Browsing by Author "Sambo, Maganga"

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Dog ownership practices and responsibilities for children's health in terms of rabies control and prevention in rural communities in Tanzania.
(PLOS ONE, 2021-03-01) Sikana, Lwitiko; Lembo, Tiziana; Hampson, Katie; Lushasi, Kennedy; Mtenga, Sally; Sambo, Maganga; Wight, Daniel; Coutts, Jane; Kreppel, Katharina
Interventions tackling zoonoses require an understanding of healthcare patterns related to both human and animal hosts. The control of dog-mediated rabies is a good example. Despite the availability of effective control measures, 59,000 people die of rabies every year worldwide. In Tanzania, children are most at risk, contributing ~40% of deaths. Mass dog vaccination can break the transmission cycle, but reaching the recommended 70% coverage is challenging where vaccination depends on willingness to vaccinate dogs. Awareness campaigns in communities often target children, but do not consider other key individuals in the prevention chain. Understanding factors related to dog ownership and household-level responsibility for dog vaccination and child health is critical to the design of vaccination strategies. We investigated who makes household decisions about dogs and on health care for children in rural Tanzania. In the Kilosa district, in-depth interviews with 10 key informants were conducted to inform analysis of data from a household survey of 799 households and a survey on Knowledge Attitudes and Practices of 417 households. The in-depth interviews were analysed using framework analysis. Descriptive analysis showed responsibilities for household decisions on dogs' and children's health. Multivariate analysis determined factors associated with the probability of dogs being owned and the number of dogs owned, as well as factors associated with the responsibility for child health. Dog ownership varied considerably between villages and even households. The number of dogs per household was associated with the size of a household and the presence of livestock. Children are not directly involved in the decision to vaccinate a dog, which is largely made by the father, while responsibility for seeking health care if a child is bitten lies with the mother. These novel results are relevant for the design and implementation of rabies interventions. Specifically, awareness campaigns should focus on decision-makers in households to improve rabies prevention practices and on the understanding of processes critical to the control of zoonoses more broadly.
Factors associated with poor compliance to rabies post-exposure prophylaxis among dog bite victims in Maswa District in Tanzania: a cross-sectional study
(Public health, 2024-05-22) Walwa, Budodi; Kimaro, Esther; Mpolya, Emmanuel; Sambo, Maganga
Introduction: administering rabies post-exposure prophylaxis (PEP) in a timely and appropriate manner remains the most fundamental measure for preventing human rabies. However, a number of barriers to accessing and completing PEP exist. Methods: a cross-sectional study was carried out from April to July 2022 to examine individual and societal barriers to accessing human rabies PEP in Maswa in Maswa District, Tanzania. Dog bite patients were interviewed to gather information about the circumstances of the bite, as well as the availability, affordability, and compliance with PEP. Descriptive and inferential analyses were conducted to address the research question. Results: of the 264 bite patients, 57.6% were male and 67.2% were under 15 years old. Dog bites accounted for the highest proportion of cases 95.5% (n=252) and category-III bites were most frequently observed 63% (n=167). About 45.1% (n=119) of patients traveled over 25 kilometers (km) from their residences to reach PEP clinics. The average cost for obtaining PEP doses was USD 51.1. Only 3.8% (n=10) of patients received all five recommended PEP doses. Travel distances and costs were significant factors for poor PEP compliance. Patients who traveled by bicycle to health facilities had higher odds of PEP compliance (aOR =17.12: 95% CI: 14.12 - 23.42) than those who walked (aOR = 6.88: 95% CI: 1.28 - 26.13). Furthermore, patients who utilized buses were four times more likely to comply to PEP (aOR = 4.23, 95% CI: 1.06 - 16.46) than those using motorcycles. Bite patients from urban areas were 6 times more likely to complete the recommended PEP (aOR = 5.79, 95% CI: 1.29 - 15.20) than their rural counterparts. Conclusion: findings from this study inform measures to improve compliance to rabies PEP among dog bite victims. These measures include subsidizing the cost of PEP, improving PEP accessibility, and raising awareness about the dangers of rabies particularly in seeking and completing the recommended PEP focusing on rural communities
Integrating contact tracing and whole- genome sequencing to track the elimination of dog-mediated rabies: An observational and genomic study
(eLife Sciences Publications Ltd, 2023-05-25) Lushasi, Kennedy; Brunker, Kirstyn; Rajeev, Malavika; Ferguson, Elaine; Jaswant, Gurdeep; Baker, Laurie; Biek, Roman; Changalucha, Joel; Cleaveland, Sarah; Czupryna, Anna; Fooks, Anthony; Govella, Nicodemus; Haydon, Daniel; Johnson, Paul; Kazwala, Rudovick; Lembo, Tiziana; Masoud, Msanif; Maziku, Matthew; Mbunda, Eberhard; Mchau, Geofrey; Mohamed, Ally; Mpolya, Emmanuel; Ngeleja, Chanasa; Ng'habi, Kija; Nonga, Hezron; Omar, Kassim; Rysava, Kristyna; Sambo, Maganga; Sikana, Lwitiko; Steenson, Rachel; Hampson, Katie
