Rural Rabies Prevention Project - A ‘One Health’ Experiment in India: An Overview.

ABSTRACT

Aim: To assess the feasibility of implementing "one health approach" to prevent human rabies and control animal rabies in a rural community. Study Design: Health services research in a rural setting. Place and Duration of Study A medical college and a veterinary college along with an animal welfare organization delivered a wide array of "integrated services" in three villages' i.e. Kumbalagodu, Thagachikuppe and Gerupalya near Bangalore, India comprising a population of 10,220 persons for a period of two years from December, 2009 to November, 2011. The nearby three villages of Ramohally, Vinayakanagara and Bhimanakuppe with a population of 6,023 persons formed the control group, with no project inputs. Methodology: This consisted of household surveys at the beginning and end of two years ; rabies awareness campaigns; clinical and laboratory surveillance of rabies in dogs; rabies post-exposure prophylaxis (PEP) in humans; pre-exposure rabies prophylaxis (PrEP) by intradermal route in school children, pet dog owners and veterinarians ; mass dog vaccination and deworming; and sero-surveillance in both dogs and humans. Results: The ratio of veterinary and medical manpower in study villages was 1 11 and dog to human ratio was 1 23.The information, education and communication materials developed and used were domestic outdoor wall writings (11), domestic indoor annual wall calendar (2000), school book labels (1000); game charts (16); wall posters (65); flip chart (15); rabies educational DVD (1). There were 102 local cable television transmissions on rabies prevention. 69 persons received rabies PEP. PrEP was given to 368 school children, pet dog owners and veterinarians. Sixty one human serum samples were analyzed by rapid fluorescent focus inhibition test for rabies antibody detection. Sixteen veterinarians were trained to use direct rapid immunohistochemical test (dRIT) for rabies diagnosis. Six ruminants were confirmed rabid by dRIT. There were no cases of human rabies. The cost of entire project was US $ 85,958. Conclusion: A blend of medical, veterinary and animal welfare services were successfully delivered through a "one health" approach. Based on this success a "conceptual model" was evolved to propagate its replication in other rural communities across India.