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

Int J Infect Dis. 2020 Jun:95:352-360. doi: 10.1016/j.ijid.2020.03.037. Epub 2020 Mar 20.

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Dog; Geo-epidemiology; Health economics; Human health; One health; Rabies; Vaccination.

Publication types

  • Evaluation Study

MeSH terms

  • Animals
  • Cat Diseases / prevention & control
  • Cats
  • Cost-Benefit Analysis
  • Dog Diseases / prevention & control
  • Dogs
  • Female
  • Humans
  • Immunization Programs* / economics
  • Rabies / economics
  • Rabies / prevention & control*
  • Rabies / transmission
  • Rabies Vaccines / administration & dosage*
  • Rabies Vaccines / economics
  • Tanzania

Substances

  • Rabies Vaccines