Rabies: Vaccination Campaigns

Data and facts from rabies vaccination campaigns.

Jump to: Case Studies | Barriers

Highlights


Case Studies

Jump to: Malawi (Blantyre) 2015 Campaign | Sri Lanka (Negombo) 2016 Campaign | Tanzania (Southeastern) Campaign

Blantyre, Malawi, 2015 Campaign

External Link:
Gibson AD, Handel IG, Shervell K, Roux T, Mayer D, Muyila S, et al. (2016) The Vaccination of 35,000 Dogs in 20 Working Days Using Combined Static Point and Door-to-Door Methods in Blantyre, Malawi. PLoS Negl Trop Dis 10(7): e0004824.
https://doi.org/10.1371%2Fjournal.pntd.0004824

Background

  • Rabies mortality in Malawi: 3 per 100,000 people annually.
  • Annual cost of rabies to Malawi: $13 million USD, including post-exposure prophylaxis (PEP), lost income, productivity losses, dog vaccination and management, livestock losses, and surveillance.
  • 2014 government campaign: 37% vaccination coverage using only static point vaccination.

Population Demographics

  • Mean free-roaming dogs sighted per km²:
    • Agriculture/Open Space: 5.6
    • Housing Category 1 (High-density, small houses): 473.2
    • Housing Category 2 (Medium-density, small houses): 234.9
    • Housing Category 3 (Low-density, small houses): 12.9
    • Housing Category 4 (Medium houses, ordered): 81.7
    • Housing Category 5 (Low/medium-density, large houses): 11.0
    • Industrial/Commercial: 3.6
  • Dog ownership: 59% of households owned a dog, averaging 1.93 adult dogs per dog-owning household.
  • Community average: 1.55 dogs per household.

Vaccination Results

  • 20-day vaccination program: 35,216 dogs vaccinated.
    • 23,442 dogs vaccinated at 44 static point stations.
    • 11,774 dogs vaccinated by door-to-door teams.
  • Post-vaccination data:
    • Total dogs recorded: 46,065 (35,216 vaccinated).
    • Already vaccinated at static points: 9,581.
    • Dogs sighted but not vaccinated: 1,268.
  • Door-to-door vaccination:
    • 42.4% of dogs were previously vaccinated at static points.
    • 90.3% of unvaccinated dogs could be restrained for vaccination.
    • Reasons for not vaccinating: unable to restrain (54.5%), owner not present (30.5%), owner refused (8.2%), already vaccinated by a non-Mission Rabies source (5.3%), other (1.4%).
    • 97.1% of dogs during door-to-door vaccination were identifiably owned.
    • 56% of “unowned” dogs were marked from static point clinics, indicating prior presentation for vaccination.
    • 38.6% of unmarked, unowned roaming dogs were caught and vaccinated.
  • Vaccination coverage:
    • Over 75% in three land types.
    • Slightly below 75% in two land types (74.9% and 69.5%).
  • Vaccinated dog demographics:
    • 57% of vaccinated dogs were male.
    • Puppy vaccination: 14.5% at static points vs. 26.7% door-to-door.
    • Emaciated/underweight dogs: 10.4% sterilized vs. 22.8% entire.

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Negombo, Sri Lanka, 2016 Campaign

External Link:
Sánchez-Soriano, C., Gibson, A.D., Gamble, L. et al. Development of a high number, high coverage dog rabies vaccination programme in Sri Lanka. BMC Infect Dis 19, 977 (2019).
https://doi.org/10.1186/s12879-019-4585-z

Background & Campaign Details

  • 2014 Survey Data:
    • Estimated dog vaccination coverage in Sri Lanka: 48%
  • Campaign Setup:
    • 146 static vaccination points (SP) set up daily in different areas of the city, from June 15th to September 1st.
    • Door-to-door (D2D) vaccination stage: September 12th to 28th.
  • Vaccination Results:
    • Total dogs vaccinated: 7804
      • Dogs vaccinated at SPs: 4382
      • Dogs seen during D2D campaign: 5177
      • Previously vaccinated during SP campaign: 1019 (19.7%)
    • Average vaccination coverage across 24 surveyed wards: 75.8%

Dog Demographics

  • Vaccination Status (D2D Campaign):
    • Previously vaccinated: 31.6%
    • Unvaccinated: 68.3%
  • Vaccination Status (SP Campaign):
    • Never vaccinated or vaccine overdue: 1961 (44.8%)
    • Already vaccinated: 2421 (55.2%)
      • Immunized at Dogstar clinic: 251 (10.4%)
      • Immunized by municipal veterinarian: 2059 (85.6%)
      • Immunized by private veterinarian: 89 (3.7%)
  • Confinement Status:
    • Free-roaming: 37%
    • Chained or leashed: 39.5%
    • Confined in a kennel or inside a household: 18.7%
  • Neutering Status:
    • Neutered dogs (D2D campaign): 1377 (26.6%)
    • Owner interest in sterilization:
      • Interested in neutering: 23.7%
      • Not interested in neutering: 69.4%

