Community attitudes and perceptions towards free-roaming dogs in Goa, India

Free-roaming dogs (FRD) represent a large proportion of the canine population in India and are often implicated as a source of conflict with humans. However, objective data on the attitudes and perceptions of local communities toward FRD are lacking. This study collected baseline data from 1141 households in Goa, India, on FRD feeding practices and assessed people's attitudes toward FRD in urban and rural communities. Additionally, respondents identified problems caused by FRD and proposed potential solutions.The study reported that 37% of respondents fed FRD with dog owners and Hindus being the most likely to feed. The majority of respondents agreed FRD were a menace (57%), a nuisance (58%) and scary (60%). Most respondents also agreed FRD were a vulnerable population (59%), that belong in communities (66%) and have a right to live on the streets (53%). Barking was the most commonly reported problem associated with FRD and the preferred solution was to impound FRD in shelters. This study reveals the complex and often misunderstood relationship between local communities and FRD and highlights potential strategies to reduce human-dog conflict.

Capturing free-roaming dogs for sterilisation: A multi-site study in Goa, India

Sterilisation and rabies vaccination programs seek to manage free-roaming domestic dog (Canis familiaris) populations with the aim to reduce inter-species disease transmission and conflicts. As effective, permanent, remotely-administered options are not yet available for sterilisation, and oral vaccination is not yet commonly used; free-roaming dogs are typically captured for these interventions. There is a paucity of information describing how dog capture rates change over time within defined areas following repeated capture efforts. This data is needed to allow efficient dog capture programmes to be developed. Using spatial co-ordinates of dog capture, we characterise where dogs are more likely to be captured in six catch-sterilise-release campaigns, in Goa state, India. Combining capture numbers with population survey data collected in five sites, we document the increasing difficulty of catching entire (non-sterilised) dogs as sterilisation coverage increases and demonstrate how this leads to increased unit costs. Accounting for the extra resources required to capture dogs when sterilisation coverage is high will improve estimation of the resources required to manage free-roaming dog populations and assist in planning the most efficient intervention strategies.

Assessing the effect of a canine surgical-neutering educational programme on the knowledge and confidence of Indian veterinary participants

India has a large, free-roaming dog population, encompassing both owned and stray dogs. Canine surgical neutering is often a central component of dog population management and rabies control initiatives. The provision of practical, surgical training opportunities remains a major challenge for veterinary educational establishments worldwide to ensure competency in this routine procedure. A 12-day educational programme, focusing on surgical neutering skills, was developed to address this need. A questionnaire comprising 26 questions covering surgical and clinical topics, and a self-assessment of confidence in undertaking five common surgical procedures, was completed immediately before and after finishing the programme. A total of 296 participants attended, with 228 achieving the inclusion criteria for the study. Total knowledge scores increased significantly after the training programme (mean score pre-18.94, 95% CI 18.13-19.74; post-28.11, 95% CI 27.44-28.77, p < 0.05) with improvements seen in all categories (surgical principles, anaesthesia, antibiotic use and wound management). After accounting for other participants' characteristics, scores increased, on average, by 9 points after training. Being female was associated with significantly higher overall scores, while compared to younger and older age groups, those aged 25-34 were associated with lower overall scores. Amongst those with post-graduate qualifications, overall scores increased with age. Furthermore, there was an increase in self-rated confidence by participants in undertaking all five procedures. This study demonstrates that a targeted training programme can improve veterinary participants' knowledge and confidence in canine surgical neutering and may provide an effective way to develop surgical expertise amongst veterinarians engaged in dog population management initiatives.

Corrigendum: Electronic application for rabies management improves surveillance, data quality, and investigator experience in Haiti

[This corrects the article DOI: 10.3389/fvets.2023.1052349.].

Electronic application for rabies management improves surveillance, data quality, and investigator experience in Haiti

Background

Integrated bite case management (IBCM) is a multi-sectoral response to animal-bites which reduces human and canine rabies mortality through animal quarantine, bite-victim counseling, and vaccination tracking. Haiti's national rabies surveillance program was established in 2013 using paper-based IBCM (pIBCM) with adoption of an electronic smartphone application (eIBCM) in 2018.

Methods

We evaluated the feasibility of implementing the electronic app in Haiti and compared pIBCM and eIBCM data quality collected January 2013–August 2019. Deaths prevented, cost-per-death averted, and cost-per-investigation during use of pIBCM and eIBCM were estimated using a previously validated rabies cost-effectiveness tool that accounted for bite-victim demographics; probability of acquiring rabies; post-exposure prophylaxis; and costs including training, supplies, and salaries. We compared pIBCM and eIBCM based on data comprehensiveness, completeness, and reporting efficiency. Surveys were administered to IBCM staff to evaluate the usefulness, simplicity, flexibility, and acceptability of eIBCM.

Results

Of 15,526 investigations, 79% were paper-based and 21% electronic. IBCM prevented 241 (estimated) human rabies deaths. Using pIBCM, cost-per-death averted was $2,692 and the cost-per-investigation was $21.02; up to 55 data variables were collected per investigation; data transmission took 26 days to reach national staff, and 180 days until analysis. Using eIBCM, the cost-per-death averted was $1,247 and the cost-per-investigation was $22.70; up to 174 data variables were collected per investigation; data transmission took 3 days to reach national staff, and 30 days until analysis. Among 12,194 pIBCM investigations, 55% were mappable by commune, compared to 100% of eIBCM investigations mappable by GPS. Animal case definitions were incorrectly ascribed by investigators in 5.5% of pIBCM investigations and zero for eIBCM; typically, errors were in determining probable vs. suspect case assignments. Overall, eIBCM was well-accepted by staff, who reported the app is easy-to-use, facilitates investigations, and compared to pIBCM hastens data reporting.

