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Re-evaluating the burden of rabies in Africa and Asia
Knobel, Darryn L.
Rabies remains an important yet neglected disease in Africa and Asia. Disparities in the affordability and accessibility of post-exposure treatment and risks of exposure to rabid dogs result in a skewed distribution of the disease burden across society, with the major impact falling on those living in poor rural communities, in particular children. Bulletin of the World Health Organization 2005, Vol. 83, Number 5, pp. 321-400 Download from: The World Health Organisation
Incidence of canine rabies in N’Djaména, Chad
Kayali, U.
"This work describes for the first time the incidence risk of passively reported canine rabies, and quantifies reported human exposure in N’Djaména (the capital of Chad). To diagnose rabies, we used a direct immunofluorescent-antibody test (IFAT). From January 2001 to March 2002, we were brought 34 rabies cases in dogs and three cases in cats. Canine cases were geographically clustered. The annual incidence risk of canine rabies was 1.4 (95% CI: 1.2, 1.7) per 1000 unvaccinated dogs. Most of the rabid dogs were owned—although free-roaming and not vaccinated against rabies. Most showed increased aggressiveness and attacked people without being provoked. Eighty-one persons were exposed to rabid dogs and four persons to rabid cats (mostly childrenPreventive Veterinary Medicine 2003, Vol. 61, Issue 3, pp. 227-233 Available from: ScienceDirect
Cost-description of a pilot parenteral vaccination campaign against rabies in dogs in N'Djaména, Chad
Kayali, U.
"In the discussion about policies and strategies for rabies prevention in developing countries, intervention costs arise as a major issue. In a pilot mass vaccination campaign against rabies in N'Djaména, Chad, 3000 dogs were vaccinated. We assessed vaccination coverage and cost, showing the cost per dog vaccinated for the public sector and for society. An extrapolation to city level calculated the approximate cost of vaccinating all 23 600 dogs in N'Djaména. In the pilot mass campaign with 3000 dogs the average cost per dog was 1.69 €. to the public and the full societal cost was 2.45 €. If all 23 600 dogs in N'Djaména were vaccinated, the average cost would fall to 1.16 € to the public and 1.93 € to society. Private sector costs account for 31% of the cost to vaccinate 3000 dogs, and 40% of the cost to vaccinate 23 600 dogs. Mass dog vaccination could be a comparatively cheap and ethical way to both control the disease in animals and prevent human cases and exposure, especially in developing countries. The cost-effectiveness of dog vaccination compared with treating victims of dog bites for prevention of human rabies should be further assessed and documented." Tropical Medicine & International Health 2006, Vol. 11, Issue 7, pp. 1058 Available for purchase from: Blackwell Synergy
Coverage of pilot parenteral vaccination campaign against canine rabies in N’Djaména, Chad
Kayali, U.
"Canine rabies, and thus human exposure to rabies, can be controlled through mass vaccination of the animal reservoir if dog owners are willing to cooperate. Inaccessible, ownerless dogs, however, reduce the vaccination coverage achieved in parenteral campaigns. This study aimed to estimate the vaccination coverage in dogs in three study zones of N’Djaména, Chad, after a pilot free parenteral mass vaccination campaign against rabies. We used a capture–mark–recapture approach for population estimates, with a Bayesian, Markov chain, Monte Carlo method to estimate the total number of owned dogs, and the ratio of ownerless to owned dogs to calculate vaccination coverage. When we took into account ownerless dogs, the vaccination coverage in the dog populations was 87% (95% confidence interval (CI), 84–89%) in study zone I, 71% (95% CI, 64–76%) in zone II, and 64% (95% CI, 58–71%) in zone III. The proportions of ownerless dogs to owned dogs were 1.1% (95% CI, 0–3.1%), 7.6% (95% CI, 0.7–16.5%), and 10.6% (95% CI, 1.6–19.1%) in the three study zones, respectively. Vaccination coverage in the three populations of owned dogs was 88% (95% CI, 84–92%) in zone I, 76% (95% CI, 71–81%) in zone II, and 70% (95% CI, 66–76%) in zone III. Participation of dog owners in the free campaign was high, and the number of inaccessible ownerless dogs was low. High levels of vaccination coverage could be achieved with parenteral mass vaccination. Regular parenteral vaccination campaigns to cover all of N’Djaména should be considered as an ethical way of preventing human rabies when post-exposure treatment is of limited availability and high in cost." Bulletin of the World Health Organization 2003, Vol. 81, No. 10, pp. 739-744 Download PDF from: World Health Organization