Increased anger and stress and heightened connectivity between IFG and vmPFC in victims during social interaction.

Self-identification as a victim of violence may lead to increased negative emotions and stress and thus, may change both structure and function of the underlying neural network(s). In a trans-diagnostic sample of individuals who identified themselves as victims of violence and a matched control group with no prior exposure to violence, we employed a social exclusion paradigm, the Cyberball task, to stimulate the re-experience of stress. Participants were partially excluded in the ball-tossing game without prior knowledge. We analyzed group differences in brain activity and functional connectivity during exclusion versus inclusion in exclusion-related regions. The victim group showed increased anger and stress levels during all conditions. Activation patterns during the task did not differ between groups but an enhanced functional connectivity between the IFG and the right vmPFC distinguished victims from controls during exclusion. This effect was driven by aberrant connectivity in victims during inclusion rather than exclusion, indicating that victimization affects emotional responses and inclusion-related brain connectivity rather than exclusion-related brain activity or connectivity. Victims may respond differently to the social context itself. Enhanced negative emotions and connectivity deviations during social inclusion may depict altered social processing and may thus affect social interactions.

Borderline personality disorder and aggressive behavior: A study based on the DSM-5 alternative model.

INTRODUCTION: Unplanned reactive aggressive acts are a clinical feature of particular interest in patients with borderline personality disorder (BPD). The early identification of personality traits correlated to aggressive behavior is certainly desirable in BDP populations. This study analyzes a clinical sample of 122 adult outpatients with BPD referred to Adult Mental Health Services of the Department of Mental Health of Bologna, in Italy. METHODS: The study examines the relationship with personality facets of the DSM-5 alternative model for personality disorders (AMPD), Personality Inventory for DSM (PID-5), with respect to the four main components of aggression measured by the Aggression Questionnaire (AQ): hostility, anger, verbal and physical aggression. Using robust regression models, the relationships between PID-5 facets and domains and the aggression components under consideration were identified. RESULTS: Verbal and physical aggression in our sample of BPD outpatients is mainly associated to PID-5 antagonism domain. Physically aggressive behavior is also related to callousness facet. CONCLUSIONS: The traits most consistently associated with aggression were the domain of Antagonism and the facet of Hostility. The study findings highlight the need for clinicians working with individuals with BPD to pay particular attention to traits of hostility, callousness, and hostility to understand aggression.

Assessing psychopathic traits with the MMPI-3: Findings from correctional, university, and community samples.

OBJECTIVE: The Minnesota Multiphasic Personality Inventory (MMPI) instruments have a long history with respect to the assessment of psychopathic personality traits. The most recent version, the MMPI-3, should be in a good position to continue this tradition, and the aim of the current research was to evaluate its scales for this purpose. We examined, on the basis of previous research, how well conceptually relevant MMPI-3 scales mapped onto dominant contemporary psychopathy models: the traditional three-factor model and triarchic psychopathy model. HYPOTHESES: We hypothesized that MMPI-3 markers of internalizing would be negatively correlated with boldness, whereas broad and specific markers of externalizing proclivities would be associated with disinhibition and antisociality. We also hypothesized that egocentricity and callousness would be associated with MMPI-3 scales measuring various features of externalizing, interpersonal aggression/antagonism, and grandiosity. METHOD: We used archival samples of male prison inmates (n = 452), community members with externalizing proclivities (n = 205), and university students (n = 645). These participants completed the Expanded Levenson Self-Report Psychopathy Scale and the Triarchic Psychopathy Measure. RESULTS: Zero-order correlation analyses indicated support for many of our hypotheses across samples, with notable exceptions. Regression and dominance analyses yielded information about the most potent MMPI-3 predictors of each psychopathy domain, with consistency across the three samples. Boldness was associated with low scores on Emotional/Internalizing Dysfunction, Low Positive Emotions, Shyness, and Negative Emotionality/Neuroticism and high scores on Self-Importance and Dominance. For meanness and disinhibition, we found substantial overlap with MMPI-3 scales (e.g., Behavioral/Externalizing Dysfunction, Antisocial Behavior). Meanness was indicated by high Aggression, Cynicism, Aggressiveness, and Disaffiliativeness; disinhibition/antisociality was primarily marked by high Antisocial Behavior, Hypomanic Activation, Impulsivity, and Disconstraint; and Anger Proneness, Aggression, and Cynicism were secondary indicators. CONCLUSIONS: These findings provide support for using the MMPI-3 in clinical assessments to corroborate other sources of information regarding psychopathy as well as generate hypotheses for further consideration. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Implicit weight bias: shared neural substrates for overweight and angry facial expressions revealed by cross-adaptation.

