A 'showcase model' canine rabies prevention and elimination programme: the Bohol Rabies Prevention and Elimination Program

摘要

Bohol Province was the region with the fourth-highest number of human rabies deaths in the Philippines before the implementation of the Bohol Rabies Prevention and Elimination Program (BRPEP). In line with the National Rabies Program goal of eliminating rabies by 2020, the BRPEP was initiated in 2007 with the goal of building a sustainable programme to prevent human rabies by eliminating rabies at its source, dogs, by 2010. The intersectoral BRPEP, managed by a council led by the Governor, integratedthe agriculture, public health, education, environment, legislation and local government sectors. The programme included: increasing community involvement; dog population control; mass dog vaccination; improving dog-bite management; veterinary quarantine; diagnostics, surveillance and monitoring. Funding came from the government, dog owners, and partner non-governmental organisations (NGOs). Community volunteers facilitated the institution of the programme. Dog population surveys were conducted to planfor sufficient resources for dog vaccination. Two island-wide mass vaccination and catch-up campaigns were conducted. Dog registration was implemented, including a small fee that was re-invested for programme sustainability. Children were educated by introducing rabies prevention modules into all elementary schools. Existing national, provincial and municipal legislation strengthened the enforcement of activities. A community awareness survey was also conducted. Two mass vaccination campaigns conductedin 2007 and 2008 successfully registered and vaccinated 44% and 70% of dogs. The 2009 awareness survey revealed >90% awareness of rabies and its transmission; 89% knew of the BRPEP and thought it was good for their community, and 73% of households no longer allowed their dogs to roam. Registration fees collected during the first two years totalled US$ 105,740, approximating the annual programme cost. These were re-allocated back into the community to sustain the programme. Between October 2008 and November 2010, no human or animal cases were detected by the provincial surveillance system. A suspected human case and a confirmed dog case were readily detected in November 2010 and April 2011, respectively. Rapid case detection prompted quick response andcontainment. The success of the programme was achieved through empowerment of the local communities and the use of the One Health inter-sectoral approach to rabies control, through the joint efforts and shared resources of local and national government,and non-government partners. The fact that the number of human deaths has dramatically decreased and surveillance has increased indicates that the programme has been successful.