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One health surveillance for rabies : a case study of integrated bite case management in Albay Province, Philippines

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Rysava, Kristyna, Espineda, Jason, Silo, Eva Angela V., Carino, Sarah, Aringo, Ariane Mae, Bernales, Rona P., Adonay, Florencio F., Tildesley, Michael J. and Hampson, Katie (2022) One health surveillance for rabies : a case study of integrated bite case management in Albay Province, Philippines. Frontiers in Tropical Diseases, 3 . 787524. doi:10.3389/fitd.2022.787524 ISSN 2673-7515.

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Official URL: http://dx.doi.org/10.3389/fitd.2022.787524

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Abstract

Canine rabies is a significant public health concern and economic burden in the Philippines. Animal Bite Treatment Centers (ABTCs) that provide post-exposure prophylaxis (PEP) to bite patients have been established across the country, but the incidence of bite patient presentations has grown unsustainably, whilst rabies transmission in domestic dogs has not been controlled. Moreover, weak surveillance leads to low case detection and late outbreak responses. Here we investigated the potential for Integrated Bite Case Management (IBCM) to improve rabies detection in Albay province. Using information obtained from animal bite histories combined with phone follow-ups and field investigations, we demonstrated that IBCM resulted in a fourfold increase in case detection over 13 months of study compared to the prior period. Bite patient incidence across Albay was very high (>600/100,000 persons/year) with PEP administered mostly indiscriminately. Clinic attendance reflected availability of PEP and proximity to ABTCs rather than rabies incidence (<3% of patient presentations were from “probable” or confirmed rabies exposures) and is therefore not a suitable indicator of rabies burden. Further analysis of the IBCM data suggests that rabies transmission is mostly localized with focal cases from the previous month and current cases in neighbouring villages being most predictive of future rabies occurrence. We conclude that investigations of suspicious biting incidents identified through IBCM have potential to foster intersectoral relationships, and collaborative investments between public health and veterinary services, enabling the One Health ethos to be applied in a more sustainable and equitable way. Triage of patients and investigations of suspect dogs offer an effective tool for improved PEP provisioning and reduction of unnecessary expenditure, whilst targeted field investigations should lead to increased and earlier detection of rabid dogs. Given the enduring risk of re-introductions from neighbouring populations, enhanced surveillance is critical to achieving and maintaining rabies freedom.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- )
Library of Congress Subject Headings (LCSH): Rabies -- Treatment -- Philippines, Rabies -- Vaccination -- Philippines, Rabies -- Prevention -- Philippines, Rabies in dogs -- Philippines, Dogs -- Virus diseases , Animals as carriers of disease
Journal or Publication Title: Frontiers in Tropical Diseases
Publisher: Frontiers Media
ISSN: 2673-7515
Official Date: 31 March 2022
Dates:
DateEvent
31 March 2022Published
25 February 2022Accepted
Volume: 3
Article Number: 787524
DOI: 10.3389/fitd.2022.787524
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 4 April 2022
Date of first compliant Open Access: 5 April 2022
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
EP/R512916/1[EPSRC] Engineering and Physical Sciences Research Councilhttp://dx.doi.org/10.13039/501100000266
BB/GCRFIAA/08[BBSRC] Biotechnology and Biological Sciences Research Councilhttp://dx.doi.org/10.13039/501100000268
BB/M01116X/1[BBSRC] Biotechnology and Biological Sciences Research Councilhttp://dx.doi.org/10.13039/501100000268
207569/Z/17/ZWellcome Trusthttp://dx.doi.org/10.13039/100010269

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