The perception of facial expression plays a crucial role in social communication, and it is known to be influenced by various facial cues. Previous studies have reported both positive and negative biases toward overweight individuals. It is unclear whether facial cues, such as facial weight, bias facial expression perception. Combining psychophysics and event-related potential technology, the current study adopted a cross-adaptation paradigm to examine this issue. The psychophysical results of Experiments 1A and 1B revealed a bidirectional cross-adaptation effect between overweight and angry faces. Adapting to overweight faces decreased the likelihood of perceiving ambiguous emotional expressions as angry compared to adapting to normal-weight faces. Likewise, exposure to angry faces subsequently caused normal-weight faces to appear thinner. These findings were corroborated by bidirectional event-related potential results, showing that adaptation to overweight faces relative to normal-weight faces modulated the event-related potential responses of emotionally ambiguous facial expression (Experiment 2A); vice versa, adaptation to angry faces relative to neutral faces modulated the event-related potential responses of ambiguous faces in facial weight (Experiment 2B). Our study provides direct evidence associating overweight faces with facial expression, suggesting at least partly common neural substrates for the perception of overweight and angry faces.

Comparative Study on the Immunogenicity and Efficacy of Different Post-exposure Intramuscular Rabies Vaccination Regimens in China.

Objective: This study aimed to compare the current Essen rabies post-exposure immunization schedule (0-3-7-14-28) in China and the simple 4-dose schedule (0-3-7-14) newly recommended by the World Health Organization in terms of their safety, efficacy, and protection. Methods: Mice were vaccinated according to different immunization schedules, and blood was collected for detection of rabies virus neutralizing antibodies (RVNAs) on days 14, 21, 28, 35, and 120 after the first immunization. Additionally, different groups of mice were injected with lethal doses of the CVS-11 virus on day 0, subjected to different rabies immunization schedules, and assessed for morbidity and death status. In a clinical trial, 185 rabies-exposed individuals were selected for post-exposure vaccination according to the Essen schedule, and blood was collected for RVNAs detection on days 28 and 42 after the first immunization. Results: A statistically significant difference in RVNAs between mice in the Essen and 0-3-7-14 schedule groups was observed on the 35th day ( P < 0.05). The groups 0-3-7-14, 0-3-7-21, and 0-3-7-28 showed no statistically significant difference ( P > 0.05) in RVNAs levels at any time point. The post-exposure immune protective test showed that the survival rate of mice in the control group was 20%, whereas that in the immunization groups was 40%. In the clinical trial, the RVNAs positive conversion rates on days 28 (14 days after 4 doses) and 42 (14 days after 5 doses) were both 100%, and no significant difference in RVNAs levels was observed ( P > 0.05). Conclusion: The simple 4-dose schedule can produce sufficient RVNAs levels, with no significant effect of a delayed fourth vaccine dose (14-28 d) on the immunization potential.

Immunogenicity evaluation of a bivalent vaccine based on a recombinant rabies virus expressing gB protein of FHV-1 in mice and cats.

