Vacunacion antirrábica en caninos y felinos de la Ciudad de Buenos Aires: Año 2021 / Rabies vaccination in Buenos Aires City: Year 2021

El objetivo del presente informe es exponer la situación actual de la vacunación antirrábica de la Ciudad de Buenos Aires, con el fin de realizar una planificación estratégica de prevención y control de la enfermedad. Se utilizaron datos sobre vacunación realizada por veterinarias privadas estimados a partir de la venta de talonarios por parte del Consejo Profesional de Médicos Veterinarios (CPMV); así como la vacunación realizada por los efectores públicos de salud: Instituto de Zoonosis Luis Pasteur (IZLP) y Mascotas de la Ciudad (MC).

Rabies Elimination in Rural Kenya: Need for Improved Availability of Human Vaccines, Awareness and Knowledge on Rabies and Its Management Among Healthcare Workers.

Background: In Africa, rabies causes an estimated 24,000 human deaths annually. Mass dog vaccinations coupled with timely post-exposure prophylaxis (PEP) for dog-bite patients are the main interventions to eliminate human rabies deaths. A well-informed healthcare workforce and the availability and accessibility of rabies biologicals at health facilities are critical in reducing rabies deaths. We assessed awareness and knowledge regarding rabies and the management of rabies among healthcare workers, and PEP availability in rural eastern Kenya. Methodology: We interviewed 73 healthcare workers from 42 healthcare units in 13 wards in Makueni and Kibwezi West sub-counties, Makueni County, Kenya in November 2018. Data on demographics, years of work experience, knowledge of rabies, management of bite and rabies patients, and availability of rabies biologicals were collected and analyzed. Results: Rabies PEP vaccines were available in only 5 (12%) of 42 health facilities. None of the health facilities had rabies immunoglobulins in stock at the time of the study. PEP was primarily administered intramuscularly, with only 11% (n = 8) of the healthcare workers and 17% (7/42) healthcare facilities aware of the dose-sparing intradermal route. Less than a quarter of the healthcare workers were aware of the World Health Organization categorization of bite wounds that guides the use of PEP. Eighteen percent (n = 13) of healthcare workers reported they would administer PEP for category I exposures even though PEP is not recommended for this category of exposure. Only one of six respondents with acute encephalitis consultation considered rabies as a differential diagnosis highlighting the low index of suspicion for rabies. Conclusion: The availability and use of PEP for rabies was sub-optimal. We identified two urgent needs to support rabies elimination programmes: improving availability and access to PEP; and targeted training of the healthcare workers to improve awareness on bite wound management, judicious use of PEP including appropriate risk assessment following bites and the use of the dose-sparing intradermal route in facilities seeing multiple bite patients. Global and domestic funding plan that address these gaps in the human health sector is needed for efficient rabies elimination in Africa.

Capacitação para profilaxia da raiva humana

Evento promovido pela Subcoordenadoria de Vigilância Ambiental (Suvam) da Secretaria de Estado da Saúde Pública (Sesap) Programação: 15h00: Acolhimento / Abertura (SUVAM/ SUCA /SESAP-RN) 15h15: Vigilância dos casos de raiva animal (Paulo Antônio da Rocha Ferreira - Médico Veterinário / Coordenador do Laboratório de Raiva do LACEN) 15h30: Raiva animal e profilaxia da raiva humana (Thaiza Helena Tavares Fernandes - Médica Veterinária do Serviço de Profilaxia Antirrábica do Hospital Giselda Trigueiro/SESAP-RN) 15h40: Profilaxia da raiva humana (Hênio Godeiro Lacerda - Médico Infectologista / Professor Adjunto da Universidade Federal do Rio Grande do Norte).

Facilities and services of postexposure prophylaxis in anti-rabies clinics: A national assessment in India.

