title: Heterogeneity in the spread and control of infectious disease: consequences for the elimination of canine rabies.
abstract: Understanding the factors influencing vaccination campaign effectiveness is vital in designing efficient disease elimination programmes. We investigated the importance of spatial heterogeneity in vaccination coverage and human-mediated dog movements for the elimination of endemic canine rabies by mass dog vaccination in Region VI of the Philippines (Western Visayas). Household survey data was used to parameterise a spatially-explicit rabies transmission model with realistic dog movement and vaccination coverage scenarios, assuming a basic reproduction number for rabies drawn from the literature. This showed that heterogeneous vaccination reduces elimination prospects relative to homogeneous vaccination at the same overall level. Had the three vaccination campaigns completed in Region VI in 2010-2012 been homogeneous, they would have eliminated rabies with high probability. However, given the observed heterogeneity, three further campaigns may be required to achieve elimination with probability 0.95. We recommend that heterogeneity be reduced in future campaigns through targeted efforts in low coverage areas, even at the expense of reduced coverage in previously high coverage areas. Reported human-mediated dog movements did not reduce elimination probability, so expending limited resources on restricting dog movements is unnecessary in this endemic setting. Enhanced surveillance will be necessary post-elimination, however, given the reintroduction risk from long-distance dog movements.
authors.affiliation: Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK, G12 8QQ.
authors.forename: Elaine A
authors.initials: EA
authors.lastname: Ferguson
authors.affiliation: Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK, G12 8QQ.
authors.forename: Katie
authors.initials: K
authors.lastname: Hampson
authors.affiliation: Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK, G12 8QQ.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cleaveland
authors.affiliation: Animal Welfare Coalition, Dacon Building, 2281 Chino Roces Ave, Makati, Metro Manila, Philippines.
authors.forename: Ramona
authors.initials: R
authors.lastname: Consunji
authors.affiliation: Department of Health, San Lazaro Compound, Santa Cruz, Manila, Metro Manila, Philippines.
authors.forename: Raffy
authors.initials: R
authors.lastname: Deray
authors.affiliation: Wise Monkey Foundation, 15600 NE 8th St, Suite B1, P #725, Bellevue, WA 98008, USA.
authors.forename: John
authors.initials: J
authors.lastname: Friar
authors.affiliation: Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK, G12 8QQ.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Haydon
authors.affiliation: Department of Health, San Lazaro Compound, Santa Cruz, Manila, Metro Manila, Philippines.
authors.forename: Joji
authors.initials: J
authors.lastname: Jimenez
authors.affiliation: Animal Welfare Coalition, Dacon Building, 2281 Chino Roces Ave, Makati, Metro Manila, Philippines.
authors.forename: Marlon
authors.initials: M
authors.lastname: Pancipane
authors.affiliation: Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK, G12 8QQ.
authors.forename: Sunny E
authors.initials: SE
authors.lastname: Townsend
mesh_terms: D000818:Animals; D003140:Communicable Disease Control; D003141:Communicable Diseases / Q000453:epidemiology / Q000635:transmission*; D060740:Disease Eradication; D004283:Dog Diseases / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D004285:Dogs; D005843:Geography; D006801:Humans; D032541:Mass Vaccination; D010679:Philippines / Q000453:epidemiology; D011818:Rabies / Q000662:veterinary*; D011819:Rabies Vaccines / Q000008:administration & dosage / Q000276:immunology; D012307:Risk Factors; D014611:Vaccination
chemical_list: D011819:Rabies Vaccines