Background: Dog-mediated rabies is endemic across Africa causing thousands of human deaths annually. A One Health approach to rabies is advocated, comprising emergency post-exposure vaccination of bite victims and mass dog vaccination to break the transmission cycle. However, the impacts and cost-effectiveness of these components are difficult to disentangle. Methods: We combined contact tracing with whole-genome sequencing to track rabies transmission in the animal reservoir and spillover risk to humans from 2010 to 2020, investigating how the components of a One Health approach reduced the disease burden and eliminated rabies from Pemba Island, Tanzania. With the resulting high-resolution spatiotemporal and genomic data, we inferred transmission chains and estimated case detection. Using a decision tree model, we quantified the public health burden and evaluated the impact and cost-effectiveness of interventions over a 10-year time horizon. Results: We resolved five transmission chains co-circulating on Pemba from 2010 that were all eliminated by May 2014. During this period, rabid dogs, human rabies exposures and deaths all progressively declined following initiation and improved implementation of annual islandwide dog vaccination. We identified two introductions to Pemba in late 2016 that seeded re-emergence after dog vaccination had lapsed. The ensuing outbreak was eliminated in October 2018 through reinstated islandwide dog vaccination. While post-exposure vaccines were projected to be highly cost-effective ($256 per death averted), only dog vaccination interrupts transmission. A combined One Health approach of routine annual dog vaccination together with free post-exposure vaccines for bite victims, rapidly eliminates rabies, is highly cost-effective ($1657 per death averted) and by maintaining rabies freedom prevents over 30 families from suffering traumatic rabid dog bites annually on Pemba island. Conclusions: A One Health approach underpinned by dog vaccination is an efficient, cost-effective, equitable, and feasible approach to rabies elimination, but needs scaling up across connected populations to sustain the benefits of elimination, as seen on Pemba, and for similar progress to be achieved elsewhere.
Integrating contact tracing and wholegenome sequencing to track the elimination of dog-mediated rabies: An observational and genomic study
(eLife, 2023-05-23) Lushasi, Kennedy; Brunker, Kirstyn; Rajeev, Malavika; Ferguson, Elaine; Jaswant, Gurdeep; Baker, Laurie; Biek, Roman; Changalucha, Joel; Cleaveland, Sarah; Czupryna, Anna; Fooks, Anthony; Govella, Nicodemus; Haydon, Daniel; Johnson, Paul; Kazwala, Rudovick; Lembo, Tiziana; Marston, Denise; Masoud, Msanif; Maziku, Matthew; Mbunda, Eberhard; Mchau, Geofrey; Mohamed, Ally; Mpolya, Emmanuel; Ngeleja, Chanasa; Ng'habi, Kija; Nonga, Hezron; Omar, Kassim; Rysava, Kristyna; Sambo, Maganga; Sikana, Lwitiko; Steenson, Rachel; Hampson, Katie
Background: Dog-mediated rabies is endemic across Africa causing thousands of human deaths annually. A One Health approach to rabies is advocated, comprising emergency post-exposure vaccination of bite victims and mass dog vaccination to break the transmission cycle. However, the impacts and cost-effectiveness of these components are difficult to disentangle. Methods: We combined contact tracing with whole-genome sequencing to track rabies transmission in the animal reservoir and spillover risk to humans from 2010 to 2020, investigating how the components of a One Health approach reduced the disease burden and eliminated rabies from Pemba Island, Tanzania. With the resulting high-resolution spatiotemporal and genomic data, we inferred transmission chains and estimated case detection. Using a decision tree model, we quantified the public health burden and evaluated the impact and cost-effectiveness of interventions over a 10-year time horizon. Results: We resolved five transmission chains co-circulating on Pemba from 2010 that were all eliminated by May 2014. During this period, rabid dogs, human rabies exposures and deaths all progressively declined following initiation and improved implementation of annual islandwide dog vaccination. We identified two introductions to Pemba in late 2016 that seeded re-emergence after dog vaccination had lapsed. The ensuing outbreak was eliminated in October 2018 through reinstated islandwide dog vaccination. While post-exposure vaccines were projected to be highly cost-effective ($256 per death averted), only dog vaccination interrupts transmission. A combined One Health approach of routine annual dog vaccination together with free post-exposure vaccines for bite victims, rapidly eliminates rabies, is highly cost-effective ($1657 per death averted) and by maintaining rabies freedom prevents over 30 families from suffering traumatic rabid dog bites annually on Pemba island. Conclusions: A One Health approach underpinned by dog vaccination is an efficient, cost-effective, equitable, and feasible approach to rabies elimination, but needs scaling up across connected populations to sustain the benefits of elimination, as seen on Pemba, and for similar progress to be achieved elsewhere.