Feline viral rhinotracheitis (FVR) is caused by the feline herpesvirus-1 (FHV-1), which commonly results in upper respiratory symptoms, and can result in death in the kittens and weak cats. Rabies is an infectious disease with zoonotic characteristics highly relevant to public health and also poses a serious threat to cats. Vaccines are the most effective method to control the spread of both FHV-1 and RABV and have the advantage that they produce long-term specific immune responses. In this study, we constructed a bivalent vaccine against FHV-1 and rabies virus (RABV) simultaneously. The vaccine was constructed by cloning FHV-1 gB into a RABV based vector, and the recombinant RABV (SRV9-FHV-gB) expressing the FHV-1 gB protein was rescued. The growth characteristics of SRV9-FHV-gB were analyzed on NA and BSR cells. To assess the immunogenicity of the vaccine, mice and cats were immunized with SRV9-FHV-gB supplemented with Gel02 adjuvant. The SRV9-FHV-gB exhibited the same growth characteristics as the parent virus SRV9 in both BSR cells and NA cells. The safety of SRV9-FHV-gB was evaluated using 5-day-old and 14-day-old suckling mice. The results showed that mice infected with the SRV9-FHV-gB survived for longer than those in the SRV9 group. Mice immunized with inactivated SRV9-FHV-gB produced high titers of specific antibodies against FHV-1 and neutralizing antibodies against RABV. Cats that received three immunizations with SRV9-FHV-gB also produced neutralizing antibodies against both FHV-1 and RABV. This study represents the first time that a bivalent vaccine targeting FHV-1 and RABV has been constructed, laying the foundations and providing inspiration for the development of other multivalent vaccines.

Spatial clusters, temporal behavior, and risk factors analysis of rabies in livestock in Ecuador.

Rabies, a globally distributed and highly lethal zoonotic neglected tropical disease, has a significant impact in South America. In Ecuador, animal rabies cases are primarily linked to livestock, and hematophagous bats play a crucial role in disease transmission. This study aims to identify temporal trends, spatial patterns, and risk factors for animal rabies in Ecuador between 2014 and 2019. Epidemiological survey reports from the official Animal Rabies Surveillance Program of the Phyto and Zoosanitary Regulation and Control Agency of Ecuador (AGROCALIDAD) were used. The Animal Rabies Surveillance Program from AGROCALIDAD consists of an official passive surveillance program that receives reports from farmers or individuals (both trained or untrained) who have observed animals with neurological clinical signs and lesions compatible with bat bites, or who have seen or captured bats on their farms or houses. Once this report is made, AGROCALIDAD personnel is sent for field inspection, having to confirm the suspicion of rabies based on farm conditions and compatibility of signs. AGROCALIDAD personnel collect samples from all suspicious animals, which are further processed and analyzed using the Direct Fluorescent Antibody (DFA) test for rabies confirmatory diagnosis. In this case, study data comprised 846 bovine farms (with intra-farm sample sizes ranging from 1 to 16 samples) located in different ecoregions of Ecuador; out of these, 397 (46.93%) farms tested positive for animal rabies, revealing six statistically significant spatial clusters. Among these clusters, three high-risk areas were identified in the southeast of Ecuador. Seasonality was confirmed by the Ljung-Box test for both the number of cases (p < 0.001) and the positivity rate (p < 0.001). The Pacific Coastal lowlands and Sierra regions showed a lower risk of positivity compared to Amazonia (OR = 0.529; 95% CI = 0.318 - 0.883; p = 0.015 and OR = 0.633; 95% CI = 0.410 - 0.977; p = 0.039, respectively). The breeding of non-bovine animal species demonstrated a lower risk of positivity to animal rabies when compared to bovine (OR = 0.145; 95% CI = 0.062 - 0.339; p < 0.001). Similarly, older animals exhibited a lower risk (OR = 0.974; 95% CI = 0.967 - 0.981; p < 0.001). Rainfall during the rainy season was also found to decrease the risk of positivity to animal rabies (OR = 0.996; 95% CI = 0.995 - 0.998; p < 0.001). This study underscores the significance of strengthening the national surveillance program for the prevention and control of animal rabies in Ecuador and other countries facing similar epidemiological, social, and geographical circumstances.

A meta-analytic review of anger management activities that increase or decrease arousal: What fuels or douses rage?

Anger is an unpleasant emotion that most people want to get rid of. Some anger management activities focus on decreasing arousal (e.g., deep breathing, mindfulness, meditation), whereas others focus on increasing arousal (e.g., hitting a bag, jogging, cycling). This meta-analytic review, based on 154 studies including 184 independent samples involving 10,189 participants, tested the effectiveness of both types of activities. The results indicated that arousal-decreasing activities decreased anger and aggression (g = -0.63, [-0.82, -0.43]), and the results were robust. Effects were stable over time for participants of different genders, races, ages, and cultures. Arousal-decreasing activities were effective in students and non-students, in criminal offenders and non-offenders, and in individuals with and without intellectual disabilities. Arousal-decreasing activities were effective regardless of how they were delivered (e.g., digital platforms, researchers, therapists), in both group and individual sessions, and in both field and laboratory settings. In contrast, arousal-increasing activities were ineffective overall (g = -0.02, [-0.13, 0.09]) and were heterogenous and complex. These findings do not support the ideas that venting anger or going for a run are effective anger management activities. A more effective approach for managing anger is "turning down the heat" or calming down by engaging in activities that decrease arousal.

