Improving dog vaccinations: a development and feasibility study to pave the way for effective, synchronized dog vaccination campaigns in Africa - Title: Improving dog vaccinations: a development and feasibility study to pave the way for effective, synchronized dog vaccination campaigns in Africa Dog-mediated human rabies has the highest case fatality rate of any known disease and kills approximately 59,000 people annually particularly in Asia and Africa, where people are infected following bites from rabid dogs. Vaccination of at least 70% of the dog population is 100% effective in preventing the spread of rabies to humans. However, achieving 70% coverage can be difficult across large geographic areas. Traditional dog vaccination in East Africa involves teams of vaccinators moving village-to village across a district. Under this team-lead approach, campaigns last 30 to 60 days depending on available personnel and geography. Although this approach sometimes works, its execution at scale is challenging, expensive, and time-consuming. The objective of the proposed research is to carry out an implementation trial to investigate the potential of synchronized dog vaccinations which have been highly successful in Latin America. Such synchronized campaigns could benefit massively from a coordinated mass media campaign in the lead-up before the vaccination day. We will investigate whether combined media and synchronized campaigns can improve vaccination coverage. Our first hypothesis is that synchronized campaigns will increase dog owners’ participation in MDV. Our second hypothesis is that synchronized campaigns will lead to the large number of dogs being vaccinated, resulting in reduction in the overall delivery cost. Our final hypothesis is that synchronized MDV delivery will result in improved public health outcomes and achieve elimination more rapidly than standard team-led MDV. Dog vaccination will be carried out into six districts in a 3-arms of the implementation trial (2 districts per Arm). We will compare (i) vaccination coverage, (ii) cost per dog vaccinated and (iii) health impacts in Arm A: team-led delivery (which is logistically challenging and results in irregular coverage, at cost), versus Arm B: synchronized campaigns without media intervention and Arm C: synchronized campaigns and media intervention. With a date of 2030 set by WHO/OIE/FAO for the global elimination of dog-mediated human rabies, these results are needed to guide elimination in dog-rabies endemic countries
