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dc.contributor.authorLushasi, Kennedyen_UK
dc.contributor.authorSteenson, Rachelen_UK
dc.contributor.authorBernard, Jubilateen_UK
dc.contributor.authorChangalucha, Joel Jacksonen_UK
dc.contributor.authorGovella, Nicodem Jamesen_UK
dc.contributor.authorHaydon, Daniel Ten_UK
dc.contributor.authorHoffu, Husnaen_UK
dc.contributor.authorLankester, Felixen_UK
dc.contributor.authorMagoti, Franken_UK
dc.contributor.authorMpolya, Emmanuel Abrahamen_UK
dc.contributor.authorMtema, Zachariaen_UK
dc.contributor.authorNonga, Hesronen_UK
dc.contributor.authorHampson, Katieen_UK
dc.description.abstractRabies is a neglected zoonotic disease that causes an estimated 59,000 human deaths worldwide annually, mostly in Africa and Asia. A target of zero human deaths from dog-mediated rabies has been set for 2030, and large-scale control programs are now advocated. However, in most low-income endemic countries surveillance to guide rabies control is weak and few cases of rabies are recorded. There is an urgent need to enhance surveillance to improve timely case detection and inform rabies control and prevention, by operationalizing a “One Health” approach. Here we present data from a study piloting Integrated Bite Case Management (IBCM) to support intersectoral collaboration between health and veterinary workers in Tanzania. We trained government staff to implement IBCM, comprising risk assessments of bite patients by health workers, investigations by livestock field officers to diagnose rabid animals, and use of a mobile phone application to support integration. IBCM was introduced across 20 districts in four regions of Tanzania and results reported after 1 year of implementation. Numbers of bite patient presentations to health facilities varied across regions, but following the introduction of IBCM reporting of bite patients at high-risk for rabies more than doubled in all regions. Over 800 high-risk investigations were carried out, with 49% assessed as probable dog rabies cases on the basis of clinical signs, animal outcome, and rapid diagnostic testing. The status of a further 20% of biting animals could not be determined but rabies could not be ruled out. Livestock field officers reported that use of rapid diagnostic tests (RDTs) were useful for confirming rabies occurrence. Overall, our study provides further evidence that IBCM is a practical approach that can improve rabies detection in endemic countries, and be used to monitor the impact of mass dog vaccinations, including potential to verify rabies freedom. However, the main challenges to implementation are limited training of health workers in rabies, perceived burden of real-time recording and limited resources for livestock field officers to undertake investigations. Nonetheless, IBCM dramatically improved case detection and communication between sectors and we recommend further implementation research to establish best practice and applicability to other settings.en_UK
dc.publisherFrontiers Media SAen_UK
dc.relationLushasi K, Steenson R, Bernard J, Changalucha JJ, Govella NJ, Haydon DT, Hoffu H, Lankester F, Magoti F, Mpolya EA, Mtema Z, Nonga H & Hampson K (2020) One Health in Practice: Using Integrated Bite Case Management to Increase Detection of Rabid Animals in Tanzania. Frontiers in Public Health, 8, Art. No.: 13.
dc.rights© 2020 Lushasi, Steenson, Bernard, Changalucha, Govella, Haydon, Hoffu, Lankester, Magoti, Mpolya, Mtema, Nonga and Hampson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY - The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.en_UK
dc.subjectcase detectionen_UK
dc.subjectdomestic dogen_UK
dc.subjectdog-mediated rabiesen_UK
dc.subjectpatient managementen_UK
dc.subjectpost-exposure prophylaxisen_UK
dc.titleOne Health in Practice: Using Integrated Bite Case Management to Increase Detection of Rabid Animals in Tanzaniaen_UK
dc.typeJournal Articleen_UK
dc.citation.jtitleFrontiers in Public Healthen_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderThe Wellcome Trusten_UK
dc.contributor.affiliationIfakara Health Instituteen_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.contributor.affiliationMinistry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC)en_UK
dc.contributor.affiliationIfakara Health Instituteen_UK
dc.contributor.affiliationIfakara Health Instituteen_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.contributor.affiliationIfakara Health Instituteen_UK
dc.contributor.affiliationWashington State Universityen_UK
dc.contributor.affiliationIfakara Health Instituteen_UK
dc.contributor.affiliationNelson Mandela African Institution of Science and Technologyen_UK
dc.contributor.affiliationIfakara Health Instituteen_UK
dc.contributor.affiliationMinistry of Livestock Development and Fisheriesen_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
Appears in Collections:Biological and Environmental Sciences Journal Articles

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