Maternal attachment security modulates the relationship between vulnerability to anxiety and attentional bias to threat in healthy children.

This study aimed to investigate whether attentional bias to threat, commonly observed in clinically anxious children, also manifests in healthy children, potentially aiding the early detection of at-risk individuals. Additionally, it sought to explore the moderating role of parent-child attachment security on the association between vulnerability factors (anxiety sensitivity, intolerance of uncertainty, perseverative cognitions) as indicators of vulnerability to anxiety, and attentional bias towards threat in healthy children. A total of 95 children aged 8 to 12 years completed the Visual Search Task to assess attentional bias. Vulnerability to anxiety was measured using a composite score derived from the Childhood Anxiety Sensitivity Index, Intolerance of Uncertainty Scale for Children, and Perseverative Thinking Questionnaire. Parent-child attachment security was assessed using the Security Scale-Child Self-Report. Analyses revealed that higher vulnerability to anxiety was associated with faster detection of anger-related stimuli compared to neutral ones, and this association was further influenced by high maternal security. These findings in healthy children suggest an interaction between specific factors related to anxiety vulnerability and the security of the mother-child relationship, leading to cognitive patterns resembling those seen in clinically anxious individuals. These results hold promise for early identification of children at risk of developing anxiety disorders.

Analyzing the effects of physical activity levels on aggressive behavior in college students using a chain-mediated model.

This study aims to examine the mediating role of self-efficacy (SE) and self-control (SC) in the relationship between physical activity (PA) and aggressive behaviors (AB) among college students. It provides a basis for the prevention and control of AB among college students. This study employed a survey research methodology, including the PA Level Scale, the General Self-efficacy Scale, the Self-control Scale, and the Chinese Aggressive Behaviors Scale on 950 college students. The chain mediating effect test and Bootstrap analysis were applied. The results were as follows: (1) There was a main effect of PA on SE, SC, and AB as well as all sub-indicators (physical aggression, verbal aggression, anger, hostility, self-directed aggression), i.e., PA had a direct effect on the control of all three; (2) PA level was significantly negatively correlated with AB and significantly positively correlated with SE and SC. That is, the higher the level of PA, the better the SE and SC, and the lower the probability of AB; (3) The three pathways had mediating effects: PA → SE → AB, PA → SC → AB, PA → SE → SC → AB, with effect sizes of 8.78%, 28.63%, and 19.08%, respectively. It is concluded that regular PA is a potent method for decreasing aggressive behavior and psychological issues in university students while additionally promoting self-efficacy and self-control. Increasing the intensity of PA may enhance the effectiveness of these chain benefits.

The effect of aggressive fantasizing on aggressive inclinations: Moderating effects of dispositional anger expression.

Experiencing victimization or mistreatment often induces feelings of anger. The catharsis hypothesis suggests that venting anger may aid in alleviating these negative emotions. Although this hypothesis has faced criticism, therapeutic interventions rooted in catharsis are employed to assist victims in managing their anger. One notable application of the catharsis principle in psychotherapeutic practice with victims involves engaging in aggressive fantasies: Victims who harbor aggressive fantasies against their offenders are supported in working with these fantasies to navigate the complex emotions arising from their victimization. Research investigating the effects of aggressive fantasizing on victims has yielded inconsistent findings, with some studies indicating positive and others suggesting negative outcomes. Herein, we examine whether (instructed) aggressive fantasizing diminishes (catharsis hypothesis) or heightens (escalation hypothesis) subsequent aggressive inclinations compared to non-aggressive fantasizing. Additionally, the moderating role of victims' dispositional tendencies to express anger, specifically Anger Expression-out and Anger Expression-control, in the relationship between aggressive fantasizing and aggressive inclinations was examined. We recruited individuals (N = 245) who had experienced victimization through highly unfair treatment and instructed them to imagine confronting their wrongdoer using either aggressive or non-aggressive communication. Participants then reported their aggressive inclinations. Data supported the escalation hypothesis, revealing that aggressive fantasizing amplifies subsequent aggressive inclinations. Importantly, individuals with higher Anger Expression-out demonstrated greater susceptibility to this effect; whereas, Anger Expression-control did not moderate the link between aggressive fantasizing and inclinations. These findings further challenge the catharsis hypothesis and underscore the role of dispositional anger expression tendencies on the effects of aggressive fantasizing.

