title: Optimal frequency of rabies vaccination campaigns in Sub-Saharan Africa.
abstract: Rabies causes more than 24 000 human deaths annually in Sub-Saharan Africa. The World Health Organization recommends annual canine vaccination campaigns with at least 70% coverage to control the disease. While previous studies have considered optimal coverage of animal rabies vaccination, variation in the frequency of vaccination campaigns has not been explored. To evaluate the cost-effectiveness of rabies canine vaccination campaigns at varying coverage and frequency, we parametrized a rabies virus transmission model to two districts of northwest Tanzania, Ngorongoro (pastoral) and Serengeti (agro-pastoral). We found that optimal vaccination strategies were every 2 years, at 80% coverage in Ngorongoro and annually at 70% coverage in Serengeti. We further found that the optimality of these strategies was sensitive to the rate of rabies reintroduction from outside the district. Specifically, if a geographically coordinated campaign could reduce reintroduction, vaccination campaigns every 2 years could effectively manage rabies in both districts. Thus, coordinated campaigns may provide monetary savings in addition to public health benefits. Our results indicate that frequency and coverage of canine vaccination campaigns should be evaluated simultaneously and tailored to local canine ecology as well as to the risk of disease reintroduction from surrounding regions.
authors.affiliation: Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA abilinski@g.harvard.edu.
authors.forename: Alyssa M
authors.identifier: 0000-0001-9108-6660
authors.initials: AM
authors.lastname: Bilinski
authors.affiliation: Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA.
authors.forename: Meagan C
authors.initials: MC
authors.lastname: Fitzpatrick
authors.affiliation: The Wistar Institute, 3601 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Rupprecht
authors.affiliation: Department of Health Policy and Management, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA.
authors.forename: A David
authors.initials: AD
authors.lastname: Paltiel
authors.affiliation: Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA.|Department of Ecology and Evolutionary Biology, Yale University, 165 Prospect Street, New Haven, CT 06511, USA.
authors.forename: Alison P
authors.initials: AP
authors.lastname: Galvani
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D004285:Dogs; D006801:Humans; D017589:Immunization Programs; D011818:Rabies / Q000453:epidemiology / Q000517:prevention & control*; D011819:Rabies Vaccines / Q000627:therapeutic use*; D011820:Rabies virus; D013636:Tanzania / Q000453:epidemiology; D014611:Vaccination / Q000662:veterinary*
chemical_list: D011819:Rabies Vaccines
keywords: One Health; Sub-Saharan Africa; cost-effectiveness; rabies; transmission model; vaccination