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Towards the elimination of dog-mediated rabies: development and application of an evidence-based management tool.
Rysava, Kristyna; Mancero, Tamara; Caldas, Eduardo; de Carvalho, Mary Freire; Castro, André P B; Gutiérrez, Veronica; Haydon, Daniel T; Johnson, Paul C D; Mancy, Rebecca; Montebello, Lúcia R; Rocha, Silene M; Gonzalez Roldan, Jesús F; Vigilato, Marco Antonio Natal; Vilas, Victor Del Rio; Hampson, Katie.
Afiliación
  • Rysava K; University of Warwick, School of Life Sciences, Gibbet Hill Road, Coventry, UK. K.Rysava@warwick.ac.uk.
  • Mancero T; University of Glasgow, Institute of Biodiversity, Animal Health and Comparative Medicine, Graham Kerr building, MVLS, Glasgow, G12 8QQ, UK. K.Rysava@warwick.ac.uk.
  • Caldas E; Pan American Health Organization (PAHO), Duque de Caxias, Rio de Janeiro, Brazil.
  • de Carvalho MF; Virology, Central Laboratory, State Center for Health Surveillance, State Department of Health, São Paulo, Rio Grande do Sul, Brazil.
  • Castro APB; Pan American Health Organization (PAHO), Duque de Caxias, Rio de Janeiro, Brazil.
  • Gutiérrez V; Ministry of Health, Brasília, Distrito Federal, Brazil.
  • Haydon DT; Ministry of Health, Mexico, Distrito Federal, Mexico.
  • Johnson PCD; University of Glasgow, Institute of Biodiversity, Animal Health and Comparative Medicine, Graham Kerr building, MVLS, Glasgow, G12 8QQ, UK.
  • Mancy R; University of Glasgow, Institute of Biodiversity, Animal Health and Comparative Medicine, Graham Kerr building, MVLS, Glasgow, G12 8QQ, UK.
  • Montebello LR; University of Glasgow, Institute of Biodiversity, Animal Health and Comparative Medicine, Graham Kerr building, MVLS, Glasgow, G12 8QQ, UK.
  • Rocha SM; Ministry of Health, Brasília, Distrito Federal, Brazil.
  • Gonzalez Roldan JF; Ministry of Health, Brasília, Distrito Federal, Brazil.
  • Vigilato MAN; Ministry of Health, Mexico, Distrito Federal, Mexico.
  • Vilas VDR; Pan American Health Organization (PAHO), Duque de Caxias, Rio de Janeiro, Brazil.
  • Hampson K; Pan American Health Organization (PAHO), Duque de Caxias, Rio de Janeiro, Brazil.
BMC Infect Dis ; 20(1): 778, 2020 Oct 20.
Article en En | MEDLINE | ID: mdl-33081712
ABSTRACT

BACKGROUND:

International organizations advocate for the elimination of dog-mediated rabies, but there is only limited guidance on interpreting surveillance data for managing elimination programmes. With the regional programme in Latin America approaching elimination of dog-mediated rabies, we aimed to develop a tool to evaluate the programme's performance and generate locally-tailored rabies control programme management guidance to overcome remaining obstacles.

METHODS:

We developed and validated a robust algorithm to classify progress towards rabies elimination within sub-national administrative units, which we applied to surveillance data from Brazil and Mexico. The method combines criteria that are easy to understand, including logistic regression analysis of case detection time series, assessment of rabies virus variants, and of incursion risk. Subjecting the algorithm to robustness testing, we further employed simulated data sub-sampled at differing levels of case detection to assess the algorithm's performance and sensitivity to surveillance quality.

RESULTS:

Our tool demonstrated clear epidemiological transitions in Mexico and Brazil most states progressed rapidly towards elimination, but a few regressed due to incursions and control lapses. In 2015, dog-mediated rabies continued to circulate in the poorest states, with foci remaining in only 1 of 32 states in Mexico, and 2 of 27 in Brazil, posing incursion risks to the wider region. The classification tool was robust in determining epidemiological status irrespective of most levels of surveillance quality. In endemic settings, surveillance would need to detect less than 2.5% of all circulating cases to result in misclassification, whereas in settings where incursions become the main source of cases the threshold detection level for correct classification should not be less than 5%.

CONCLUSION:

Our tool provides guidance on how to progress effectively towards elimination targets and tailor strategies to local epidemiological situations, while revealing insights into rabies dynamics. Post-campaign assessments of dog vaccination coverage in endemic states, and enhanced surveillance to verify and maintain freedom in states threatened by incursions were identified as priorities to catalyze progress towards elimination. Our finding suggests genomic surveillance should become increasingly valuable during the endgame for discriminating circulating variants and pinpointing sources of incursions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rabia / Virus de la Rabia / Control de Infecciones / Enfermedades de los Perros / Erradicación de la Enfermedad Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Animals / Humans País/Región como asunto: America do sul / Brasil / Mexico Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2020 Tipo del documento: Article País de afiliación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rabia / Virus de la Rabia / Control de Infecciones / Enfermedades de los Perros / Erradicación de la Enfermedad Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Animals / Humans País/Región como asunto: America do sul / Brasil / Mexico Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2020 Tipo del documento: Article País de afiliación: Reino Unido