Reservoir dynamics of rabies in south-east Tanzania and the roles of cross-species transmission and domestic dog vaccination
(John Wiley & Sons, Inc., 2021-08-21) Lushasi, Kennedy; Hayes, Sarah; Ferguson, Elaine; Changalucha, Joel; Cleaveland, Sarah; Govella, Nicodem; Haydon, Daniel; Sambo, Maganga; Mchau, Geofrey; Mpolya, Emmanuel; Mtema, Zacharia; Nonga, Hezron; Steenson, Rachel; Nouvellet, Pierre; Donnelly, Christl; Hampson, Katie
Understanding the role of different species in the transmission of multi-host pathogens, such as rabies virus, is vital for effective control strategies. Across most of sub-Saharan Africa domestic dogs Canis familiaris are considered the reservoir for rabies, but the role of wildlife has been long debated. Here we explore the multi-host transmission dynamics of rabies across south-east Tanzania. Between January 2011 and July 2019, data on probable rabies cases were collected in the regions of Lindi and Mtwara. Hospital records of animal-bite patients presenting to healthcare facilities were used as sentinels for animal contact tracing. The timing, location and species of probable rabid animals were used to reconstruct transmission trees to infer who infected whom and the relative frequencies of within- and between-species transmission. During the study, 688 probable human rabies exposures were identified, resulting in 47 deaths. Of these exposures, 389 were from domestic dogs (56.5%) and 262 from jackals (38.1%). Over the same period, 549 probable animal rabies cases were traced: 303 in domestic dogs (55.2%) and 221 in jackals (40.3%), with the remainder in domestic cats and other wildlife species. Although dog-to-dog transmission was most commonly inferred (40.5% of transmission events), a third of inferred events involved wildlife-to-wildlife transmission (32.6%), and evidence suggested some sustained transmission chains within jackal populations. A steady decline in probable rabies cases in both humans and animals coincided with the implementation of widespread domestic dog vaccination during the first 6 years of the study. Following the lapse of this program, dog rabies cases began to increase in one of the northernmost districts. Synthesis and applications. In south-east Tanzania, despite a relatively high incidence of rabies in wildlife and evidence of wildlife-to-wildlife transmission, domestic dogs remain essential to the reservoir of infection. Continued dog vaccination alongside improved surveillance would allow a fuller understanding of the role of wildlife in maintaining transmission in this area. Nonetheless, dog vaccination clearly suppressed rabies in both domestic dog and wildlife populations, reducing both public health and conservation risks and, if sustained, has potential to eliminate rabies from this region.
Use of lay vaccinators in animal vaccination programmes: A scoping review
(PLOS ONE, 2021-08-11) Duamor, Christian; Hampson, Katie; Lankester, Felix; Sambo, Maganga; Kreppel, Katharina; Wyke, Sally; Cleaveland, Sarah
Background The human resource gap in veterinary sectors, particularly in low-income countries, imposes limitations on the delivery of animal healthcare in hard-to-reach populations. Lay animal health workers have been deployed in these settings to fill the gap though there are mixed views about the benefits of doing this and whether they can deliver services safely. We mapped evidence on the nature and extent of roles assigned to lay animal vaccinators, and identified lessons useful for their future deployment. Methodology/Principal findings Following the PRISMA Extension for Scoping Reviews guidelines, we searched seven bibliographic databases for articles published between 1980 and 2021, with the search terms lay OR community-based OR volunteer AND "animal health worker" OR vaccinator*, and applied an a priori exclusion criteria to select studies. From 30 identified studies, lay vaccinators were used by non-government developmental (n = 12, 40%), research (n = 10, 33%) and government (n = 5, 17%) programmes to vaccinate domestic animals. The main reason for using lay vaccinators was to provide access to animal vaccination in the absence of professional veterinarians (n = 12, 40%). Reported positive outcomes of programmes included increased flock and herd sizes and farmer knowledge of best practice (n = 13, 43%); decreased disease transmission, outbreaks and mortality (n = 11, 37%); higher vaccination coverage (10, 33%); non-inferior seroconversion and birth rates among vaccinated herds (n = 3, 10%). The most frequently reported facilitating factor of lay vaccinator programmes was community participation (n = 14, 47%), whilst opposition from professional veterinarians (n = 8, 27%), stakeholders seeking financial gains to detriment of programmes goals (n = 8, 27%) and programming issues (n = 8, 27%) were the most frequently reported barriers. No study reported on cost-effectiveness and we found no record from a low and middle-income country of lay vaccinator programmes being integrated into national veterinary services. Conclusion Although the majority of included studies reported more benefits and positive perceptions of lay vaccinator programmes than problems and challenges, regularization will ensure the programmes can be designed and implemented to meet the needs of all stakeholders