Discussion

In Haiti, eIBCM showed improved data completeness, data quality, and shorter notification times with minimal increase in operational cost. The electronic app is simple-to-use and facilitates IBCM investigations. Rabies endemic countries could refer to eIBCM in Haiti as a cost-effective means to reduce human rabies mortality and improve surveillance capacity.

First study on molecular detection of three major canine tick-borne pathogens in subclinically infected dogs in Chiang Mai, Thailand

Background and Aim:

Canine tick-borne pathogens (CTBPs) are an important cause of morbidity in dogs in Thailand. This study aimed to evaluate the occurrence of three CTBPs in clinically normal, owned dogs to understand the risk for the general canine population. We also examined sex, age, tick infestation, and packed cell volume (PCV) of the animals in association with active infection of the CTBPs.

Materials and Methods:

A total of 139 dogs were included in the study. Blood samples were collected for thin blood smear, PCV and nested polymerase chain reaction (PCR) assay. Statistical analyses were performed to examine the association between individual factors and CTBP infection status determined by PCR. In addition, sensitivity, specificity, and Cohen’s kappa were calculated to assess the utility of routine blood smear.

Results:

The PCR results showed that 31 dogs (22.3%) were infected with at least one of the three pathogens. The occurrence rate for Ehrlichia canis, Anaplasma platys, and Hepatozoon canis was 2.2% (3/139), 18.7% (24/139), and 2.8% (4/139), respectively. There were two cases of coinfection with A. platys and E. canis. The univariate analyses did not yield any associations between recorded variables and the active infection. Microscopic examination showed good sensitivity and agreement only for H. canis (Sn: 75%, 95% confidence interval: 24.9-98.7, k=0.85).

Conclusion:

Our findings confirmed the endemicity of the CTBPs in owned canine population in the study site. In-depth epidemiological investigation would be warranted to elucidate environmental risk factors for CTBP infection.

A One Medicine Mission for an Effective Rabies Therapy

Despite the disease's long history, little progress has been made toward a treatment for rabies. The prognosis for patient recovery remains dire. For any prospect of survival, patients require aggressive critical care, which physicians in rabies endemic areas may be reluctant or unable to provide given the cost, clinical expertise required, and uncertain outcome. Systematic clinical research into combination therapies is further hampered by sporadic occurrence of cases. In this Perspective, we examine the case for a One Medicine approach to accelerate development of an effective therapy for rabies through the veterinary care and investigational treatment of naturally infected dogs in appropriate circumstances. We review the pathogenesis of rabies virus in humans and dogs, including recent advances in our understanding of the molecular basis for the severe neurological dysfunction. We propose that four categories of disease process need to be managed in patients: viral propagation, neuronal degeneration, inflammation and systemic compromise. Compassionate critical care and investigational treatment of naturally infected dogs receiving supportive therapy that mimics the human clinical scenario could increase opportunities to study combination therapies that address these processes, and to identify biomarkers for prognosis and therapeutic response. We discuss the safety and ethics of this approach, and introduce the Canine Rabies Treatment Initiative, a non-profit organization with the mission to apply a One Medicine approach to the investigation of diagnostic, prognostic, and therapeutic options for rabies in naturally infected dogs, to accelerate transformation of rabies into a treatable disease for all patients.

Review of Oral Rabies Vaccination of Dogs and Its Application in India

Oral rabies vaccines (ORVs) have been in use to successfully control rabies in wildlife since 1978 across Europe and the USA. This review focuses on the potential and need for the use of ORVs in free-roaming dogs to control dog-transmitted rabies in India. Iterative work to improve ORVs over the past four decades has resulted in vaccines that have high safety profiles whilst generating a consistent protective immune response to the rabies virus. The available evidence for safety and efficacy of modern ORVs in dogs and the broad and outspoken support from prominent global public health institutions for their use provides confidence to national authorities considering their use in rabies-endemic regions. India is estimated to have the largest rabies burden of any country and, whilst considerable progress has been made to increase access to human rabies prophylaxis, examples of high-output mass dog vaccination campaigns to eliminate the virus at the source remain limited. Efficiently accessing a large proportion of the dog population through parenteral methods is a considerable challenge due to the large, evasive stray dog population in many settings. Existing parenteral approaches require large skilled dog-catching teams to reach these dogs, which present financial, operational and logistical limitations to achieve 70% dog vaccination coverage in urban settings in a short duration. ORV presents the potential to accelerate the development of approaches to eliminate rabies across large areas of the South Asia region. Here we review the use of ORVs in wildlife and dogs, with specific consideration of the India setting. We also present the results of a risk analysis for a hypothetical campaign using ORV for the vaccination of dogs in an Indian state.

Every Dog Has Its Data: Evaluation of a Technology-Aided Canine Rabies Vaccination Campaign to Implement a Microplanning Approach