BACKGROUND: The rabies postexposure prophylaxis (PEP) is provided through anti-rabies clinics in the country. It was considered important to assess their facilities under a nationwide multi-centric survey. OBJECTIVES: The objective of this study is to assess the facilities available for PEP at the anti-rabies clinics and to ascertain the PEP provided at the anti-rabies clinics. METHODS: The cross-sectional assessment was made from May 2017 to January 2018 in selected seven states of India. Thirty-five anti-rabies clinics from both Government and private; urban and rural areas from the states were assessed by an expert team using a pretested checklist for facilities and services available for PEP. RESULTS: On an average, 10 new animal bite cases were attended at each anti-rabies clinic per day. The cold chain facilities for rabies biologicals were satisfactory. The facilities for wound washing (54.3%) and the use of antiseptics to animal bite wounds were not adequate. Rabies vaccines were administered by intramuscular in 54.3% and by intradermal route in 45.7% of the cases. The vaccine stock-outs were reported only in the government sector (18.5%). The type of rabies immunoglobulin (RIG) used was equine (63.2%) and human (36.8%); given free of cost in 40% of Anti rabies clinics. The local wound infiltration of RIG was in practice at 58.6% of anti-rabies clinics. The stock-out of RIG was more in private (50%) hospitals than in Government (40.7%) hospitals. CONCLUSION: The facilities available for PEP at the anti-rabies clinics were inadequate and have to be improved across the country.

Assessment of procurement, distribution, availability, and utilization of rabies biologicals for postexposure prophylaxis in seven states of India.

BACKGROUND: To achieve the elimination of dog-mediated human rabies by 2030, all bite victims shall have access to life-saving rabies biologicals across the country. The information on procurement, distribution, availability, and utilization of rabies biologicals for postexposure prophylaxis is insufficient. OBJECTIVES: The objective of the study is to assess the demand, procurement, distribution, availability, storage, and utilization of rabies biologicals and to appraise the monitoring and reporting of rabies biologicals at all the levels. METHODS: A multicentric survey was conducted from July to December 2017 in seven regional representative states across the country. The survey team visited the offices in-charge for logistics of rabies biologicals at the survey states and districts; information was collected using structured pro formas and perusing relevant records. District vaccine stores and health institutions in urban and rural areas were visited to assess the availability and stock-outs of rabies biologicals. RESULTS: Procurement, distribution, and availability of rabies biologicals grossly vary between states, since it is the state subject. In Gujarat, both vaccines and immunoglobulins were available even at the Primary Health Centre level; paradoxically, there was a scarcity of both at the district level in Manipur. Immunoglobulins were used only in nine of the surveyed 27 government health-care facilities (33.3%) and two of the eight private facilities (25%). The cold chain facility for storage of rabies biologicals was satisfactory; however, the monitoring and reporting of rabies biologicals were not complete. CONCLUSION: The procurement, distribution, availability, and utilization of rabies biologicals were not universal across the states. Frequent shortages of supply have to be improved to attain universal coverage.

Market mapping and landscape analysis of human rabies biologicals in India.

BACKGROUND: Rabies vaccines and immunoglobulins are lifesaving in humans following animal exposures. These biologicals should continuously be available throughout the year to prevent and eliminate human rabies by 2030. OBJECTIVES: The present study aimed at assessing availability of different kinds of human rabies biologicals in the country and undertaking market mapping and landscape analysis of human rabies biologicals in India. METHODS: The study comprising both quantitative and qualitative approach was conducted from May to November 2017 as a part of the Indian multicentric rabies survey by Association for Prevention and Control of Rabies in India. All stakeholders (agencies/personnel) associated with rabies biologicals were the study units/participants. Required data were generated through brainstorming sessions with key stakeholders; reviewing of databases/existing literature; conducting in-depth surveys; interviewing; focused group discussions, etc. RESULTS: Two types of cell culture rabies vaccines are available in the country manufactured by different pharmaceutical companies; most of the vaccines are indigenously produced and the market size of the rabies vaccines is about INR 125 crores with highest sales in the northern region followed by South. Likewise, there are 2 types of immunoglobulin available, i.e., equine rabies immunoglobulins (RIGs), which are indigenously produced and human RIGs, which are imported. The market value of RIGs is about INR 83 crores. A novel rabies monoclonal antibody is also been marketed in the country from November 2017. CONCLUSIONS: There are many lacunas in the market availability of rabies biologicals in different parts of the country; therefore, a significant expansion/shift in focus must be considered, through rigorous strategic planning process.

Background paper for developing a policy for the use of rabies biologicals and vaccination of humans in India.

