title: The feasibility of canine rabies elimination in Africa: dispelling doubts with data.
abstract: BACKGROUND
  Canine rabies causes many thousands of human deaths every year in Africa, and continues to increase throughout much of the continent.
  
  
  RESULTS
  This paper identifies four common reasons given for the lack of effective canine rabies control in Africa: (a) a low priority given for disease control as a result of lack of awareness of the rabies burden; (b) epidemiological constraints such as uncertainties about the required levels of vaccination coverage and the possibility of sustained cycles of infection in wildlife; (c) operational constraints including accessibility of dogs for vaccination and insufficient knowledge of dog population sizes for planning of vaccination campaigns; and (d) limited resources for implementation of rabies surveillance and control. We address each of these issues in turn, presenting data from field studies and modelling approaches used in Tanzania, including burden of disease evaluations, detailed epidemiological studies, operational data from vaccination campaigns in different demographic and ecological settings, and economic analyses of the cost-effectiveness of dog vaccination for human rabies prevention.
  
  
  CONCLUSIONS
  We conclude that there are no insurmountable problems to canine rabies control in most of Africa; that elimination of canine rabies is epidemiologically and practically feasible through mass vaccination of domestic dogs; and that domestic dog vaccination provides a cost-effective approach to the prevention and elimination of human rabies deaths.
authors.affiliation: Boyd Orr Centre for Population and Ecosystem Health, University of Glasgow, Glasgow, United Kingdom. T.Lembo@vet.gla.ac.uk
authors.forename: Tiziana
authors.initials: T
authors.lastname: Lembo
authors.forename: Katie
authors.initials: K
authors.lastname: Hampson
authors.forename: Magai T
authors.initials: MT
authors.lastname: Kaare
authors.forename: Eblate
authors.initials: E
authors.lastname: Ernest
authors.forename: Darryn
authors.initials: D
authors.lastname: Knobel
authors.forename: Rudovick R
authors.initials: RR
authors.lastname: Kazwala
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Haydon
authors.forename: Sarah
authors.initials: S
authors.lastname: Cleaveland
mesh_terms: D000349:Africa / Q000453:epidemiology; D000818:Animals; D003140:Communicable Disease Control / Q000458:organization & administration; D004283:Dog Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D004285:Dogs; D006801:Humans; D032541:Mass Vaccination / Q000458:organization & administration; D011818:Rabies / Q000453:epidemiology* / Q000517:prevention & control / Q000662:veterinary*; D011819:Rabies Vaccines / Q000008:administration & dosage / Q000191:economics / Q000276:immunology*; D014611:Vaccination / Q000191:economics / Q000706:statistics & numerical data*
chemical_list: D011819:Rabies Vaccines