Anger and disgust shape judgments of social sanctions across cultures, especially in high individual autonomy societies.

When someone violates a social norm, others may think that some sanction would be appropriate. We examine how the experience of emotions like anger and disgust relate to the judged appropriateness of sanctions, in a pre-registered analysis of data from a large-scale study in 56 societies. Across the world, we find that individuals who experience anger and disgust over a norm violation are more likely to endorse confrontation, ostracism and, to a smaller extent, gossip. Moreover, we find that the experience of anger is consistently the strongest predictor of judgments of confrontation, compared to other emotions. Although the link between state-based emotions and judgments may seem universal, its strength varies across countries. Aligned with theoretical predictions, this link is stronger in societies, and among individuals, that place higher value on individual autonomy. Thus, autonomy values may increase the role that emotions play in guiding judgments of social sanctions.

Bewilderment, aquilombar, and the antimanicolonial: three ideas to radicalize Brazilian Psychiatric Reform. / Desnortear, aquilombar e o antimanicolonial: três ideias-força para radicalizar a Reforma Psiquiátrica Brasileira.

This article is part of a study aimed to map antiracist knowledge and practices in mental health by monitoring the practices of three collectives of professionals working in/with the psychosocial care network in the city of São Paulo, allowing us to characterize their intervention strategies. To contribute to the conceptualization of this article, through a review of the decolonial literature, three major ideas have been outlined that have allowed us to give substance to the decolonization of Psychiatric Reform: bewilderment, which, in dialogue with Achille Mbembe and Frantz Fanon, invites us to affirm madness and blackness without, however, establishing fixations; the antimanicolonial, which occurs in the promotion of the free and countercultural exercise of imagining diasporas, in light of that proposed by Édouard Glissant, Paul Gilroy, and Lélia Gonzales regarding an Atlantic (de)orientation in which elements of the black diaspora and Latin America can re-signify blackness and unreason; and aquilombar, as a liberatory praxis whose genesis lies in the quilombos as a living metaphor for the radicalisation of relationships in differences, based on Abdias do Nascimento's quilombismo, Clóvis Moura's quilombagem, Beatriz Nascimento's (k)quilombo, and Mariléa de Almeida's devir quilomba.

Este artigo é parte de uma pesquisa que buscou cartografar saberes e fazeres antirracistas em saúde mental por meio do acompanhamento das práticas de três coletivos de profissionais trabalhando na/com a rede de atenção psicossocial na cidade de São Paulo, o que possibilitou caracterizar suas estratégias de intervenção. Buscando contribuir para sua conceitualização, delineamos, por meio da revisão da literatura descolonial, três ideias-força que nos permitem dar corpo à descolonização da Reforma Psiquiátrica: o desnortear, que, em diálogo com Achille Mbembe e Frantz Fanon, nos convida à afirmação da loucura e da negritude - sem, no entanto, estabelecer fixações; o antimanicolonial, que se dá no fomento do exercício livre e contracultural de imaginar diásporas, em relação com as proposições de Édouard Glissant, Paul Gilroy e Lélia Gonzales quanto a uma (des)orientação atlântica na qual elementos da diáspora negra e da América Latina possam ressignificar negritude e desrazão; e o aquilombar, como práxis libertária que tem em sua gênese os quilombos como metáfora viva da radicalização das relações nas diferenças, a partir do quilombismo de Abdias do Nascimento, da quilombagem de Clóvis Moura, do (k)quilombo de Beatriz Nascimento e do devir quilomba de Mariléa de Almeida.

Distinct correlation network of clinical characteristics in suicide attempters having adolescent major depressive disorder with non-suicidal self-injury.

