the role of human and animal health professionals towards rabies free ethiopia
TRANSCRIPT
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The Role of Human and Animal Health Professionals towards
Rabies Free Ethiopia
By Abraham Haile (DVM,MVPH)
““Human and animal Health Professionals Together To End rabies”September 26, 2015, Addis Ababa
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Outline
• Introduction
• Gaps in Rabies services Provision in Ethiopia
• The role of Human and Animal Health
Professionals in Prevention and Control of
Rabies
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Introduction
• Rabies is a viral disease of mammals that is transmitted from animals to humans.
• Rabies virus attacks nervous system.• There is NO CURE for the disease once
manifested 100% case fatality rate.• It results in annual loss of more than 55,000-
70,000 lives worldwide. • People at rural areas and Children under 15
years are highly affected.
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Introduction….cont’d
• Transmission:– Spread by bites or contact of infected saliva with
mucous membranes (eyes, mouth, etc)– Contact with nervous tissue– People have been infected by aerosol– Organ transplantation – Consumption of food (milk and meat) from animal
products
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Animal pointHuman point
Anti rabies treatment
Education
Animal vaccination
Dog population
management
Surveillance
Responsible dog
ownership
Improve research
Multi-sectoral and agency
collaboration
Law enforcement
Rabies Prevention and Control Strategies
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Challenges in rabies prevention and control efforts in Ethiopia
• Weak collaboration between veterinary and public health sectors
• Lack of legal enforcement• Weak surveillance system• Lack of sufficient data • Limited access to anti rabies vaccine• Limited laboratory capacity • No standard guidelines for case management• Low awareness among the community and
Professionals
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Gaps in Rabies services Provision in Ethiopia
• Only one laboratory in the country• Few facilities providing anti rabies treatment
service (Only 2 in Addis)• No RX guideline is being used• No training has been given to workers• Lack of human rabies management system• Lack of animal quarantine station and supplies to
capturing, Pre exposure vaccine, drugs• No network between the Public health and
veterinary facilities (EPHI efforts)
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What needs to be done?
Strengthen and capacitate regional public health facilities (Hospitals) on treatment services– Provision of Training and National PET protocol
guidelines– Provision of cell culture vaccine and anti rabies
immunoglobulin (RIG)– Establish human rabies Case management system– Establish referral system
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What needs to be done?….cont’d
Build and strengthen clinical and laboratory diagnostic service at laboratories and clinics – Training for professionals (Veterinary clinics
and regional laboratories)– Provision of guidelines – Scale up laboratory capacity– Establish referral system
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What needs to be done?….cont’d
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What needs to be done?….cont’d
LABORATORY
HOSPITAL/ HEALTH CENTER
VET CLINIC
COMMUNITYEPHI
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The Role of Human and Animal Health in Prevention and Control of Rabies
What is your role?
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The Role of Human and Animal Health in Prevention and Control of Rabies
The Concept of One Health in Prevention and Control of Rabies One Health is collaborative effort of multiple disciplines to attain optimal health for people, animals, and our environment.
Joint collaboration in Research, surveillance, education and Intervention.
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The Role of Human and Animal Health in Prevention and Control of Rabies
Anti rabies treatment
Education
Animal vaccination
Dog population
management
Surveillance
Responsible dog
ownership
Improve research
Multi-sectoral and agency
collaboration
Law enforcement
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The role of animal health professionals
Dog population registration Animal vaccination (>3 months of age) Animal population management Capturing and Quarantining animals for 10
days observation Education of the general public (animal
owners) Information Sharing to public health
professionals
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The role of Human health professionals
First aid treatment Wash wounds immediately with soap and water for
15 minutes Avoid wounds suturing/bandaging TAT and Antibiotics
Pre exposure prophylaxis (PEP) Post exposure prophylaxis (PEP) Education of the general public Information Sharing to Animal health
professionals
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The role of Human health professionals
Address Post exposure prophylaxis (PEP) based on Risk Assessment Algorithm Minimize unnecessary treatments (psychological, financial loss) Ensure appropriate distribution of vaccine
Advocate the use of modern Anti rabies treatment Nerve tissue vaccine (17 injections)
Severe adverse effects Poor immunogenicity
Cell Culture vaccine (5 injections) Minimum adverse effects Good treatment outcomes
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Where do we need collaboration to strengthen service provision ???
Appropriate wound management Observation of suspected animal for 10 days Provide referral of patients
Consult individuals on brain sample transfer to EPHI
Result communication (formal and informal reporting)
Encourage Appropriate animal management Encourage pets Vaccination (dogs and cats)
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Where do we need collaboration to strengthen service provision ???
Create awareness on animal rights Animal feel pain like humans!
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Common Misperceptions
"Vaccinated" animals do not harbor the disease Leashed animals are free of rabies Avoiding vaccination of young animals Puppies cannot get the disease Bitches gave birth Minor bite and scratch Healed wounds as indicator of rabies virus absence
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Common Misperceptions
Considering first aid treatments as anti rabiesRX Inappropriate use of vaccine
IM for fermi type (local vaccine) reduce dose
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EPHI Experience
LABORATORY
EPHI
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What need to be changed ?
EPHI LABORATORY
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What benefits will be gained• Ensured standardized case management will
enable to reducePsychological Financial loss• Facilitate decision making through reliable
data• Enable successful Prevention and Control of
rabies to point of Elimination
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End Rabies Together To See Rabies Free
Ethiopia