Key Findings
With the right logistical and political support, Mission Rabies successfully vaccinated 35,000 dogs in a month in a sub-Saharan African city, achieving a vaccination coverage of over 75%.
Researchers found that short, intensive campaigns in urban locations are more effective in gathering both local and international support, while local staff can be trained to carry out vaccinations in surrounding rural areas using a more extended approach.
The combined static point and door-to-door methods are effective in capturing a large number of dogs that were not vaccinated at the static points, as well as young puppies whose owners may be reluctant to bring them to vaccination sites.
Summary
Achieving 70% vaccination coverage in dog populations is essential for controlling rabies outbreaks, but it has proven to be a significant challenge. Past vaccination campaigns have often fallen short of this target, primarily due to logistical and practical difficulties. Various approaches have been attempted to improve coverage rates, including house-to-house visits, fixed vaccination posts at well-recognized community sites, and temporary vaccination posts set up by mobile teams. House-to-house visits are labor-intensive and costly, requiring extensive manpower and resources to reach every household. Fixed vaccination posts rely on dog owners bringing their pets to specific locations, which often leads to low turnout due to transportation barriers, lack of awareness, and distrust. Temporary vaccination posts, while more flexible, still face issues of accessibility and coverage consistency. These challenges highlight the need for innovative strategies to ensure a higher proportion of dogs are vaccinated, particularly in areas with high rabies prevalence.
Blantyre, the second largest city in Malawi with a population of 825,000, faces significant public health challenges, including a high incidence of rabies. In 2015, Mission Rabies launched a campaign in Blantyre with the goal of vaccinating at least 75% of the city’s dog population within one month. The campaign employed a combination of static point and door-to-door vaccination methods, with static point locations operating on weekends and mobile vaccination teams traveling door-to-door on Monday, Tuesday, and Wednesday in surrounding areas. This effort marked the start of a three-year program aimed at eliminating rabies in Blantyre District.
The study, titled “The Vaccination of 35,000 Dogs in 20 Working Days Using Combined Static Point and Door-to-Door Methods in Blantyre, Malawi,” was conducted to complement this vaccination campaign. It focuses on collecting demographic data about the dog population and investigating the feasibility of such large-scale vaccination drives.
To prepare for the vaccination campaign, a population assessment was conducted to estimate the dog population size and distribution across Blantyre. The city was divided into 25 administrative wards with diverse land use, including residential, industrial, agricultural, and open spaces, and a dog sight survey was carried out in randomly selected working zones. Details such as GPS location, confinement status, sex, age, and lactation status of sighted dogs were recorded.
The population assessment provided significant insights into the dog demographics in Blantyre. The human-to-dog ratio was found to be 18.1:1, closely aligning with the reference African urban ratio of 21.2:1. This similarity gave the research team confidence in using the human-to-dog ratio as a rapid and cost-effective method for estimating the initial dog population going forward. Additionally, the team observed a diverse distribution of dogs across various land types, with the highest densities in high-density residential areas and the lowest densities in industrial and commercial spaces.
The vaccination campaign successfully vaccinated 35,216 dogs within a 20-day period. A total of 23,442 dogs were vaccinated at static point stations, while 11,774 dogs were vaccinated during door-to-door sessions. The latter effort was particularly crucial, as only 42.4% of the dogs identified during the door-to-door vaccination drive had been vaccinated at static point stations held the previous weekend in the same area. Another notable issue encountered during the campaign was the low presentation of puppies at static point vaccination sites. This reluctance from owners to bring young puppies to vaccination posts was likely due to concerns about their safety and exposure to other dogs. The door-to-door vaccination approach helped mitigate this issue by reaching puppies within their homes.
Post-vaccination surveys conducted through door-to-door visits revealed a vaccination coverage rate of 79.3%. This exceeded the target coverage rate of 75%, demonstrating the effectiveness of the combined vaccination approach. Overall, this initiative marks a significant step towards the elimination of rabies in Blantyre District and provides a model for future mass vaccination efforts in Africa and beyond.
Reflecting on the campaign, the authors believed that an intensive campaign ran over a short time frame is useful for getting greater political engagement as well as international expertise. The local teams were also trained during the month, and were able to carry on the work autonomously after the end of the intensive campaign.
Miscellaneous
Read Next:
What stops people from visiting static point vaccination stations?
Data From Study:
Rabies Vaccination Campaigns / Blantyre, Malawi, 2015
Year of Publication:
2016
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