Neglected tropical diseases

Haiti uses mobile phones to promote rabies vaccination campaigns

28 September 2018 | Geneva | Port-au-Prince –– Rabies is a public health hazard in Haiti, with eight officially-reported deaths in 2017. Estimates suggest, however, that it is likely that the death toll from this entirely vaccine-preventable disease is much higher.. Despite annual vaccination, reaching 100 000–300 000 dogs in Haiti, achieving the coverage rate of 70% has been difficult.

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Currently, rabies campaigns, managed by the Ministry of Agriculture, rely on central vaccination points and labour-intensive door-to-door methods. However, both methods require that dog owners are aware of the vaccination programme dates and locations, and limited access to television, radio and newspapers in low-resource areas presents a challenge when informing the public about campaigns.

Thanks to increased mobile phone ownership, health authorities in Haiti are now turning to instant messaging to spread the word about rabies and dog vaccination campaigns.

"We have found that one of the best ways to reach people is through mobile technology, and this is helping us to spread the message about rabies and the need to vaccinate dogs,” said Julie Cleaton, Epidemiologist, United States Centers for Disease Control and Prevention. “As an estimated 90% of adult Haitians have a cell phone today, we found that communicating with them through this medium is prompt, practical, and engaging".

Some 600,000 text messages were sent to phones across two Haitian communes in May 2017, reminding people to bring their dogs for vaccination. Customized text messages to communities can also help authorities to support broader public health and behavioural change campaigns. A post-campaign survey to assess the impact on dog owner awareness and participation in dog vaccination programmes found that 91.9% of dog owners who received texts indicated that they were helpful, and more than 70% of text recipients brought their dogs to the central point campaigns.

"We are using smartphones to send and receive records every time a dog in Haiti is vaccinated; during 2017 we tracked the vaccination of more than 250,000 dogs using a mobile app. Data collected are being used to identify areas of low vaccination coverage and are helping to improve surveillance and education efforts,” said Ryan Wallace, Veterinary Epidemiologist, United States Centers for Disease Control and Prevention.

At the same time, the World Health Organization/Pan American Health Organization (WHO/PAHO) has been working with Haiti and other countries in the region on the elimination of rabies. Through PANAFTOSA, the Veterinary Public Health Unit of PAHO, the organization has provided human rabies life-saving vaccine for post exposure prophylaxis in Haiti. “This vaccine offers life-saving treatment to those people that have been bitten by an infected animal in order to prevent the disease from taking hold, if administered shortly after exposure,” said Ottorino Cosivi, Director of PANAFTOSA.

While the text message reminders contributed to improving participation in the one-day central point vaccination zones, overall vaccination coverage remained below the required 70%. Also, in areas in which there had been a three-day door-to-door campaign, the benefits of text message reminders were not observed.

The survey concluded that text message contact improved community awareness and participation, and may, if combined with increased vaccination intensity, improve dog vaccination coverage.

The authorities in Haiti are expanding their use of mobile technology from text messages to apps that can greatly capture vaccination records, help manage bite incidents and for training purposes.

“We are also working on a project to use mobile apps to train health workers and improve communication and access to information after victims are bitten by suspect rabid animals. During the first two months of a pilot programme in Port-au-Prince, more than 180 electronic bite investigation records have been logged,” added Ryan Wallace.

By combining these technologies, Haitian health officials hope to improve their capabilities for vaccination coverage and assessment, and thereby to eliminate canine rabies by 2023.

In 1983, PAHO/WHO launched the Program to Eliminate Human Rabies Transmitted by Dogs, which coordinates regional action among a range of partners and created an epidemiological surveillance system for the disease. Countries began carrying out mass dog vaccination campaigns that led to sustained reductions in the number of both human and canine rabies. In 2017, only four countries of Latin America and the Caribbean reported human cases of canine rabies.

Ashok Moloo
Telephone: +41 22 791 16 37
Mobile phone: +41 79 540 50 86

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