Background: Robust dog vaccination coverage is the primary way to eliminate canine rabies. Haiti conducts annual canine mass vaccination campaigns, but still has the most human deaths in the Latin American and Caribbean region. We conducted an evaluation of dog vaccination methods in Haiti to determine if more intensive, data-driven vaccination methods, using smartphones for data reporting and geo-communication, could increase vaccination coverage to a level capable of disrupting rabies virus transmission. Methods: Two cities were designated into "Traditional" and "Technology-aided" vaccination areas. Traditional areas utilized historical methods of vaccination staff management, whereas Technology-aided areas used smartphone-supported spatial coordination and management of vaccination teams. Smartphones enabled real time two-way geo-communication between campaign managers and vaccinators. Campaign managers provided geographic instruction to vaccinators by assigning mapped daily vaccination boundaries displayed on phone handsets, whilst vaccinators uploaded spatial data of dogs vaccinated for review by the campaign manager to inform assignment of subsequent vaccination zones. The methods were evaluated for vaccination effort, coverage, and cost. Results: A total of 11,420 dogs were vaccinated during the 14-day campaign. The technology-aided approach achieved 80% estimated vaccination coverage as compared to 44% in traditional areas. Daily vaccination rate was higher in Traditional areas (41.7 vaccinations per team-day) compared to in technology-aided areas (26.8) but resulted in significantly lower vaccination coverages. The cost per dog vaccinated increased exponentially with the associated vaccination coverage, with a cost of $1.86 to achieve 25%, $2.51 for 50% coverage, and $3.19 for 70% coverage. Conclusions: Traditional vaccination methods failed to achieve sufficiently high vaccination coverages needed to interrupt sustained rabies virus transmission, whilst the technology-aided approach increased coverage above this critical threshold. Over successive campaigns, this difference is likely to represent the success or failure of the intervention in eliminating the rabies virus. Technology-aided vaccination should be considered in resource limited settings where rabies has not been controlled by Traditional vaccination methods. The use of technology to direct health care workers based on near-real-time spatial data from the field has myriad potential applications in other vaccination and public health initiatives.

Bite Injuries among Vaccination Staff Participating in a Mass Canine Rabies Vaccination Campaign, Haiti 2016-2017

Elimination of dog-transmitted human rabies worldwide will require large-scale dog vaccination campaigns. However, this places participating vaccinators at increased risk. Data from the 2016-2017 Haitian mass rabies vaccination campaign was analyzed to determine dog bite incidence among vaccinators. A survey was then developed for completion by all identifiable bitten vaccinators covering demographics; experience and training; bite episode details; attitudes toward dogs and rabies; and medical care. A parallel group of unbitten vaccinators was also surveyed. Dog bite incidence was 0.03% (43/127,000) of all dogs vaccinated. The capture, vaccinate, and release method of vaccination carried a significantly higher risk of dog bite (0.35%, 6/1,739 vaccinations) than other methods (P < 0.001). Twenty-seven bitten vaccinators, and 54 control vaccinators were included in the survey analysis. No differences were found between groups in demographics, experience, or training. However, bitten vaccinators were significantly more likely than the control group to have experienced a dog bite before the study period (P < 0.001). This may be associated with a lesser appreciation of dogs, and/or a poorer ability to interpret dog behavioral signals within this group. Although 98% of the control group indicated they would seek medical care for a dog bite, only 35% of bitten vaccinators sought such care. On a yearly basis, for the Haitian campaign, a full series of postexposure rabies vaccinations for all bite victims would prove more cost-effective than preexposure vaccination of all vaccinators. These findings may prove useful for the planning and safety of future mass dog vaccination campaigns.

Oral bait preferences and feasibility of oral rabies vaccination in Bangladeshi dogs

Oral rabies vaccination (ORV) can increase rabies vaccination coverage among dogs that are inaccessible to parenteral vaccination (i.e., inaccessible dogs). Because bait uptake can differ according to the bait attractant used and dog characteristics, we evaluated proportion of bait uptake and time to bait uptake using three bait formulations. We looked for associations between bait uptake and dog characteristics (temperament, age, and body condition) and assessed the efficiency of using these bait formulations, as measured by number of dogs vaccinated per hour. A total of 356 baits were offered to free roaming dogs in urban and peri-urban districts of Bangladesh. Fish baits were ignored by 86% (n = 122; 95% CI: 79-91%) of dogs, whereas 60% (n = 45; 95% CI: 49-70%) consumed egg baits and 89% (n = 124; 95% CI: 83-93%) consumed intestine baits. Among the consumed baits, dogs fully consumed 56% (n = 10; 95% CI: 34-75%) of fish baits, 84% (n = 38; 95% CI: 71-92%) of egg baits, and 98% (n = 122; 95% CI: 94-100%) of intestine baits. Among inaccessible dogs, no associations were found between bait uptake and dog characteristics in either bivariate or multivariate analyses. Bait consumption averaged 2 dogs per hour for fish baits, 10 dogs per hour for egg baits, and 18 dogs per hour for intestine baits. The absence of association between bait type preference and individual dog characteristics simplifies the process of choosing attractants for oral rabies vaccines. While intestine attractants achieved highest uptake, egg baits may prove a suitable compromise when considering biological and operational constraints. The efficiency of ORV was demonstrated when compared to parenteral vaccination of free-roaming dogs previously described.

Barriers to attendance of canine rabies vaccination campaigns in Haiti, 2017

We conducted a cross-sectional survey to better understand the barriers to attendance at canine rabies vaccination campaigns in Haiti. A structured community-based questionnaire was conducted over a 15-day period during May-June 2017, focused on socio-economic status correlated with participation at canine rabies vaccination campaigns. Questions phrased as a bidding game were asked to determine individuals' willingness to pay (WTP) for dog rabies vaccination and willingness to walk (WTW) to fixed-point vaccination campaigns. The Kaplan-Meier estimator was applied to determine relationships between survey variables. Logistic regression was used to examine factors associated with participants' WTP and WTW. A total of 748 households from eight communities were surveyed. Respondents were predominantly female (54.4%) and had a median age of 45 years. The total number of owned dogs reported from households was 926, yielding a human-to-dog ratio in dog-owning households of 5.2:1. The majority of dogs (87.2%) were acquired for security, and 49% were allowed to roam freely; 42.0% of dog owners reported that they were unable to manage (or restrain) their dogs using a leash. Seventy per cent of dog owners were willing to pay up to 15.9 gourdes (0.25 USD) and/or walk up to 75 m to vaccinate their dogs. Households that owned free-roaming dogs, owned dogs for the purpose of companionship and owned dogs that they were unable to walk on a leash were associated with a higher WTP for vaccination. Living in Artibonite Department, having a middle or higher household income, and owning a dog for security purpose were associated with a higher WTW for vaccination. Low leash use and propensity for dogs to roam freely are barriers to successful fixed-point vaccination methods in Haiti, and alternative methods such as door to door (DD), capture-vaccinate-release (CVR) or oral vaccination should be explored. There may be some prospect for fee-for-service vaccination in Haiti; however, this programme should be introduced as a supplement, rather than a replacement for free rabies vaccination programmes so that mass dog vaccination is not discouraged.

