Issue: February 2016
December 17, 2015
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Incentives improve rabies vaccination coverage

Issue: February 2016
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Recent findings published in PLoS Neglected Tropical Diseases showed that brightly colored dog collars and owner wristbands, which distinguished vaccinated dogs, increased participation in rabies vaccination clinics in Tanzania. In addition, the findings showed that the program was economically viable.

According to researchers, an estimated 59,000 people die each year from canine-mediated rabies. More than 99% of cases occur in developing countries where rabies is endemic, and almost half are children.

“Though collars have been commonly used to aid the identification of dogs while estimating vaccination coverage, this is the first study to quantify the impact that collars and wristbands used as incentives have on owner participation in mass dog vaccination campaigns,” the researchers wrote.

In the study, 62 villages in northwestern Tanzania were randomly assigned to four testing groups to determine the effectiveness of dog collars and wristbands. Depending on the group, vaccinated dogs were given brightly colored collars; owners of vaccinated dogs were given brightly colored wristbands; both collars and wristbands were used; or there were no incentives for vaccination.

The researchers estimated the economic viability of the program by comparing the price of vaccinating each dog vs. the price of the wristbands and collars. After the program ended, they tested the accuracy of a household questionnaire and transect surveys to determine vaccine coverage vs. the more expensive “gold standard” village-wide census. An interviewer administered an oral questionnaire for at least 70 houses per village. Vaccinated dogs were marked with a water-soluble purple spray for the transect survey, and the researchers observed and recorded the number of marked and unmarked dogs.

The researchers found that 34 more dogs per village were brought into the vaccination clinic in villages that were given a wristband or dog collar vs. the control group.

Although the collars and wristbands had a positive impact, vaccination coverage was 16% below the recommended 70% required in endemic areas to disrupt rabies transmission, the researchers said.

They found that the program resulted in a reduction in the cost-per-dog of 47 cents, which means that the wristband or dog collar must cost less than that for the program to be economically viable. In addition, they found that the household questionnaire underestimated vaccine coverage by 6.6%, while the transect survey overestimated coverage by 7.1%. These results did not significantly differ from the results of the villagewide census.

“The use of collars and wristbands as incentives in dog vaccination coverage clinics had a significant impact on vaccination turnout,” the researchers wrote. “Assuming cheap options are available, they can reduce the cost of immunization per dog. We therefore recommend their use. However, improving the dissemination of advertising … is required.” – by Will Offit

Disclosure: The researchers report no relevant financial disclosures.