Notes From the Field
by Dr. Felix Lankester, clinical assistant professor in the Paul G. Allen School for Global Animal Health. This column is Dr. Lankester’s personal account giving a first-hand glimpse of his latest scientific work in Tanzania to improve the lives of animals and people.
On February 1, we began our first field season to investigate whether administering mass dog rabies vaccinations, along with mass deworming of children in hard to reach communities such as Maasai villages in northern Tanzania, can more effectively reduce the incidence of both diseases. Our research is a Bill & Melinda Gates Foundation Grand Challenge project entitled Integrating community-directed interventions to eliminate neglected tropical diseases caused by soil-transmitted helminth infections and rabies in Tanzania. It is part of a One Health initiative to link interventions targeting animals and people. By pairing the already effective canine rabies program with the deworming program, we believe we can reach more people and reduce the costs of administering treatment.
In the developing world, rabies and intestinal worms, called soil-transmitted helminths, continue to exert significant impacts on public health. Rabies alone kills more than 60,000 people every year, mainly children. Intestinal worms, which infect over a billion people, are the world’s leading cause of physical and intellectual growth retardation. If our research shows that these programs are improved by being administered together, it could have an impact on global efforts to eliminate these two diseases.
On the first day of field activities, having set up our dual clinic in the center of a Maasai village called Oldonyowas in the Loliondo District (just east of the Serengeti National Park), we were doubtful whether anybody would to turn up. However, with the rain holding off and a blue sky over head, we were surprised and delighted to see Maasai villagers coming for treatment, many bringing their children and their dogs with them. And by the end of the first day we had vaccinated just under a 100 dogs and dewormed over 400 people. Not bad for a first day.
The project will eventually target 24 villages, some of which will receive dog vaccination and deworming separately, whilst the rest will receive the integrated approach. This will
allow us to determine whether linking the interventions has an impact on coverage. We are also collecting socio-economic data that will enable us to quantify whether taking an integrated approach to improving animal and human health results in time and cost savings.
We are now approaching the half way mark for the project and although we are some way off analyzing the data to see what impact the integrated strategy has on the delivery of these two important health interventions, we have noticed one really interesting finding. Many primary school age children whose parents have not been able to afford to enroll them in school are bringing their dogs to our clinics. As a result, their dogs are being vaccinated and, importantly, these children, who would have been missed by the school based national control programs, have received treatment for worms. This preliminary data is encouraging as local elimination of worms will depend on a large proportion of residents being treated regularly, and if there are large numbers of children who are not attending school, the programs will need to find a way of targeting them too. This new community based integrated approach may be one way to do that.
Close to one billion children worldwide are infected by soil-transmitted helminths, better known as worms. Infected children are nutritionally, physically, and cognitively impaired—robbing them of their full human potential.
There are multiple global efforts to eliminate this burden, primarily by mass drug treatment. Logically, these treatment efforts focus on administering medication at schools to reach a large number of children at one time. But for pastoralist families, who are often semi-nomadic, there are large gaps in coverage. These hard to access children are critical to global campaigns for their own health and to eliminate a source that can later reinfect already treated children.
Fortunately, the Allen School has worked for several years with pastoralist communities in connection with our partners in the Serengeti Health Initiative. Dr. Felix Lankester developed a strategy to link rabies vaccination of dogs in the pastoralist communities with mass drug treatment to eliminate worms. At first glance, these two efforts, vaccination of dogs and drug treatment of children, may appear incongruous, however Dr. Lankester knew that years of rabies vaccination campaigns had gained the trust of the pastoralist communities and that this would allow unique access.
With funding from the Bill & Melinda Gates Foundation, Dr. Lankester has implemented this program with the goals of increasing coverage for both the drug treatment and the rabies vaccination—and to save costs by combining transport and personnel costs. This effort illustrates the Allen School’s faculty commitment to not only implement, but to lead through innovation. As always, on behalf of the Allen School faculty, staff, and students, our global partners, and, most importantly, the people we serve, thank you for your continued support.
Creighton Endowed Chair and WSU Senior Director of Global Health
Eric Lofgren, an epidemiologist specializing in computational and mathematical modeling of infectious diseases, joined the Allen School faculty in December 2015. Lofgren’s work focuses on developing disease transmission mathematical models to better understand how diseases spread and then evaluate possible interventions. His data visualizations help communicate potential epidemic scenarios to decision-makers. Lofgren’s modeling expertise offers many collaborative opportunities with Allen School faculty members and others at WSU, including proposed research on the epidemiology of antimicrobial resistance. He earned a Ph.D. in epidemiology from the University of North Carolina, Gillings School of Global Public Health in 2013.
Thumbi Mwangi, clinical assistant professor, was selected as an Aspen New Voices Fellow for 2016. The Aspen Institute based in Washington, DC offers experts from the developing world a year-long program to learn how to craft their messages and receive media training from experienced communication mentors and trainers.
Keesha Matz, an undergraduate microbiology major in the WSU Honors College mentored by Hector Aguilar-Carreño in the Allen School, received honorable mention from the national Barry M. Goldwater Scholarship and Excellence in Education Program. She also received an award for outstanding oral presentation at the Annual Biomedical Research Conference for Minority Students (ABRCMS).
Sylvia Omulo, a doctoral student in Dr. Douglas Call’s lab, received an Epidemiology and Population Health Summer Institute at Columbia, or EPIC, scholarship to attend Columbia University in June. The scholarship is funded through a grant from the National Institute for General Medical Sciences. Omulo was also awarded the WSU Graduate School’s $1,000 Karen DePauw Leadership Award for 2016-2017. The award is named for former Graduate School dean, Karen P. DePauw, to honor graduate students who exhibit exceptional leadership skills and involvement at WSU.