Suicidal behavior and non-suicidal self-injury (NSSI) are common in adolescent patients with major depressive disorder (MDD). Thus, delineating the unique characteristics of suicide attempters having adolescent MDD with NSSI is important for suicide prediction in the clinical setting. Here, we performed psychological and biochemical assessments of 130 youths having MDD with NSSI. Participants were divided into two groups according to the presence/absence of suicide attempts (SAs). Our results demonstrated that the age of suicide attempters is lower than that of non-attempters in participants having adolescent MDD with NSSI; suicide attempters had higher Barratt Impulsiveness Scale (BIS-11) impulsivity scores and lower serum CRP and cortisol levels than those having MDD with NSSI alone, suggesting levels of cortisol and CRP were inversely correlated with SAs in patients with adolescent MDD with NSSI. Furthermore, multivariate regression analysis revealed that NSSI frequency in the last month and CRP levels were suicidal ideation predictors in adolescent MDD with NSSI, which may indicate that the increased frequency of NSSI behavior is a potential risk factor for suicide. Additionally, we explored the correlation between psychological and blood biochemical indicators to distinguish suicide attempters among participants having adolescent MDD with NSSI and identified a unique correlation network that could serve as a marker for suicide attempters. Our research data further suggested a complex correlation between the psychological and behavioral indicators of impulsivity and anger. Therefore, our study findings may provide clues to identify good clinical warning signs for SA in patients with adolescent MDD with NSSI.

An experience of multidisciplinary tutorials sessions about antibiotics in the third year of pharmacy studies in Angers, France: learning assessment and evaluation of students' feelings by a mixed approach.

For undergraduate pharmacy students, the first step of antimicrobial stewardship learning objectives is to integrate antimicrobial knowledge from the foundational sciences. We hypothesised that using a multidisciplinary approach including two sessions of tutorials could be relevant in term of students' interest, satisfaction and learning retention time. The evaluation of students' feelings was based on a questionnaire including different dimensions and three focus groups with four students. Quantitative data were analysed with the EPI-INFO 7.2 software and a thematic analysis was implemented for qualitative data by using NVivo 12 software. The evaluation of students' learning concerned both short-time learning retention (STLR) and medium-time learning retention (MTLR), six months after the last session. Overall, 63 students responded to the questionnaire. Most of them appreciated the tutorials according to the different dimensions envisaged. Focus groups confirmed the interest of students for the multidisciplinary approach, interactions with teachers and opportunities of learning transfers. Concurrently, a lack of self-efficacy, low confidence towards the other students, external regulation of motivation and poor autonomy were recorded for some participants. Finally, there was no significant decrease between the scores of the STLR assessment and those of the MTLR assessment (58.5 ± 12.1/100 and 54.4 ± 8.9/100, respectively).

Do They Look the Same Unless They Are Angry? Investigating the Other-Race Effect in the Presence of Angry Expressions.

Ethnic out-group members are disproportionately more often the victim of misidentifications. The so-called other-race effect (ORE), the tendency to better remember faces of individuals belonging to one's own ethnic in-group than faces belonging to an ethnic out-group, has been identified as one causal ingredient in such tragic incidents. Investigating an important aspect for the ORE-that is, emotional expression-the seminal study by Ackerman and colleagues (2006) found that White participants remembered neutral White faces better than neutral Black faces, but crucially, Black angry faces were better remembered than White angry faces (i.e., a reversed ORE). In the current study, we sought to replicate this study and directly tackle the potential causes for different results with later work. Three hundred ninety-six adult White U.S. citizens completed our study in which we manipulated the kind of employed stimuli (as in the original study vs. more standardized ones) whether participants knew of the recognition task already at the encoding phase. Additionally, participants were asked about the unusualness of the presented faces. We were able to replicate results from the Ackerman et al. (2006) study with the original stimuli but not with more standardized stimuli.

Mixed methods to evaluate knowledge, attitudes and practices (KAP) towards rabies in central and remote communities of Moramanga district, Madagascar.

