Update from Tanzania
To do this we have a team (led by PhD student Kennedy Lushasi who you can read more about below) who have set up an Integrated Case Bite Management network across the Mara region. This enhanced surveillance network comprises health facility-based risk assessments that trigger animal health investigations and enhances the identification of dog rabies cases.
The primary outcome of the network is that it allows bite victims to be identified and to receive proper care. The secondary outcome is that it allows the team to collect data from district hospitals and health clinics on the number of cases of dog bite injuries and rabies that occur. This network was established before the randomized controlled trial and will allow us to see how the rolling out of mass dog vaccination impacts the incidence of dog bite injuries and cases of human rabies.
Going forward, we will use the outputs from the randomized controlled trial and the human health surveillance to model the impact that delivery strategy (team-led and community-led) has on public health outcomes, including lives saved, rabies exposures prevented, and changes in post-exposure prophylaxis use as well as the time to elimination of dog-mediated rabies. The hypothesis is that community-led delivery of mass dog vaccination results in improved public health outcomes and achieves elimination more rapidly.
As we will also be collecting cost-data for each mass dog vaccination strategy. The data generated will allow estimation of the public health impacts, the cost-effectiveness and the net benefits in terms of public health outcomes that can be achieved under the different vaccination delivery strategies.
With mass dog vaccination programs in rabies endemic countries typically funded and implemented by external agencies, national policy makers are often unaware of the public health and economic benefits of mass dog vaccination. In quantifying the reduction in the burden of human rabies that mass dog vaccination provides and the comparative effectiveness and cost effectiveness of the different delivery strategies, our program will provide much needed data that will inform decision makers on the best approaches to eliminate human rabies at regional and national levels. With governments of rabies endemic countries developing national elimination plans in response to the Zero by 30 target, the program outputs will be extremely timely.
Employee Spotlight: Kennedy Lushasi
I have been working with Rabies Free Tanzania since October 2017.
It’s important to me, and I think all of us, to work towards eliminating rabies. This is a disease of poverty. The costs of preventing rabies in humans is very high as few people can afford the treatment, but very cheap and easy to eliminate in dog populations which have been identified as the main source of infection to humans. In addition, rabies has no treatment once someone develops the symptoms. He/she eventually dies in a short period. I am not interested in seeing people die due to rabies or someone spend a lot of money buying costly post exposure prophylaxes. Rabies also causes psychological and mental issues to the affected families. To end these issues, we need to get rid of rabies the same way polio was eliminated.