Reasons for Not Bringing Dogs to Static Points (by Dog Owners)

  • Unaware of the campaign: 37.9%
  • Unavailable: 29.3%
  • Couldn’t handle the dog: 10.2%
  • Dog is stray/semi-owned: 5.3%
  • Dog too young for vaccination: 5.3%
  • Distance too great: 4.5%
  • No answer: 2.9%
  • Other: 1.9%
  • Procedure is unnecessary: 1.6%
  • Procedure is harmful: 0.5%
  • Dog previously vaccinated: 0.5%
  • Dog under private vet care: 0.2%

Reasons Against Sterilization (by Dog Owners)

  • Procedure is unnecessary: 42.6%
  • No answer: 32.5%
  • Plan to breed the dog: 13.4%
  • Procedure is sinful: 5.2%
  • Will change the dog’s behavior: 4.6%
  • Dog should be able to mate: 0.7%
  • Procedure is inconvenient/time loss: 0.5%

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Southeastern Tanzania, 2010-2017 Campaign

External Link:
Sambo M, Ferguson EA, Abela-Ridder B, Changalucha J, Cleaveland S, Lushasi K, et al. (2022) Scaling-up the delivery of dog vaccination campaigns against rabies in Tanzania. PLoS Negl Trop Dis 16(2): e0010124.
https://doi.org/10.1371/journal.pntd.0010124

Campaign Background

  • Cost of PEP: In rural Tanzania, where most people live on less than $1.25 per day, accessing and completing the WHO-recommended post-exposure prophylaxis (PEP) for rabies costs over $100.
  • Rabies burden: Rabies is endemic in Tanzania, causing an estimated 552 human deaths annually, with 98% of cases linked to rabid domestic dogs.

Mass Dog Vaccination Campaign Results

  • Number of dogs vaccinated: Between 2010 and 2017, 349,513 dogs were vaccinated across 2,066 vaccination units, generating data from 8,959 units over the study period.
  • Completeness of campaign: Initially, only 3 out of 25 districts achieved full coverage in their vaccination units, but by the fifth round, 7 districts had reached 100% coverage in all units.
  • Coverage of campaign: 
    • During rounds 3 to 5, only 19–21% of vaccination units met the recommended 70% coverage.
    • In the final three rounds, district-level coverage ranged from 31% in Masasi Township to 83% in Rufiji, with only one district consistently achieving the 70% coverage target.
    • The analysis indicated that annual vaccination campaigns need at least 66% coverage to prevent a drop below 30% before the next campaign.
  • Monitoring efforts: From 2013 to 2017, 3,777 post-vaccination transects were conducted in 1,322 (64%) of the vaccination units, with 38.1% of these transects counting fewer than five dogs, and 13.7% observing no dogs at all.

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Barriers

Jump to: Blantyre, Malawi, 2015 Campaign Barriers

Blantyre, Malawi, 2015 Campaign Barriers

Campaign Background
  • In the 2015 vaccination program, 79% of dogs were vaccinated, with 53% vaccinated at static points (SPs) and 26% via door-to-door campaigns.
Identified Barriers
  • Distance and Attendance:
    • Dog owners were willing to travel an average of 1.22 km to an SP, with 75% walking up to 1.5 km.
    • The mean straight-line distance was 0.812 km, with an upper quartile of 1.016 km.
  • Dog Characteristics and Attendance:
    • Puppies and pregnant or lactating dogs were less likely to be brought to SPs.
    • Healthy or neutered dogs had higher odds of being taken to SPs.
    • Dogs that never roamed were less likely to attend SPs, while those roaming daily but restrained part-time were more likely to attend.
  • Socio-Economic Factors:
    • High poverty levels and high or medium housing density were positive predictors of SP attendance.
    • Increased poverty levels exacerbated the decline in attendance with increasing distance.
  • Reasons for Not Attending SPs:
    • Unaware of the campaign: 27.4%
    • Unavailable to attend: 23.9%
    • Difficulty handling dogs: 18.9%
    • Distance to SP: 16.8%
    • Too young: 8.6%
    • Other reasons: 3.4%
    • Perceived as harmful: 0.6%
    • Considered unnecessary: 0.5%
  • Awareness and Distance:
    • People unaware of the SP campaign were located farther from SPs compared to those who cited other reasons for non-attendance.

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