National Rabies Control Programme, India, is in operation since 2012-2013 without much impact due to poor funding and no set policy for the rabies prevention and control. An effort was made to develop a draft policy paper which can help the Government of India to develop a national rabies vaccination policy for humans and for achieving the goal of zero dog-mediated human rabies deaths by the year 2030. A technical stakeholders meeting was held under the chairmanship of the Drug Controller General of India at New Delhi in December 2017 to discuss the problems and solutions for providing essential rabies postexposure prophylaxis (PEP). The following problems and dilemmas were identified: frequent shortages of life-saving rabies vaccines and rabies immunoglobulin for PEP; as rabies vaccines are mostly procured by the state governments that often face resource crunch and hurdles in logistics within the states; production levels of rabies biologicals in the public sector are low; and the export of rabies biologicals from the private sector needs to be critically evaluated in the context of frequent stock-outs in the domestic market and also the national vaccine security.

Overview of rabies post-exposure prophylaxis access, procurement and distribution in selected countries in Asia and Africa, 2017-2018.

BACKGROUND: Rabies is a neglected zoonotic disease with a global burden of approximately 59,000 human deaths a year. Once clinical symptoms appear, rabies is almost invariably fatal; however, with timely and appropriate post-exposure prophylaxis (PEP) consisting of wound washing, vaccine, and in some cases rabies immunoglobulin (RIG), the disease is almost entirely preventable. Access to PEP is limited in many countries, and when available, is often very expensive. METHODS: We distributed a standardized assessment tool electronically to a convenience sample of 25 low- and middle-income countries in Asia and Africa to collect information on rabies PEP procurement, forecasting, distribution, monitoring and reporting. Information was collected from national rabies focal points, focal points at the World Health Organization (WHO) country offices, and others involved in procurement, logistics and distribution of PEP. Because RIG was limited in availability or unavailable in many countries, the assessment focused on vaccine. Data were collected between January 2017 and May 2018. RESULTS: We received responses from key informants in 23 countries: 11 countries in Asia and 12 countries in Africa. In 9 of 23 (39%) countries, rabies vaccine was provided for free in the public sector and was consistently available. In 10 (43%) countries, all or some patients were required to pay for the vaccine in the public sector, with the cost of a single dose ranging from US$ 6.60 to US$ 20/dose. The primary reason for the high cost of the vaccine for patients was a lack of funding at the central level to subsidize vaccine costs. In the remaining 4 (17%) countries, vaccine was provided for free but was often unavailable so patients were required to purchase it instead. The majority of countries used the intramuscular route for vaccine administration and only 5 countries exclusively used the dose-sparing intradermal (ID) route. Half (11/22; 50%) of all countries assessed had a standardized distribution system for PEP, separate from the systems used for routine childhood vaccines, and almost half used separate storage facilities at both central and health facility levels. Approximately half (9/22; 41%) of all countries assessed reported having regular weekly, monthly or quarterly reporting on rabies vaccination. CONCLUSIONS: While all countries in our assessment had rabies vaccines available in the public sector to some extent, barriers to access include the high cost of the vaccine to the government as well as to patients. Countries should be encouraged to use ID administration as this would provide access to rabies vaccine for many more people with the same number of vaccine vials. In addition, standardized monitoring and reporting of vaccine utilization should be encouraged, in order to improve data on PEP needs.

Rabies vaccine and immunoglobulin supply and logistics: Challenges and opportunities for rabies elimination in Kenya.

Prompt provision of post-exposure-prophylaxis (PEP) including vaccines and rabies immunoglobulin (RIG) to persons bitten by suspect rabid dogs is a key strategy to eliminating human deaths from dog-mediated rabies in Kenya by 2030. We assessed the availability, forecasting and supply chain logistics for rabies PEP in Kenya, compared with the system used for vaccines in the expanded program of immunization (routine vaccines). Semi-structured questionnaires capturing data on forecasting, procurement, distribution, cold chain and storage, monitoring and reporting for routine vaccines and rabies vaccines and RIG were administered to 35 key personnel at the national, county, sub-county and health facility levels in five counties. Results showed large variability in PEP availability (stockouts ranged from 3 to 36 weeks per year) with counties implementing rabies elimination activities having shorter stockouts. PEP is administered intramuscularly using the 5-dose Essen regimen (day 0, 3, 7, 14 and 28). PEP costs to bite patients were reported to range from 10 to 15 US dollars per dose; RIG was seldom available. A less robust supply and logistics infrastructure is used for rabies PEP compared to routine vaccines. Forecasting and monitoring mechanisms for rabies PEP was poor in the study counties. The supply of vaccines from the national to the sub-national level is mainly through two government agencies and a private agency. Since government decentralization, the National Vaccine and Immunization Program has remained as the main supplier of the routine vaccines, playing a lesser role in the supply of rabies biologicals. Adoption of the dose-saving intradermal route for PEP administration, reduction of PEP costs to patients, and placing rabies vaccines within the routine vaccines supply and logistics system would significantly improve PEP availability and accessibility to persons at risk of rabies; a critical step to achieving elimination of human deaths from rabies.

