Tolentino Júnior Dilceu Silveira, Santos Vasconcelos Marques Maryana, Zatti Pereira Jomar Otávio, de Oliveira Roberto Carlos
Postgraduate Program in Collective Health, Oswaldo Cruz Foundation, René Rachou Institute, Belo Horizonte, Minas Gerais, Brazil.
Special Indigenous Health District of Minas Gerais and Espírito Santo, Ministry of Health of Brazil, Governador Valadares, Minas Gerais, Brazil.
One Health Outlook. 2025 Aug 22;7(1):41. doi: 10.1186/s42522-025-00167-3.
This article presents and evaluates the One Health interventions implemented after a rabies outbreak in indigenous Maxakali children living in the Pradinho Village in the municipality of Bertópolis, Minas Gerais, Brazil, which occurred between April and May 2022, in the third month and in the first year after the event.
This was an evaluation study conducted using official documents. The One Health approaches implemented in response to the outbreak were assessed from the perspective of continuity and self-sustainability, in order to conjecture the tactical and strategic operational measures adopted. The One Health interventions were assessed based on the analysis of qualitative and quantitative data from observations and records of environmental, observational, and animal and human behavior samples. The coordination mechanisms between the Rabies Working Group of the Ministry of Health, composed of the National, State and District Strategic Information Centers for Health Surveillance, the Field Epidemiology Training Program, the Special Secretariat for Indigenous Health, the State Secretariat of Health of Minas Gerais, the Agricultural Institute of Minas Gerais, the Municipal Secretariats of Health and Environment of Bertópolis, hospitals in the region and the Fire Department of Minas Gerais were assessed.
Training activities were carried out for health team professionals; a post-exposure prophylaxis scheme was implemented for susceptible contacts and a pre-exposure prophylaxis scheme was implemented by the vaccination team for all village residents; the animal anti-rabies vaccine was administered to 100% of the canine and feline population in Aldeia Pradinho, within a focal and perifocal radius of 3 to 5 km from the outbreak site. Approximately 100 households were inspected and natural and artificial roosts of sanguivorous bats were identified. An epidemiological survey was carried out in the region to verify attacks by sanguivorous bats on cattle and horses. The evaluation of the operational approaches in the 3rd month showed high efficacy, but after 1 year they were considered of low to medium efficacy. Evaluations of the tactical and strategic approaches after 1 year were considered of low efficacy due to the lack of self-sustainability.
One Health interventions were useful in addressing health challenges and consolidating partnerships. Although not all strategic response actions have proven to be self-sustainable after a year of this rabies outbreak that affected indigenous Maxakali children, gains were observed in terms of trust, community engagement, and intersectoral collaboration.
本文介绍并评估了巴西米纳斯吉拉斯州贝托波利斯市普拉迪尼奥村的马克萨卡利族原住民儿童在2022年4月至5月狂犬病疫情爆发后的第三个月及事件发生后的第一年所实施的“同一健康”干预措施。
这是一项利用官方文件开展的评估研究。从连续性和自我可持续性的角度评估了为应对疫情而实施的“同一健康”方法，以便推测所采取的战术和战略行动措施。基于对环境、观察以及动物和人类行为样本的观察与记录中的定性和定量数据的分析，对“同一健康”干预措施进行了评估。对由国家、州和地区卫生监测战略信息中心、现场流行病学培训项目、原住民健康特别秘书处、米纳斯吉拉斯州卫生秘书处、米纳斯吉拉斯州农业研究所、贝托波利斯市卫生和环境秘书处、该地区医院以及米纳斯吉拉斯州消防部门组成的卫生部狂犬病工作组之间的协调机制进行了评估。
为卫生团队专业人员开展了培训活动；为易感接触者实施了暴露后预防方案，疫苗接种团队为所有村民实施了暴露前预防方案；在距疫情爆发地点3至5公里的焦点和周边半径范围内，对普拉迪尼奥村100%的犬猫种群接种了动物用狂犬病疫苗。检查了约100户家庭，发现了吸血蝙蝠的天然和人工栖息地。在该地区开展了一项流行病学调查，以核实吸血蝙蝠对牛和马的攻击情况。对第三个月的行动方法评估显示效果良好，但1年后，其效果被认为是低到中等。由于缺乏自我可持续性，1年后对战术和战略方法的评估被认为效果不佳。
“同一健康”干预措施有助于应对健康挑战并巩固伙伴关系。尽管在这场影响马克萨卡利族原住民儿童的狂犬病疫情爆发一年后，并非所有战略应对行动都证明具有自我可持续性，但在信任、社区参与和部门间合作方面取得了进展。
