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Challenges and needs for China to eliminate rabies

机译:中国消除狂犬病的挑战和需求

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In China, rabies is a significant public health concern where dogs remain the main reservoir of disease transmission to humans; rabies-related mortality ranks second in the world. We compiled all published articles and official documents on rabies in mainland China to examine challenges and needs to eliminate rabies in the country. The Chinese authorities have identified rabies as a priority, recognized rabies control in dogs as key to control rabies in humans and required intersectoral collaborations. Efforts have been made to respond effectively to the latest re-emergence of rabies, which peaked in 2007 with >3,300 cases. Despite these outcomes and the increasing volume of publications and regulations in the recent years, our review points to some major information gaps to improve rabies control activities and envisage elimination program. An emphasis on laboratory or pathogen-associated and basic epidemiology research in the literature has contrasted with the absence of information to monitor various systems in humans and animals (e.g. quality of surveillance, response and post-exposure prophylaxis). Information is also lacking to appropriately inform policymakers (e.g. economic disease burden, impact of policies) and assist program managers (e.g. comprehensive and strategic guidance for cost-effective prevention and control activities, public education and dog population management). In conclusion, strategic planning is needed to provide a sense of direction, demonstrate feasibility of elimination in China, and develop a research agenda, addressing country’s operational needs and constraints. The planning should be a multisectoral effort.
机译:在中国,狂犬病是一个重大的公共卫生问题,狗仍然是人类传播疾病的主要场所。与狂犬病有关的死亡率居世界第二位。我们汇编了有关中国大陆狂犬病的所有已发表文章和官方文件,以研究在中国消除狂犬病的挑战和需求。中国当局已将狂犬病列为优先事项,将犬的狂犬病控制视为控制人类狂犬病的关键,并要求部门间开展合作。为有效应对最新的狂犬病再发作出了努力,狂犬病最近在2007年达到峰值,有3,300多例。尽管取得了这些成果,并且近年来出版物和法规的数量不断增加,但我们的审查指出,在改善狂犬病控制活动和设想消灭计划方面存在一些重大信息空白。文献中对实验室或病原体相关的流行病学和基础流行病学研究的重视与缺乏监测人类和动物各种系统的信息(例如,监测,反应和暴露后预防的质量)形成对比。缺乏信息也无法适当地向决策者提供信息(例如经济疾病负担,政策影响)和协助计划管理人员(例如针对具有成本效益的预防和控制活动,公共教育和狗群管理的全面和战略指导)。总之,需要进行战略规划,以提供方向感,证明在中国进行淘汰的可行性并制定研究议程,以解决该国的运营需求和制约因素。该计划应是一项多部门努力。

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