A social justice perspective on access to human rabies vaccines.

Rabies kills tens of thousands of people every year despite being entirely vaccine preventable. Key global health actors have launched a country-driven plan to achieve zero human deaths from dog-mediated rabies by 2030 worldwide. This partnership has recently been strengthened by Gavi, the Vaccine Alliance's decision to invest in human rabies vaccines for post-exposure prophylaxis (PEP). While nation states are key to rabies elimination, the importance of Gavi's role cannot be understated. Unlike any other actor, Gavi can directly address an otherwise intractable market failure in the inadequate supply of rabies PEP. In this commentary, we employ the Capabilities Approach to identify the barriers to PEP access that lead to this market failure and, as a result, unnecessary deaths and suffering. We show the role that Gavi can play in reducing exposure of PEP supply to market forces as a matter of social justice, and hence redress the inequity underlying human rabies deaths.

Global characteristics of the rabies biologics market in 2017.

In 2017, the World Health Organization, the World Organisation for Animal Health, the Food and Agriculture Organization of the United Nations and the Global Alliance for Rabies control developed a strategic plan to end human rabies deaths by 2030. A survey for manufacturing capacity and product characteristics of rabies biologics was conducted to inform this process. Twenty-three of 42 manufacturers, responded, giving a market capacity for 2017 of 90 million vials for human vaccines, 2.5 million vials for rabies immunoglobulins, 2 million vials for monoclonal antibodies and 181 million vials for dog vaccines. Production capacity could be increased by many manufacturers but was limited by country demand, lack of long-term planning and restricted market expansion. Should countries implement national rabies elimination programmes where biologic needs are forecasted and production lead times respected, manufacturers can meet future supply needs towards global elimination of human dog-mediated rabies deaths.

Descriptive assessment of rabies post-exposure prophylaxis procurement, distribution, monitoring, and reporting in four Asian countries: Bangladesh, Bhutan, Cambodia, and Sri Lanka, 2017-2018.

BACKGROUND: There are approximately 35,000 human deaths from rabies in Asia annually. Rabies can be prevented through timely post-exposure prophylaxis (PEP) consisting of wound washing, rabies vaccine, and in some cases, rabies immunoglobulin (RIG). However, access to rabies PEP often remains limited to urban areas and is cost-prohibitive. There is little information on procurement, distribution, monitoring, and reporting of rabies PEP. METHODS: We interviewed key informants in the public sector from various levels in Bangladesh, Bhutan, Cambodia, and Sri Lanka between March 2017 and May 2018 using a descriptive assessment tool to obtain information on procurement, distribution, monitoring, and reporting of rabies PEP. These four countries in Asia were chosen to showcase a range of rabies PEP systems. National rabies focal points were interviewed in each country and focal points helped identify additional key informants at lower levels. RESULTS: A total of 22 key informants were interviewed at various levels (central level to health facility level) including national rabies focal points in each country. Each country has a unique system for managing rabies PEP procurement, distribution, monitoring, and reporting. There are varying levels of PEP access for those with potential rabies exposures. Rabies PEP is available in select health facilities throughout the country in Bangladesh, Bhutan, and Sri Lanka. In Cambodia, rabies PEP is limited to two urban centers. The availability of RIG in all four countries is limited. In these four countries, most aspects of the rabies PEP distribution system operate independently of systems for other vaccines. However, in Bhutan, rabies PEP and Expanded Programme on Immunization (EPI) vaccines share cold chain space in some locations at the lowest level. All countries have a monitoring system in place, but there is limited reporting of data, particularly to the central level. CONCLUSION: Systems to procure, deliver, monitor, and report on rabies PEP are variable across countries. Sharing information on practices more widely among countries can help programs to increase access to this life-saving treatment.