Sociodemographic factors which predict low private rabies vaccination coverage in dogs in Blantyre, Malawi

Although rabies kills approximately 60,000 people globally every year, vaccination of over 70 per cent of the canine population has been shown to eliminate the disease in both dogs and human beings. In some rabies endemic countries, owners are able to vaccinate their dogs through private veterinary clinics. However, uptake of dog vaccinations through private veterinary clinics is often low in many rabies endemic countries. In this study, the authors examined the sociodemographic factors which predicted low private rabies vaccination coverage in Blantyre, Malawi. Data on 23,205 dogs were recorded during a door-to-door rabies vaccination programme in 2016. A multivariable logistic regression model was built to identify factors associated with private rabies vaccination. Negative predictors of private vaccination included increasing poverty levels, higher housing densities, male dogs, pregnant or lactating dogs, and puppies and dogs allowed to roam. In contrast, neutered and healthy dogs had greater odds of being privately vaccinated. The present study demonstrated that low private rabies vaccination coverage can be accurately predicted by sociodemographic factors. This information may help inform public health interventions which deliver mass vaccination programmes in rabies endemic countries.

Reviewing Solutions of Scale for Canine Rabies Elimination in India

Canine rabies elimination can be achieved through mass vaccination of the dog population, as advocated by the WHO, OIE and FAO under the 'United Against Rabies' initiative. Many countries in which canine rabies is endemic are exploring methods to access dogs for vaccination, campaign structures and approaches to resource mobilization. Reviewing aspects that fostered success in rabies elimination campaigns elsewhere, as well as examples of largescale resource mobilization, such as that seen in the global initiative to eliminate poliomyelitis, may help to guide the planning of sustainable, scalable methods for mass dog vaccination. Elimination of rabies from the majority of Latin America took over 30 years, with years of operational trial and error before a particular approach gained the broad support of decision makers, governments and funders to enable widespread implementation. The endeavour to eliminate polio now enters its final stages; however, there are many transferrable lessons to adopt from the past 32 years of global scale-up. Additionally, there is a need to support operational research, which explores the practicalities of mass dog vaccination roll-out and what are likely to be feasible solutions at scale. This article reviews the processes that supported the scale-up of these interventions, discusses pragmatic considerations of campaign duration and work-force size and finally provides an examples hypothetical resource requirements for implementing mass dog vaccination at scale in Indian cities, with a view to supporting the planning of pilot campaigns from which expanded efforts can grow.

Implementation of a mass canine rabies vaccination campaign in both rural and urban regions in southern Malawi

Rabies is a devastating zoonotic disease causing nearly 60,000 deaths globally each year. The disease causes Malawi an economic loss of 13 million USD and kills almost 500 people annually. Domestic dogs are the main reservoir for rabies and vaccinating over 70% of the dog population is the most efficient method to reduce its incidence in both humans and canines. However, achieving such coverages is often difficult and depend on many geospatial factors. Rural and pastoral regions are considered difficult to vaccinate efficiently due to low dog densities, and reports of campaigns spanning large areas containing vastly different communities are lacking. This study describes a mass canine vaccination campaign covering rural and urban regions in southern Malawi. The campaign achieved an average vaccination coverage of 83.4% across 3 districts, and vaccinated over 89,000 dogs through a combined static point and door-to-door effort. A dog population of 107,574 dogs was estimated (dog:human ratio of 1:23). The canine population was found to be almost completely owned (99.2%) and mostly kept for security purposes (82.7%). The dogs were mainly adults, males, and not neutered. Regression analysis identified education level and proportion of young dogs as the only factors influencing (positively and negatively, respectively) whether vaccination coverage over 70% was achieved in a region, independently of variables such as population density or poverty. A second regression analysis was performed predicting absolute vaccination coverage. While education level and the proportion of confined dogs were associated with positive vaccination coverage, higher proportions of young animals and female dogs were associated with a decrease in coverage. This study confirms the feasibility of homogeneously vaccinating over 70% of the dogs in a large area including rural and urban communities. These findings can inform the logistics of future campaigns and might be used as a template to facilitate high-number, high-coverage vaccination campaigns to other regions in sub-Saharan Africa.

Development of a high number, high coverage dog rabies vaccination programme in Sri Lanka

BACKGROUND

Rabies is estimated to cause 59,000 deaths and economic losses of US$8.6 billion every year. Despite several years of rabies surveillance and awareness programmes, increased availability of post-exposure prophylaxis vaccinations and dog population control, the disease still remains prevalent in Sri Lanka. This study reports the roll-out of a high number, high coverage canine rabies vaccination campaign in Sri Lanka, providing estimates for the vaccination coverage achieved, analysing the local dog demographics, and identifying barriers of attendance to static vaccination clinics.

METHODS

A mass dog vaccination campaign was undertaken in Negombo, Sri Lanka. The campaign was composed of static point and door-to-door vaccination stages, with a final survey of vaccination coverage. A large volume of data on the distribution, health, and signalment of vaccinated dogs was collected through a mobile phone application. A logistic regression model was developed to investigate which socio-spatial and dog-related factors influenced attendance of owners to static vaccination points.

RESULTS

The campaign vaccinated over 7800 dogs achieving a vaccination coverage of 75.8%. A dog:human ratio of 1:17 was estimated. Most dogs were owned, and the dog population was mostly male, adult, and non-sterilized. Unawareness, unavailability and handling problems were the most common reasons given by owners to explain failure to attend a static vaccination point. The regression analysis showed that increasing distance to a static point, in addition to young age and poor health of the dog, were associated with a decrease in the likelihood of attendance to a static vaccination points.

