International Journal of Infectious Diseases (Jun 2020)

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

  • Folorunso O. Fasina,
  • Niwael Mtui-Malamsha,
  • Gladys R. Mahiti,
  • Raphael Sallu,
  • Moses OleNeselle,
  • Bachana Rubegwa,
  • Yilma J. Makonnen,
  • Fred Kafeero,
  • Martin Ruheta,
  • Hezron E. Nonga,
  • Emmanuel Swai,
  • Selemani Makungu,
  • Japhet Killewo,
  • Edward G. Otieno,
  • Athumani M. Lupindu,
  • Erick Komba,
  • Robinson Mdegela,
  • Justine K. Assenga,
  • Jubilate Bernard,
  • Mohamed Hussein,
  • Walter Marandu,
  • James Warioba,
  • Eliona Kaaya,
  • Pius Masanja,
  • Gundelinda Francis,
  • Violet M. Kessy,
  • Janique Savy,
  • Hija Choyo,
  • Justus Ochieng,
  • Almira L. Hoogesteijn,
  • Margaret M. Fasina,
  • Ariel L. Rivas

Journal volume & issue
Vol. 95
pp. 352 – 360

Abstract

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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.

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