The need to improve access to rabies post-exposure vaccines: Lessons from Tanzania.

BACKGROUND: Rabies is preventable through prompt administration of post-exposure prophylaxis (PEP) to exposed persons, but PEP access is limited in many rabies-endemic countries. We investigated how access to PEP can be improved to better prevent human rabies. METHODS: Using data from different settings in Tanzania, including contact tracing (2,367 probable rabies exposures identified) and large-scale mobile phone-based surveillance (24,999 patient records), we estimated the incidence of rabies exposures and bite-injuries, and examined health seeking and health outcomes in relation to PEP access. We used surveys and qualitative interviews with stakeholders within the health system to further characterise PEP supply and triangulate these findings. RESULTS: Incidence of bite-injury patients was related to dog population sizes, with higher incidence in districts with lower human:dog ratios and urban centres. A substantial percentage (25%) of probable rabies exposures did not seek care due to costs and limited appreciation of risk. Upon seeking care a further 15% of probable rabies exposed persons did not obtain PEP due to shortages, cost barriers or misadvice. Of those that initiated PEP, 46% did not complete the course. If no PEP was administered, the risk of developing rabies following a probable rabies exposure was high (0.165), with bites to the head carrying most risk. Decentralized and free PEP increased the probability that patients received PEP and reduced delays in initiating PEP. No major difficulties were encountered by health workers whilst switching to dose-sparing ID administration of PEP. Health infrastructure also includes sufficient cold chain capacity to support improved PEP provision. However, high costs to governments and patients currently limits the supply chain and PEP access. The cost barrier was exacerbated by decentralization of budgets, with priority given to purchase of cheaper medicines for other conditions. Reactive procurement resulted in limited and unresponsive PEP supply, increasing costs and risks to bite victims. CONCLUSION: PEP access could be improved and rabies deaths reduced through ring-fenced procurement, switching to dose-sparing ID regimens and free provision of PEP.

Vigilancia, prevención y control de la rabia: Ciudad de Buenos Aires: Junio 2018 / Surveillance, prevention and control of rabies: City of Buenos Aires: June 2018

La rabia es una enfermedad viral, de distribución mundial que afecta al hombre y a todos los mamíferos tanto domésticos como silvestres, con una letalidad del 100% afectando el sistema nervioso central. Se transmite por medio de la inoculación del virus contenido en la saliva del animal infectado, principalmente por mordeduras o el lamido de heridas, o por predación cuando un animal caza un murciélago infectado y toma contacto con el virus desde el encéfalo del quiróptero. Otras formas de transmisión, menos frecuentes son por trasplante de tejidos infectados o por aerosoles. En este apartado, se describe la situación epidemiológica de esta zoonosis en la Ciudad de Buenos Aires: observación de animales mordedores, detección de virus rábico en muestras mediante diagnóstico de laboratorio, vacunación de animales y control poblacional mediante esterilizaciones quirúrgicas, acciones de control de focos de rabia, y seguimiento de animales con exposición a murciélagos positivos a rabia o no analizables

Vaccine banks for controlling dog-mediated rabies.

The World Organisation for Animal Health (OIE) regional vaccine banks are established for priority diseases, following a business model that depends largely on financial support from donors (with vaccine also purchased directly by individual countries and international organisations that have been granted access by the OIE to the mechanism), and is based on the concept of starting small and scaling up. The OIE vaccine bank for rabies was established in 2012 with a first production order of just 50,000 doses, but as of 31 December 2016, after five years, the OIE had ordered almost 16 million doses of rabies vaccines for deliveries in 24 countries. It was set up on the basis of OIE internationally recognised procurement procedures and the outcome of an international call for tender. Vaccine manufacturers are contracted to produce and supply high-quality vaccine on demand, but they also keep vaccines available at any moment so that they can deliver small quantities of vaccines for emergencies.