Control of dog-mediated rabies relies on raising awareness, access to post-exposure prophylaxis (PEP) and mass dog vaccination. To assess rabies awareness in Moramanga district, Madagascar, where rabies is endemic, two complementary quantitative and qualitative approaches were carried out in 2018. In the quantitative approach, a standardized questionnaire was administered to 334 randomized participants living in 170 households located less than 5 km from the anti-rabies treatment center (ARTC) located in Moramanga city (thereafter called the central area), and in 164 households located more than 15 km away from the ARTC in two rural communes (thereafter called the remote area). Logistic regression models were fitted to identify factors influencing knowledge and practice scores. The qualitative approach consisted in semi-structured interviews conducted with 28 bite victims who had consulted the ARTC, three owners of biting dogs, three ARTC staff and two local authorities. Overall, 15.6% (52/334) of households owned at least one dog. The dog-to-human ratio was 1:17.6. The central area had a significantly higher dog bite incidence (0.53 per 100 person-years, 95% CI: 0.31-0.85) compared to the remote area (0.22 per 100 person-years, 95% CI: 0.09-0.43) (p = 0.03). The care pathway following a bite depended on wound severity, how the dog was perceived and its owner's willingness to cover costs. Rabies vaccination coverage in dogs in the remote area was extremely low (2.4%). Respondents knew that vaccination prevented animal rabies but owners considered that their own dogs were harmless and cited access and cost of vaccine as main barriers. Most respondents were not aware of the existence of the ARTC (85.3%), did not know the importance of timely access to PEP (92.2%) or that biting dogs should be isolated (89.5%) and monitored. Good knowledge scores were significantly associated with having a higher socio-economic status (OR = 2.08, CI = 1.33-3.26) and living in central area (OR = 1.91, CI = 1.22-3.00). Good practice scores were significantly associated with living in central area (OR = 4.78, CI = 2.98-7.77) and being aware of the ARTC's existence (OR = 2.29, CI = 1.14-4.80). In Madagascar, knowledge on rabies was disparate with important gaps on PEP and animal management. Awareness campaigns should inform communities (i) on the importance of seeking PEP as soon as possible after an exposure, whatever the severity of the wound and the type of biting dog who caused it, and (ii) on the existence and location of ARTCs where free-of-charge PEP is available. They should also encourage owners to isolate and monitor the health of biting dogs. Above all, awareness and dog vaccination campaigns should be designed so as to reach the more vulnerable remote rural populations as knowledge, good practices and vaccination coverage were lower in these areas. They should also target households with a lower socio-economic status. If awareness campaigns are likely to succeed in improving access to ARTCs in Madagascar, their impact on prompting dog owners to vaccinate their own dogs seems more uncertain given the financial and access barriers. Therefore, to reach the 70% dog vaccination coverage goal targeted in rabies elimination programs, awareness campaigns must be combined with free-of-charge mass dog vaccination.

Bovine rabies cases in Ecuador: a retrospective cross-sectional observational study (2007 to 2020).

The hematophagous bats are usually the main reservoir of sylvatic rabies, being one of the most important viral zoonoses affecting humans and livestock in Latin America. Despite the most countries have already studied spatio-temporal distribution of bovine rabies, however, in Ecuador, little has been reported about the state of rabies in the country. Aiming to this objective, a descriptive observational study was realized from 2007 to 2020 based on the formal reports by WAHI-OIE and surveillance of bovine rabies retrieved from its official website. During the study period in Ecuador, some 895 cases of rabies were confirmed in cattle. In addition, in the total of bovine rabies cases seen in Andean and Coast regions (185 effected bovines), Loja and Esmeraldas had 95 (6.16% cases per 10,000 animals) and 51 (1.7% cases per 10,000 animals), respectively. Furthermore, the Amazon region indicated higher rabies cases in cattle than to the observed in other regions (710 rabies cases) while it was highly fluctuating with respect to the years (9.74 to 42.82% cases per 10,000 animals). However, Zamora (292 rabies cases), Orellana (115 rabies cases) and Sucumbíos (113 rabies cases) yielded the highest incidence rates than other provinces (9 to 42% cases per 10,000 animals). Based on this evidence, it has been fundamental to assess the current national program for preventing and control of the sylvatic rabies, being also necessary to include concept of the ecology of the vampire bat. Regardless of these results, vaccination is vital for control programs to prevent rabies in livestock and need to be widely increased for limiting their geographic and temporal spread.