CONCLUSION

This study demonstrates the feasibility of high number, high coverage vaccination campaigns in Sri Lanka. The information on dog ecology and barriers of attendance to static point vaccination clinics will facilitate development of future vaccination campaigns.

Evaluation of an Immunochromatographic Assay as a Canine Rabies Surveillance Tool in Goa, India

Rabies is a fatal zoonotic disease transmitted by the bite of a rabid animal. More than 95% of the human rabies cases in India are attributed to exposure to rabid dogs. This study evaluated the utility of a lateral flow immunochromatographic assay (LFA) (Anigen Rapid Rabies Ag Test Kit, Bionote, Hwaseong-si, Korea) for rapid post mortem diagnosis of rabies in dogs. Brain tissue was collected from 202 animals that were screened through the Government of Goa rabies surveillance system. The brain tissue samples were obtained from 188 dogs, nine cats, three bovines, one jackal and one monkey. In addition, 10 dogs that died due to trauma from road accidents were included as negative controls for the study. The diagnostic performance of LFA was evaluated using results from direct fluorescence antibody test (dFT); the current gold standard post mortem test for rabies infection. Three samples were removed from the analysis as they were autolysed and not fit for testing by dFT. Of the 209 samples tested, 117 tested positive by LFA and 92 tested negative, while 121 tested positive by dFT and 88 tested negative. Estimates of LFA sensitivity and specificity were 0.96 (95% CI 0.91-0.99) and 0.99 (95% CI 0.94-1.00), respectively. The LFA is a simple and low-cost assay that aids in the rapid diagnosis of rabies in the field without the need for expensive laboratory equipment or technical expertise. This study found that Bionote LFA has potential as a screening tool in rabies endemic countries.

A comparison of population estimation techniques for individually unidentifiable free-roaming dogs

Background

Measuring the size of free roaming dog populations quickly and accurately is critical in the implementation of numerous preventive health and population control interventions. However, few studies have investigated the relative performance of population size assessment tools when applied to dogs. The aim of this study was to compare the commonly used mark-resight methodology with distance sampling methods, which are less resource intensive, to estimate free-roaming dog abundance in Goa, India.

Twenty-six working zones were surveyed along all roads twice by the same surveyor at the same time of day, following a vaccination campaign which included marking of vaccinated dogs with a coloured paint. The Chapman estimate was then used to evaluate the mark-resight abundance. Additionally, the number of dogs and perpendicular distance from the road for all dogs sighted was recorded. This was used to estimate dog density and abundance using distance sampling methods. The detection function was fitted based on goodness-of-fit and AIC.

Results

The Chapman abundance estimate for the entire study area was 5202 dogs (95%CI 4733.8–5671.0), and the distance sampling method abundance estimate was 5067 dogs (95%CI 4454.3–5764.2). For individual working zones, after taking other factors into account in a mixed effects model, the average distance sampling estimate was 35% higher (95%CI 20–53%) than the Chapman estimate. There was also evidence of a difference in estimates between surveyors of 21% (95%CI 7–37%) and between days (22% lower on day 2, 95%CI 8–38%) for individual working zones.

Conclusion

Our study demonstrated that the distance sampling estimates were comparable overall to the Chapman method of abundance estimation of free roaming dogs across the entire study region but there was noticeable variation between the two methods when individual zones were compared. Consequently, distance sampling methods may be suitable to enumerate dogs over large areas in a more time efficient manner than the widely used mark-resight approach.

Electronic supplementary material

The online version of this article (10.1186/s12917-019-1938-1) contains supplementary material, which is available to authorized users.

The problem of stray dogs

The effective management of stray dogs is critically important in any rabies vaccination programme. In many rabies-endemic countries, stray dogs represent a significant proportion of both the free-roaming and total dog populations, and to ensure that rabies elimination programmes are successful, it is essential that this portion of the dog population (stray dogs) is vaccinated at high coverage. However, there are a number of challenges to managing and delivering rabies vaccinations to stray dogs. This paper will review the most pertinent issues relating to the problem of stray dogs and rabies elimination, focusing on the challenges relating to the estimation of population size, vaccination administration and vaccine coverage assessment in stray dog populations. The authors will highlight how these challenges can be overcome, notably by reviewing the census techniques that have been employed to assess stray dog populations, which then facilitate the planning and design of vaccination programmes. In addition, they discuss the range of vaccination strategies that are available and that have been used to vaccinate stray dogs and review how vaccination coverage can be assessed in this population. Finally, the benefits of population management in stray dogs through neutering programmes are reviewed. In short, this paper highlights the importance of ensuring that stray dogs, as well as owned dogs, are included in vaccination programmes and emphasises that many of the challenges related to protecting stray dogs from rabies can be overcome.

Reproducibility of the mark-resight method to assess vaccination coverage in free-roaming dogs

The mark-resight methodology is a widely used tool to assess both population size and vaccination coverage of free-roaming dogs. Evaluating coverage is often critical to determine the progress and impact of vaccination interventions. The aim of this study was to assess the reproducibility of the mark-resight method during a rabies vaccination campaign. A total of 90 areas in Goa, India, were surveyed on two occasions following a vaccination campaign, during which vaccinated dogs were marked. The estimated vaccination coverage for both confined and free-roaming dogs in the study area after a first round of vaccination was 68.9% (95% CI, 66.7-71.0%). The number of dogs counted in each survey, as well as the proportion of marked dogs, were the main outcomes recorded. Linear and mixed-effects models were used to evaluate the effect of survey order, surveyor, time of day, days between surveys, and weather on the outcomes between repeated surveys. Fewer dogs were likely to be counted in afternoon surveys compared to morning surveys (19.2% fewer dogs, 95%CI 7.5-31.9%) and a 17.2% (95%CI 3.6-32.7%) higher proportion of marked dogs was associated with the repeated survey compared to the first survey. Increased variation of the marked percentage between surveys was associated with using different surveyors (8.3%, 95%CI 0.4-16.2). This study demonstrated that external or personnel factors can influence the number of dogs counted and the estimated vaccination coverage of individual survey areas. Regular staff training, to ensure equal effort and quality of survey techniques between surveyors, could help standardise survey outcomes.