L'Organisation mondiale de la santé animale (OIE) a mis en place des banques de vaccins régionales pour certaines maladies prioritaires, suivant un modèle économique fortement axé sur le soutien financier des donateurs (avec la possibilité également pour les pays individuels et les organisations internationales d'acquérir directement des vaccins dès lors que l'OIE leur a donné accès au dispositif) ; le principe opérationnel de ces banques est celui d'un démarrage modeste suivi d'une montée en puissance progressive. La banque de vaccins de l'OIE contre la rage a été lancée en 2012 avec une première commande pour une production de 50 000 doses. Au 31 décembre 2016, soit après cinq ans d'existence de la banque, le total des commandes de l'OIE s'élevait à près de 16 millions de doses de vaccin contre la rage distribuées dans 24 pays. La mise en place de la banque de vaccins s'inscrit dans les procédures de passation des marchés de l'OIE reconnues au plan international et a fait l'objet d'un appel d'offres international. Le cahier des charges des fabricants de vaccin porte tant sur la production et fourniture à la demande de vaccins de qualité que sur le maintien d'un stock permanent de petites quantités de vaccin pouvant être livrées à tout moment en cas d'urgence.

Los bancos de vacunas regionales de la Organización Mundial de Sanidad Animal (OIE), creados para responder a las enfermedades prioritarias, responden a un modelo económico que depende en gran medida del apoyo financiero de donantes (y también la compra directa de vacunas por parte de países u organizaciones internacionales a los que la OIE ha dado acceso al mecanismo) y reposa en la idea de empezar a pequeña escala e ir ampliando la magnitud de las operaciones. El banco de vacunas antirrábicas de la OIE, creado en 2012, empezó a funcionar con una producción del orden de apenas 50 000 dosis, pero a 31 de diciembre de 2016, cinco años después, la OIE había encargado casi 16 millones de dosis de vacuna para entregarlas a 24 países. Fue establecido conforme a los procedimientos de compra de la OIE, reconocidos a escala internacional, y a los resultados de un proceso internacional de licitación. Los fabricantes de vacunas firman un contrato para producir y entregar vacunas de gran calidad previo pedido, pero también tienen una reserva de vacunas disponibles para poder entregar en todo momento pequeñas cantidades de vacuna en respuesta a situaciones de emergencia.

Rabies elimination research: juxtaposing optimism, pragmatism and realism.

More than 100 years of research has now been conducted into the prevention, control and elimination of rabies with safe and highly efficacious vaccines developed for use in human and animal populations. Domestic dogs are a major reservoir for rabies, and although considerable advances have been made towards the elimination and control of canine rabies in many parts of the world, the disease continues to kill tens of thousands of people every year in Africa and Asia. Policy efforts are now being directed towards a global target of zero human deaths from dog-mediated rabies by 2030 and the global elimination of canine rabies. Here we demonstrate how research provides a cause for optimism as to the feasibility of these goals through strategies based around mass dog vaccination. We summarize some of the pragmatic insights generated from rabies epidemiology and dog ecology research that can improve the design of dog vaccination strategies in low- and middle-income countries and which should encourage implementation without further delay. We also highlight the need for realism in reaching the feasible, although technically more difficult and longer-term goal of global elimination of canine rabies. Finally, we discuss how research on rabies has broader relevance to the control and elimination of a suite of diseases of current concern to human and animal health, providing an exemplar of the value of a 'One Health' approach.

Census and vaccination coverage of owned dog populations in four resource-limited rural communities, Mpumalanga province, South Africa.

Dogs (Canis familiaris) are often free-roaming in sub-Saharan African countries. Rabies virus circulates in many of these populations and presents a public health issue. Mass vaccination of dog populations is the recommended method to decrease the number of dog and human rabies cases. We describe and compare four populations of dogs and their vaccination coverage in four different villages (Hluvukani, Athol, Utah and Dixie) in Bushbuckridge Municipality, Mpumalanga province, South Africa. Cross-sectional surveys were conducted in the villages of Athol, Utah and Dixie, while data from a Health and Demographic Surveillance System were used to describe the dog population in Hluvukani village. All households of the villages were visited to obtain information on the number, sex, age and rabies vaccination status of dogs. From May to October 2013, 2969 households were visited in the four villages and 942 owned dogs were reported. The populations were all young and skewed towards males. No differences were observed in the sex and age distributions (puppies 0-3 months excluded) among the villages. Athol had a higher proportion of dog-owning households than Hluvukani and Utah. Vaccination coverages were all above the 20% - 40% threshold required for herd immunity to rabies (38% in Hluvukani, 51% in Athol, 65% in Dixie and 74% in Utah). For the preparation of vaccination campaigns, we recommend the use of the relatively stable dog:human ratio (between 1:12 and 1:16) to estimate the number of dogs per village in Bushbuckridge Municipality.