Browsing by Author "Lembo, T."
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Item Comparing methods of assessing dog rabies vaccination coverage in rural and urban communities in Tanzania(Frontiers in Veterinary Science) Sambo, M.; Johnson, P.; Hotopp, K.; Changalucha, J.; Cleaveland, S.; Kazwala, R.; Lembo, T.; Lugelo, A.; Lushasi, K.; Maziku, M.Item Elucidating the phylodynamics of endemic rabies virus in eastern Africa using whole-genome sequencing(Virus Evolution) Brunker, K.; Marston, D. A.; Horton, D. L.; Cleaveland, S.; Fooks, A. R.; Kazwala, R. R.; Ngeleja, C.; Lembo, T.; Sambo, M; Mtema, Z. J.; Sikana, L.; Wilkie, G.; Biek, R.; Hampson, K.Item Progress towards rabies elimination from Pemba Island, Southern Tanzania.(Online Journal of Public Health Informatics .) Lushasi, K. S.; Cleaveland, S.; Changalucha, J. J.; Haydon, D.; Kazwala, R.; Lembo, T.; Masoud, M.; Maziku, M.; Mchau, G.; Mtema, Z.; Omar, K.; Maganga, S.; Rysava, K.; Hampson, K.Item Progress towards rabies elimination from Pemba Island, Southern Tanzania.(Online Journal of Public Health Informatics ., 2017) Lushasi, K. S.; Cleaveland, S.; Changalucha, J. J.; Haydon, D.; Kazwala, R.; Lembo, T.; Masoud, M.; Maziku, M.; Mchau, G.; Mtema, Z.; Omar, K.; Maganga, S.; Rysava, K.; Hampson, K.Using active surveillance approaches to investigate the transmission dynamics of rabies on Pemba Island and across Southern Tanzania, whilst a large-scale dog vaccination program was underway1 , to gain a greater understanding of the dynamics of infection as the disease is driven towards eliminationItem The feasibility of canine rabies elimination in Africa: Dispelling doubts with dataLembo, T.; Hampson, K.; Kaare, M. T.; Ernest, E.; Knobel, D.; Kazwala, R. R.; Haydon, D. T.; Cleaveland, S.Item The feasibility of canine rabies elimination in Africa: Dispelling doubts with data(2010-02-23) Lembo, T.; Hampson, K.; Kaare, M. T.; Ernest, E.; Knobel, D.; Kazwala, R. R.; Haydon, D. T.; Cleaveland, S.Background: Canine rabies causes many thousands of human deaths every year in Africa, and continues to increase throughout much of the continent. Methodology/Principal Findings: This paper identifies four common reasons given for the lack of effective canine rabies control in Africa: (a) a low priority given for disease control as a result of lack of awareness of the rabies burden; (b) epidemiological constraints such as uncertainties about the required levels of vaccination coverage and the possibility of sustained cycles of infection in wildlife; (c) operational constraints including accessibility of dogs for vaccination and insufficient knowledge of dog population sizes for planning of vaccination campaigns; and (d) limited resources for implementation of rabies surveillance and control. We address each of these issues in turn, presenting data from field studies and modelling approaches used in Tanzania, including burden of disease evaluations, detailed epidemiological studies, operational data from vaccination campaigns in different demographic and ecological settings, and economic analyses of the cost-effectiveness of dog vaccination for human rabies prevention. Conclusions/Significance: We conclude that there are no insurmountable problems to canine rabies control in most of Africa; that elimination of canine rabies is epidemiologically and practically feasible through mass vaccination of domestic dogs; and that domestic dog vaccination provides a cost-effective approach to the prevention and elimination of human rabies deaths.Item Toward Elimination of Dog-Mediated Human Rabies: Experiences from Implementing a Large-scale Demonstration Project in Southern Tanzania(Original research article.) Mpolya, E. A; Lembo, T.; Lushasi, K.; Mancy, R.; Mbunda, E. M.; Makungu, S.; Maziku, M.; Sikana, L.; Jaswant, G.; Townsend, S.; Meslin, F. X.; Abela, B.; Ngeleja, C.; Changalucha, J.; Mtema, Z.; Sambo, M.; Mchau, G.; Rysava, K.; Nanai, A.; Kazwala, R.; Cleaveland, S.; Hampson, K.Item Toward Elimination of Dog-Mediated Human Rabies: Experiences from Implementing a Large-scale Demonstration Project in Southern Tanzania(Original research article., 2017) Mpolya, E. A; Lembo, T.; Lushasi, K.; Mancy, R.; Mbunda, E. M.; Makungu, S.; Maziku, M.; Sikana, L.; Jaswant, G.; Townsend, S.; Meslin, F. X.; Abela, B.; Ngeleja, C.; Changalucha, J.; Mtema, Z.; Sambo, M.; Mchau, G.; Rysava, K.; Nanai, A.; Kazwala, R.; Cleaveland, S.; Hampson, K.A Rabies Elimination Demonstration Project was implemented in Tanzania from 2010 through to 2015, bringing together government ministries from the health and veterinary sectors, the World Health Organization, and national and international research institutions. Detailed data on mass dog vaccination campaigns, bite exposures, use of post-exposure prophylaxis (PEP), and human rabies deaths were collected throughout the project duration and project areas. Despite no previous experience in dog vaccination within the project areas, district veterinary officers were able to implement district-wide vaccination campaigns that, for most part, progressively increased the numbers of dogs vaccinated with each phase of the project. Bite exposures declined, particularly in the southernmost districts with the smallest dog populations, and health workers successfully transitioned from primarily intramuscular administration of PEP to intradermal administration, resulting in major cost savings. However, even with improved PEP provision, vaccine shortages still occurred in some districts. In laboratory diagnosis, there were several logistical challenges in sample handling and submission but compared to the situation before the project started, there was a moderate increase in the number of laboratory samples submitted and tested for rabies in the project areas with a decrease in the proportion of rabies-positive samples over time. The project had a major impact on public health policy and practice with the formation of a One Health Coordination Unit at the Prime Minister’s Office and development of the Tanzania National Rabies Control Strategy, which lays a roadmap for elimination of rabies in Tanzania by 2030 by following the Stepwise Approach towards Rabies Elimination (SARE). Overall, the project generated many important lessons relevant to rabies prevention and control in particular and disease surveillance in general. Lessons include the need for (1) a specific unit in the government for managing disease surveillance; (2) application of innovative data collection and management approaches such as the use of mobile phones; (3) close cooperation and effective communication among all key sectors and stakeholders; and (4) flexible and adaptive programs that can incorporate new information to improve their delivery, and overcome challenges of logistics and procurement.