One million dog vaccinations recorded on mHealth innovation used to direct teams in numerous rabies control campaigns

Background

Canine transmitted rabies kills an estimated 59,000 people annually, despite proven methods for elimination through mass dog vaccination. Challenges in directing and monitoring numerous remote vaccination teams across large geographic areas remain a significant barrier to the up-scaling of focal vaccination programmes to sub-national and national level. Smartphone technology (mHealth) is increasingly being used to enhance the coordination and efficiency of public health initiatives in developing countries, however examples of successful scaling beyond pilot implementation are rare. This study describes a smartphone app and website platform, “Mission Rabies App”, used to co-ordinate rabies control activities at project sites in four continents to vaccinate over one million dogs.

Methods

Mission Rabies App made it possible to not only gather relevant campaign data from the field, but also to direct vaccination teams systematically in near real-time. The display of user-allocated boundaries on Google maps within data collection forms enabled a project manager to define each team’s region of work, assess their output and assign subsequent areas to progressively vaccinate across a geographic area. This ability to monitor work and react to a rapidly changing situation has the potential to improve efficiency and coverage achieved, compared to regular project management structures, as well as enhancing capacity for data review and analysis from remote areas. The ability to plot the location of every vaccine administered facilitated engagement with stakeholders through transparent reporting, and has the potential to motivate politicians to support such activities.

Results

Since the system launched in September 2014, over 1.5 million data entries have been made to record dog vaccinations, rabies education classes and field surveys in 16 countries. Use of the system has increased year-on-year with adoption for mass dog vaccination campaigns at the India state level in Goa and national level in Haiti.

Conclusions

Innovative approaches to rapidly scale mass dog vaccination programmes in a sustained and systematic fashion are urgently needed to achieve the WHO, OIE and FAO goal to eliminate canine-transmitted human deaths by 2030. The Mission Rabies App is an mHealth innovation which greatly reduces the logistical and managerial barriers to implementing large scale rabies control activities. Free access to the platform aims to support pilot campaigns to better structure and report on proof-of-concept initiatives, clearly presenting outcomes and opportunities for expansion. The functionalities of the Mission Rabies App may also be beneficial to other infectious disease interventions.

A rabies lesson improves rabies knowledge amongst primary school children in Zomba, Malawi

Rabies is an important neglected disease, which kills around 59,000 people a year. Over a third of these deaths are in children less than 15 years of age. Almost all human rabies deaths in Africa and Asia are due to bites from infected dogs. Despite the high efficacy of current rabies vaccines, awareness about rabies preventive healthcare is often low in endemic areas. It is therefore common for educational initiatives to be conducted in conjunction with other rabies control activities such as mass dog vaccination, however there are few examples where the efficacy of education activities has been assessed. Here, primary school children in Zomba, Malawi, were given a lesson on rabies biology and preventive healthcare. Subsequently, a mass dog vaccination programme was delivered in the same region. Knowledge and attitudes towards rabies were assessed by a questionnaire before the lesson, immediately after the lesson and 9 weeks later to assess the impact the lesson had on school children’s knowledge and attitudes. This assessment was also undertaken in children who were exposed to the mass dog vaccination programme but did not receive the lesson. Knowledge of rabies and how to be safe around dogs increased following the lesson (both p<0.001), and knowledge remained higher than baseline 9 weeks after the lesson (both p<0.001). Knowledge of rabies and how to be safe around dogs was greater amongst school children who had received the lesson compared to school children who had not received the lesson, but had been exposed to a rabies vaccination campaign in their community (both p<0.001) indicating that the lesson itself was critical in improving knowledge. In summary, we have shown that a short, focused classroom-based lesson on rabies can improve short and medium-term rabies knowledge and attitudes of Malawian schoolchildren.

Rabies is a fatal disease that claims the lives of approximately 59,000 people every year. Children under the age of 15 make up 40% of all human rabies deaths yet this is preventable through a combination of vaccinating dogs against rabies and education. Numerous studies have shown that people in rabies endemic areas lack sufficient knowledge about rabies, and there are many misconceptions about its treatment and prevention. Whilst many organisations run vaccination and education campaigns, few have assessed their impact on rabies knowledge, attitudes or practices (KAP). Fewer still have assessed the impact on children. This study investigated the impact of a rabies lesson on school children’s knowledge and attitudes about rabies in conjunction with a rabies vaccination campaign in Zomba, Malawi. We found that a rabies lesson improved school children’s knowledge about rabies and how to be safe around dogs. We observed that knowledge remained higher several weeks later. Knowledge about both canine rabies and bite prevention was greater amongst school children who had received the lesson compared to school children who had not received the lesson, but had been exposed to a rabies vaccination campaign in their community. This indicates that the lesson itself was critical in improving knowledge.

