Where and when to vaccinate? Interdisciplinary design and evaluation of the 2018 Tanzanian anti-rabies campaign

•A two-phase vaccination against rabies was designed and executed in northern Tanzania, in 2018, which included geo-epidemiological and economic perspectives.•It had faster implementation: more people and larger areas were protected from rabies in less time.•Lower costs: by decreasing the time invol...

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Bibliographic Details
Published in:	International journal of infectious diseases Vol. 95; pp. 352 - 360
Main Authors:	Fasina, Folorunso O., Mtui-Malamsha, Niwael, Mahiti, Gladys R., Sallu, Raphael, OleNeselle, Moses, Rubegwa, Bachana, Makonnen, Yilma J., Kafeero, Fred, Ruheta, Martin, Nonga, Hezron E., Swai, Emmanuel, Makungu, Selemani, Killewo, Japhet, Otieno, Edward G., Lupindu, Athumani M., Komba, Erick, Mdegela, Robinson, Assenga, Justine K., Bernard, Jubilate, Hussein, Mohamed, Marandu, Walter, Warioba, James, Kaaya, Eliona, Masanja, Pius, Francis, Gundelinda, Kessy, Violet M., Savy, Janique, Choyo, Hija, Ochieng, Justus, Hoogesteijn, Almira L., Fasina, Margaret M., Rivas, Ariel L.
Format:	Journal Article
Language:	English
Published:	Canada Elsevier Ltd 01-06-2020 Elsevier
Subjects:	Dog Geo-epidemiology Health economics Human health One health Rabies Vaccination One health Human health Health economics Geo-epidemiology Rabies Vaccination Dog
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Summary:	•A two-phase vaccination against rabies was designed and executed in northern Tanzania, in 2018, which included geo-epidemiological and economic perspectives.•It had faster implementation: more people and larger areas were protected from rabies in less time.•Lower costs: by decreasing the time involved in the implementation and increasing the number of people and areas protected, the cost per person and animal protected decreased.Longer prevention: prevention may have lasted longer because the geographical density of virus carriers – dogs – decreased earlier. Hoping to improve health-related effectiveness, a two-phase vaccination against rabies was designed and executed in northern Tanzania in 2018, which included geo-epidemiological and economic perspectives. Considering the local bio-geography and attempting to rapidly establish a protective ring around a city at risk, the first phase intervened on sites surrounding that city, where the population density was lower than in the city at risk. The second phase vaccinated a rural area. No rabies-related case has been reported in the vaccinated areas for over a year post-immunisation; hence, the campaign is viewed as highly cost-effective. Other metrics included: rapid implementation (concluded in half the time spent on other campaigns) and the estimated cost per protected life, which was 3.28 times lower than in similar vaccinations. The adopted design emphasised local bio-geographical dynamics: it prevented the occurrence of an epidemic in a city with a higher demographic density than its surrounding area and it also achieved greater effectiveness than average interventions. These interdisciplinary, policy-oriented experiences have broad and immediate applications in settings of limited and/or time-sensitive (expertise, personnel, and time available to intervene) resources and conditions.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	1201-9712 1878-3511
DOI:	10.1016/j.ijid.2020.03.037