Folorunso O Fasina1, Niwael Mtui-Malamsha2, Gladys R Mahiti3, Raphael Sallu2, Moses OleNeselle2, Bachana Rubegwa2, Yilma J Makonnen2, Fred Kafeero2, Martin Ruheta4, Hezron E Nonga4, Emmanuel Swai4, Selemani Makungu4, Japhet Killewo3, Edward G Otieno5, Athumani M Lupindu5, Erick Komba5, Robinson Mdegela5, Justine K Assenga6, Jubilate Bernard7, Mohamed Hussein3, Walter Marandu8, James Warioba9, Eliona Kaaya10, Pius Masanja10, Gundelinda Francis10, Violet M Kessy11, Janique Savy12, Hija Choyo2, Justus Ochieng13, Almira L Hoogesteijn14, Margaret M Fasina15, Ariel L Rivas16. 1. Food and Agriculture Organization of the United Nations, Dar es Salaam, United Republic of Tanzania. Electronic address: Folorunso.fasina@fao.org. 2. Food and Agriculture Organization of the United Nations, Dar es Salaam, United Republic of Tanzania. 3. Muhimbili University of Health and Allied Sciences, United Republic of Tanzania; One Health Central and Eastern Africa, Eastern Africa, United Republic of Tanzania. 4. Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania. 5. One Health Central and Eastern Africa, Eastern Africa, United Republic of Tanzania; Sokoine University of Agriculture, Morogoro, United Republic of Tanzania. 6. Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania; One Health Coordination Desk, Prime Minister's Office, Dodoma, United Republic of Tanzania. 7. One Health Coordination Desk, Prime Minister's Office, Dodoma, United Republic of Tanzania; Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, United Republic of Tanzania. 8. District Veterinary Office, Moshi District, United Republic of Tanzania. 9. Zonal Veterinary Center, Arusha, United Republic of Tanzania. 10. Tanzania Veterinary Laboratory Agency, Dar es Salaam, United Republic of Tanzania. 11. Tanzania National Parks Authority, Same, United Republic of Tanzania. 12. Unit of Geoinformation and Mapping, University of Pretoria, Pretoria, South Africa. 13. AVRDC - The World Vegetable Center, Eastern and Southern Africa, Arusha, United Republic of Tanzania. 14. Human Ecology, Centro de Investigación y de Estudios Avanzados (CINVESTAV), Mérida, Yucatán, Mexico. 15. Department of Nursing Science, University of Pretoria, Pretoria, South Africa. 16. Center for Global Health, School of Medicine, University of New Mexico, Albuquerque, NM, USA.
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.
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.