabies in developing countries, causing 99% of human rabies cases. Despite substantial control efforts, dog rabies is still widely endemic and is spreading across previously rabies-free areas. Developing a detailed understanding of dog rabies dynamics and the impact of vaccination is essential to optimize existing control strategies and developing new ones. In this scoping review, we aimed at disentangling the respective contributions of mathematical models and phylodynamic approaches to advancing the understanding of rabies dynamics and control in domestic dog populations. We also addressed the methodological limitations of both approaches and the remaining issues related to studying rabies spread and how this could be applied to rabies control.
METHODOLOGY/PRINCIPAL FINDINGS: We reviewed how mathematical modelling of disease dynamics and phylodynamics have been developed and used to characterize dog rabies dynamics and control. Through a detailed search of the PubMed, Web of Science, and Scopus databases, we identified a total of n = 59 relevant studies using mathematical models (n = 30), phylodynamic inference (n = 22) and interdisciplinary approaches (n = 7). We found that despite often relying on scarce rabies epidemiological data, mathematical models investigated multiple aspects of rabies dynamics and control. These models confirmed the overwhelming efficacy of massive dog vaccination campaigns in all settings and unraveled the role of dog population structure and frequent introductions in dog rabies maintenance. Phylodynamic approaches successfully disentangled the evolutionary and environmental determinants of rabies dispersal and consistently reported support for the role of reintroduction events and human-mediated transportation over long distances in the maintenance of rabies in endemic areas. Potential biases in data collection still need to be properly accounted for in most of these analyses. Finally, interdisciplinary studies were determined to provide the most comprehensive assessments through hypothesis generation and testing. They also represent new avenues, especially concerning the reconstruction of local transmission chains or clusters through data integration.
CONCLUSIONS/SIGNIFICANCE: Despite advances in rabies knowledge, substantial uncertainty remains regarding the mechanisms of local spread, the role of wildlife in dog rabies maintenance, and the impact of community behavior on the efficacy of control strategies including vaccination of dogs. Future integrative approaches that use phylodynamic analyses and mechanistic models within a single framework could take full advantage of not only viral sequences but also additional epidemiological information as well as dog ecology data to refine our understanding of rabies spread and control. This would represent a significant improvement on past studies and a promising opportunity for canine rabies research in the frame of the One Health concept that aims to achieve better public health outcomes through cross-sector collaboration.
狂犬病是一种致命但可通过疫苗预防的疾病。在过去的二十年中,家养犬已被证明是发展中国家狂犬病的主要宿主,导致 99%的人类狂犬病病例。尽管采取了大量控制措施,但犬狂犬病仍然广泛流行,并正在向以前无狂犬病的地区蔓延。深入了解犬狂犬病的动态和疫苗接种的影响对于优化现有控制策略和制定新策略至关重要。在本范围综述中,我们旨在阐明数学模型和系统发育动力学方法各自对推进对家犬狂犬病动态和控制的理解的贡献。我们还解决了这两种方法的方法学局限性以及与研究狂犬病传播及其在狂犬病控制中的应用相关的剩余问题。
方法/主要发现:我们回顾了疾病动态数学模型和系统发育动力学的发展和应用,以描述犬狂犬病的动态和控制。通过详细搜索 PubMed、Web of Science 和 Scopus 数据库,我们共确定了 n = 59 项使用数学模型(n = 30)、系统发育推断(n = 22)和跨学科方法(n = 7)的相关研究。我们发现,尽管这些模型通常依赖于有限的狂犬病流行病学数据,但它们研究了狂犬病动态和控制的多个方面。这些模型证实了大规模犬疫苗接种运动在所有环境中的有效性,并揭示了犬种群结构和频繁传入在维持犬狂犬病中的作用。系统发育动力学方法成功地分解了狂犬病传播的进化和环境决定因素,并一致支持重新引入事件和人类介导的长途运输在维持流行地区狂犬病中的作用。在这些分析中,仍需要适当考虑数据收集的潜在偏差。最后,跨学科研究被确定为通过假设生成和检验提供最全面的评估。它们还代表了新的途径,特别是在通过数据集成重建本地传播链或簇方面。
结论/意义:尽管对狂犬病的认识有所提高,但对于局部传播的机制、野生动物在犬狂犬病维持中的作用以及社区行为对包括犬只疫苗接种在内的控制策略效果的影响,仍存在很大的不确定性。未来的综合方法可以在单个框架内使用系统发育分析和机制模型,充分利用病毒序列以及其他流行病学信息和犬生态学数据,从而更好地了解狂犬病的传播和控制。这将是对过去研究的重大改进,也是在“同一健康”概念框架内进行犬狂犬病研究的一个有希望的机会,该概念旨在通过跨部门合作实现更好的公共卫生成果。