Barriers of attendance to dog rabies static point vaccination clinics in Blantyre, Malawi

Rabies is a devastating yet preventable disease that causes around 59,000 human deaths annually. Almost all human rabies cases are caused by bites from rabies-infected dogs. A large proportion of these cases occur in Sub Saharan Africa (SSA). Annual vaccination of at least 70% of the dog population is recommended by the World Health Organisation in order to eliminate rabies. However, achieving such high vaccination coverage has proven challenging, especially in low resource settings. Despite being logistically and economically more feasible than door-to-door approaches, static point (SP) vaccination campaigns often suffer from low attendance and therefore result in low vaccination coverage. Here, we investigated the barriers to attendance at SP offering free rabies vaccinations for dogs in Blantyre, Malawi. We analysed data for 22,924 dogs from a city-wide vaccination campaign in combination with GIS and household questionnaire data using multivariable logistic regression and distance estimation techniques. We found that distance plays a crucial role in SP attendance (i.e. for every km closer the odds of attending a SP point are 3.3 times higher) and that very few people are willing to travel more than 1.5 km to bring their dog for vaccination. Additionally, we found that dogs from areas with higher proportions of people living in poverty are more likely to be presented for vaccination (ORs 1.58-2.22). Furthermore, puppies (OR 0.26), pregnant or lactating female dogs (OR 0.60) are less likely to be presented for vaccination. Owners also reported that they did not attend an SP because they were not aware of the campaign (27%) or they could not handle their dog (19%). Our findings will inform the design of future rabies vaccination programmes in SSA which may lead to improved vaccination coverage achieved by SP alone.

The Vaccination of 35,000 Dogs in 20 Working Days Using Combined Static Point and Door-to-Door Methods in Blantyre, Malawi

An estimated 60,000 people die of rabies annually. The vast majority of cases of human rabies develop following a bite from an infected dog. Rabies can be controlled in both human and canine populations through widespread vaccination of dogs. Rabies is particularly problematic in Malawi, costing the country an estimated 13 million USD and 484 human deaths annually, with an increasing paediatric incidence in Blantyre City. Consequently, the aim of this study was to vaccinate a minimum of 75% of all the dogs within Blantyre city during a one month period. Blantyre’s 25 administrative wards were divided into 204 working zones. For initial planning, a mean human:dog ratio from the literature enabled estimation of dog population size and dog surveys were then performed in 29 working zones in order to assess dog distribution by land type. Vaccination was conducted at static point stations at weekends, at a total of 44 sites, with each operating for an average of 1.3 days. On Monday to Wednesday, door-to-door vaccination sessions were undertaken in the areas surrounding the preceding static point stations. 23,442 dogs were vaccinated at static point stations and 11,774 dogs were vaccinated during door-to-door vaccinations. At the end of the 20 day vaccination programme, an assessment of vaccination coverage through door-to-door surveys found that of 10,919 dogs observed, 8,661 were vaccinated resulting in a vaccination coverage of 79.3% (95%CI 78.6–80.1%). The estimated human:dog ratio for Blantyre city was 18.1:1. Mobile technology facilitated the collection of data as well as efficient direction and coordination of vaccination teams in near real time. This study demonstrates the feasibility of vaccinating large numbers of dogs at a high vaccination coverage, over a short time period in a large African city.

Rabies is a devastating disease that is estimated to result in the death of approximately 60,000 people every year. Most humans contract rabies following a bite from an infected dog and it has been demonstrated that provided a large enough proportion of the dog population is vaccinated; rabies incidence can be markedly reduced in both humans and dogs. However, few studies have described the vaccination of large numbers of dogs in a short period. An increasing incidence of childhood rabies has been reported in Blantyre, Malawi’s second largest city, over the past decade. This study reports the development and implementation of a mass canine rabies vaccination campaign which used a combined approach of static point and door-to-door vaccination strategies. 23,442 dogs were vaccinated at static point stations and 11,774 dogs were vaccinated during door-to-door vaccination during 20 working days of vaccination. Post vaccination surveys revealed vaccine coverage of 79.3% (95% CI 78.6–80.1). This study, through the unique approach of using novel mobile technology and two vaccination strategies, demonstrates the feasibility of vaccinating over 35,000 dogs within a one month period in an African city where rabies has a high prevalence in the human population.

Environmental factors in the development of autism spectrum disorders

Autism spectrum disorders (ASD) are highly heterogeneous developmental conditions characterized by deficits in social interaction, verbal and nonverbal communication, and obsessive/stereotyped patterns of behavior and repetitive movements. Social interaction impairments are the most characteristic deficits in ASD. There is also evidence of impoverished language and empathy, a profound inability to use standard nonverbal behaviors (eye contact, affective expression) to regulate social interactions with others, difficulties in showing empathy, failure to share enjoyment, interests and achievements with others, and a lack of social and emotional reciprocity. In developed countries, it is now reported that 1%-1.5% of children have ASD, and in the US 2015 CDC reports that approximately one in 45 children suffer from ASD. Despite the intense research focus on ASD in the last decade, the underlying etiology remains unknown. Genetic research involving twins and family studies strongly supports a significant contribution of environmental factors in addition to genetic factors in ASD etiology. A comprehensive literature search has implicated several environmental factors associated with the development of ASD. These include pesticides, phthalates, polychlorinated biphenyls, solvents, air pollutants, fragrances, glyphosate and heavy metals, especially aluminum used in vaccines as adjuvant. Importantly, the majority of these toxicants are some of the most common ingredients in cosmetics and herbicides to which almost all of us are regularly exposed to in the form of fragrances, face makeup, cologne, air fresheners, food flavors, detergents, insecticides and herbicides. In this review we describe various scientific data to show the role of environmental factors in ASD.

Vaccinate-assess-move method of mass canine rabies vaccination utilising mobile technology data collection in Ranchi, India

BACKGROUND

Over 20,000 people die from rabies each year in India. At least 95 % of people contract rabies from an infected dog. Annual vaccination of over 70 % of the dog population has eliminated both canine and human rabies in many countries. Despite having the highest burden of rabies in the world, there have been very few studies which have reported the successful, large scale vaccination of dogs in India. Furthermore, many Indian canine rabies vaccination programmes have not achieved high vaccine coverage.

