Measuring the impact of an integrated bite case management program on the detection of canine rabies cases in Vietnam
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Published:2023-10-18
Issue:
Volume:11
Page:
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ISSN:2296-2565
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Container-title:Frontiers in Public Health
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language:
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Short-container-title:Front. Public Health
Author:
Ross Yasmeen B.,Vo Chuong Dinh,Bonaparte Sarah,Phan Minh Quang,Nguyen Diep Thi,Nguyen Thin Xuan,Nguyen Thanh Tat,Orciari Lillian,Nguyen Tho Dang,Nguyen Oanh Kim Thi,Do Trang Thuy,Dao Anh Thi Phuong,Wallace Ryan,Nguyen Long Van,
Abstract
IntroductionDog-mediated rabies is enzootic in Vietnam, resulting in at least 70 reported human deaths and 500,000 human rabies exposures annually. In 2016, an integrated bite cases management (IBCM) based surveillance program was developed to improve knowledge of the dog-mediated rabies burden in Phu Tho Province of Vietnam.MethodsThe Vietnam Animal Rabies Surveillance Program (VARSP) was established in four stages: (1) Laboratory development, (2) Training of community One Health workers, (3) Paper-based-reporting (VARSP 1.0), and (4) Electronic case reporting (VARSP 2.0). Investigation and diagnostic data collected from March 2016 to December 2019 were compared with historical records of animal rabies cases dating back to January 2012. A risk analysis was conducted to evaluate the probability of a rabies exposure resulting in death after a dog bite, based on data collected over the course of an IBCM investigation.ResultsPrior to the implementation of VARSP, between 2012 and 2015, there was an average of one rabies investigation per year, resulting in two confirmed and two probable animal rabies cases. During the 46 months that VARSP was operational (2016 – 2019), 1048 animal investigations were conducted, which identified 79 (8%) laboratory-confirmed rabies cases and 233 (22%) clinically-confirmed(probable) cases. VARSP produced a 78-fold increase in annual animal rabies case detection (one cases detected per year pre-VARSP vs 78 cases per year under VARSP). The risk of succumbing to rabies for bite victims of apparently healthy dogs available for home quarantine, was three deaths for every 10,000 untreated exposures.DiscussionA pilot IBCM model used in Phu Tho Province showed promising results for improving rabies surveillance, with a 26-fold increase in annual case detection after implementation of a One Health model. The risk for a person bitten by an apparently healthy dog to develop rabies in the absence of rabies PEP was very low, which supports the WHO recommendations to delay PEP for this category of bite victims, when trained animal assessors are available and routinely communicate with the medical sector. Recent adoption of an electronic IBCM system is likely to expedite adoption of VARSP 2.0 to other Provinces and improve accuracy of field decisions and data collection.
Publisher
Frontiers Media SA
Subject
Public Health, Environmental and Occupational Health
Reference26 articles.
1. Estimating the global burden of endemic canine rabies;Hampson;PLoS Negl Trop Dis,2015
2. Re-evaluating the burden of rabies in Africa and Asia;Knobel;Bull World Health Organ,2005
3. Progress towards rabies control and elimination in Vietnam;Nguyen;Rev Sci Tech,2019