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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. |
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