METHODS

In this study, we utilised a catch-vaccinate-release approach in a canine rabies vaccination programme in 18 wards in Ranchi, India. Following vaccination, surveys of the number of marked, vaccinated and unmarked, unvaccinated dogs were undertaken. A bespoke smartphone 'Mission Rabies' application was developed to facilitate data entry and team management. This enabled GPS capture of the location of all vaccinated dogs and dogs sighted on post vaccination surveys. In areas where coverage was below 70 %, catching teams were re-deployed to vaccinate more dogs followed by repeat survey.

RESULTS

During the initial vaccination cycle, 6593 dogs were vaccinated. Vaccination coverage was over 70 % in 14 of the 18 wards. A second cycle of vaccination was performed in the 4 wards where initial vaccination coverage was below 70 %. Following this second round of vaccination, coverage was reassessed and found to be over 70 % in two wards and only just below 70 % in the final two wards (66.7 % and 68.2 %, respectively).

CONCLUSION

Our study demonstrated that mobile technology enabled efficient team management and rapid data entry and analysis. The vaccination approach outlined in this study has the potential to facilitate the rapid vaccination of large numbers of dogs at a high coverage in free roaming dog populations in India.

Multiple acquired portosystemic shunts in a cat secondary to chronic diaphragmatic rupture

Case summary

A cat with a chronic diaphragmatic rupture presented with neurological signs, including twitching and focal seizures. Blood ammonia level was markedly elevated and therefore neurological signs were thought to be related to hepatic encephalopathy. Exploratory laparotomy revealed that the left lateral and medial liver lobes were herniated into the thorax and multiple acquired portosystemic shunts (MAPSS) were present. The hernia was reduced and the diaphragm repaired. Neurological signs gradually resolved following surgery and 1 year postoperatively the cat was clinically normal, was not on any medication and had no evidence of hepatic dysfunction.

Relevance and novel information

This is the first report of a chronic diaphragmatic rupture leading to MAPSS in a cat.

Full-length and truncated forms of vitronectin provide insight into effects of proteolytic processing on function

A genetic polymorphism in the vitronectin allele directs the production of two distinct forms of the 459 amino acid glycoprotein. A methionine present at position 381 favors production of the single-chain form of vitronectin, while threonine at this position increases the susceptibility of vitronectin to cleavage just beyond its heparin-binding domain at residue 379. This reaction gives rise to a disulfide-bonded, two-chain form of vitronectin. In order to investigate the functional significance of the vitronectin polymorphism, the baculovirus system has been used to express recombinant full-length vitronectin and a truncated form of the molecule that represents the 62-kDa fragment of two-chain vitronectin. Both forms of vitronectin bind and neutralize heparin anticoagulant activity. The proteins also bind PAI-1 and stabilize its active conformation. These experiments suggest that the C-terminal 80 amino acids do not confer a functional difference in the two allelic variants. Immunoassays and gel filtration experiments indicate that both full-length and truncated recombinant forms of vitronectin are multimeric. Together with other reports from this laboratory, these results provide information regarding the primary binding sites for two vitronectin ligands and further define regions that may be involved in multimerization of the protein.

Guanylyl cyclases as a family of putative odorant receptors

Mammals can discriminate among a large number (> 10,000) of unique odorants. The most highly supported explanation for this ability is that olfactory neurons express a large number of seven transmembrane receptors that are not spatially organized at the level of the olfactory epithelium, but whose axonal projections form a distinct pattern within the olfactory bulb. The odor-induced signaling pathway in olfactory neurons includes a Gs-like protein (G(olf)) that activates a specific adenylyl cyclase (type III) isoform, resulting in elevations of cyclic AMP and subsequent activation of a cyclic nucleotide-gated channel. The channel also can be regulated by cyclic GMP. Recently, an olfactory neuron-specific guanylyl cyclase was discovered in rodents, and subsequently a large family of sensory neuronal guanylyl cyclases was identified in nematodes. These guanylyl cyclases are concentrated in the plasma membrane of the dendritic cilia and contain extracellular domains that retain many of the primary sequence characteristics of guanylyl cyclases known to be receptors for various peptides. Thus, the guanylyl cyclases appear to represent a second family of odorant/pheromone receptors.

Orientation of heparin-binding sites in native vitronectin. Analyses of ligand binding to the primary glycosaminoglycan-binding site indicate that putative secondary sites are not functional

A primary heparin-binding site in vitronectin has been localized to a cluster of cationic residues near the C terminus of the protein. More recently, secondary binding sites have been proposed. In order to investigate whether the binding site originally identified on vitronectin functions as an exclusive and independent heparin-binding domain, solution binding methods have been used in combination with NMR and recombinant approaches to evaluate ligand binding to the primary site. Evaluation of the ionic strength dependence of heparin binding to vitronectin according to classical linkage theory indicates that a single ionic bond is prominent. It had been previously shown that chemical modification of vitronectin using an arginine-reactive probe results in a significant reduction in heparin binding (Gibson, A., Baburaj, K., Day, D. E., Verhamme, I. , Shore, J. D., and Peterson, C. B. (1997) J. Biol. Chem. 272, 5112-5121). The label has now been localized to arginine residues within the cyanogen bromide fragment-(341-380) that contains the primary heparin-binding site on vitronectin. One- and two-dimensional NMR on model peptides based on this primary heparin-binding site indicate that an arginine residue participates in the ionic interaction and that other nonionic interactions may be involved in forming a complex with heparin. A recombinant polypeptide corresponding to the C-terminal 129 amino acids of vitronectin exhibits heparin-binding affinity that is comparable to that of full-length vitronectin and is equally effective at neutralizing heparin anticoagulant activity. Results from this broad experimental approach argue that the behavior of the primary site is sufficient to account for the heparin binding activity of vitronectin and support an exposed orientation for the site in the structure of the native protein.