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.

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Intestinal worms, which infect over a billion people, are the world’s leading cause of physical and intellectual growth retardation.

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.

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Children receiving deworming medication in Tanzania.

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.

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More than 60,000 people die worldwide from rabies each year. Most contract the disease from a dog bite.

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.