Designing programs for eliminating canine rabies from islands: Bali, Indonesia as a case study

<p>Background: Canine rabies is one of the most important and feared zoonotic diseases in the world. In some regions rabies elimination is being successfully coordinated, whereas in others rabies is endemic and continues to spread to uninfected areas. As epidemics emerge, both accepted and contentious control methods are used, as questions remain over the most effective strategy to eliminate rabies. The Indonesian island of Bali was rabies-free until 2008 when an epidemic in domestic dogs began, resulting in the deaths of over 100 people. Here we analyze data from the epidemic and compare the effectiveness of control methods at eliminating rabies.</p> <p>Methodology/Principal Findings: Using data from Bali, we estimated the basic reproductive number, R0, of rabies in dogs, to be ~1·2, almost identical to that obtained in ten–fold less dense dog populations and suggesting rabies will not be effectively controlled by reducing dog density. We then developed a model to compare options for mass dog vaccination. Comprehensive high coverage was the single most important factor for achieving elimination, with omission of even small areas (<0.5% of the dog population) jeopardizing success. Parameterizing the model with data from the 2010 and 2011 vaccination campaigns, we show that a comprehensive high coverage campaign in 2012 would likely result in elimination, saving ~550 human lives and ~$15 million in prophylaxis costs over the next ten years.</p> <p>Conclusions/Significance: The elimination of rabies from Bali will not be achieved through achievable reductions in dog density. To ensure elimination, concerted high coverage, repeated, mass dog vaccination campaigns are necessary and the cooperation of all regions of the island is critical. Momentum is building towards development of a strategy for the global elimination of canine rabies, and this study offers valuable new insights about the dynamics and control of this disease, with immediate practical relevance.</p&gt

Ovarian Cancer Immature Teratoma Type in Pregnancy: Management and Feto-Maternal Outcomes

BACKGROUND: Immature teratoma is malignant ovarian germ cell tumours (MOGCTs). The case in pregnancy is very rare which less than 1% of all ovarian teratoma cases. The aim is to reach optimal and comprehensive management for immature ovarian teratoma in pregnancy to gain the healthiest maternal and fetal outcomes. CASE PRESENTATION: Thirty-one years old female G2P1A0, 8 weeks 1-day pregnancy, with left ovarian solid tumour 15 x 15 x 15 cm in size. At gestational age (GA) of 19 weeks 5 days, the size of the tumour was increasing rapidly to 30 x 30 x 30 cm. Alfa-fetoprotein raised to 699.9 IU/mL and LDH 579 U/L. The patient had gone primary conservative left oophorectomy, omentectomy, and ascites fluid cytology with histopathological conclusion grade II immature teratoma of left ovary containing the immature neuroepithelial and fat component: magnetic resonance imaging (MRI) at 25 weeks 3 days GA, no spreading. Amniocentesis performed at 27 weeks 2 days GA, the fetus had normal 46 chromosomes and sex XX without major structural abnormality. The patient had BEP chemotherapy start at 27 weeks 2 days GA. Patient in labour at 40 weeks 2 days GA. The female baby had spontaneous delivery with 2700 grams in body weight without congenital abnormality. Complete surgical staging performed at 58th days postpartum and histopathological result there was no malignant cell anymore, but post-chemotherapy ovarian atrophy feature had found on the contralateral ovary. The patient showed psychosocial problem including post-chemotherapy depression and premature ovarian failure (POF). Immunohistochemistry (IHC) ER and PR of teratoma tissue showed immature component had ER (-) and PR (+). Follow up of the baby was in good condition. CONCLUSION: BEP chemotherapy become regimen choice for this case with fetal outcomes was good, but there was a POF sign on the mother. Survival of patient on this case is 62%, free recurrence survival post-BEP 84% and progressivity post complete surgical staging 8% without delay the chemotherapy

Management Comprehensive Multidisciplinary of Malignant Ovarian Germ Cell Tumors and Feto - Maternal Outcome: A Case Series Report and Literature Review

BACKGROUND: Malignant Ovarian Germ Cell Tumors (MOGCT) most commonly occur in young women in the reproductive age group. Timely antenatal diagnosis and treatment of the tumour to enhance maternal and perinatal outcomes are the main challenges confronting the obstetrician and the gyne-oncologist. CASE PRESENTATION: Here we present three cases of pregnancy complicated with MOGCTs. The first case (immature teratoma) was complicated by maternal psychological symptoms consistent with stress and histopathological examination confirmed the diagnosis of premature ovarian failure (POF). The second case (dysgerminoma) preterm labour occurred as an obstetric complication, but the baby was born in good condition without IUGR. The third case (yolk sac tumour) treated with docetaxel (brexel)-carboplatin chemotherapy administration there was no maternal or fetal complication. At the end of the pregnancy and delivery, complete surgical staging and cytoreduction were performed, and no metastases were found. CONCLUSION: Optimal management strategies centre on a multi-disciplinary comprehensive team approach is critical resulting in better outcomes for the mother and the baby by avoiding complications

Scoping review of indicators and methods of measurement used to evaluate the impact of dog population management interventions

Background: Dogs are ubiquitous in human society and attempts to manage their populations are common to most countries. Managing dog populations is achieved through a range of interventions to suit the dog population dynamics and dog ownership characteristics of the location, with a number of potential impacts or goals in mind. Impact assessment provides the opportunity for interventions to identify areas of inefficiencies for improvement and build evidence of positive change. Methods: This scoping review collates 26 studies that have assessed the impacts of dog population management interventions. Results: It reports the use of 29 indicators of change under 8 categories of impact and describes variation in the methods used to measure these indicators. Conclusion: The relatively few published examples of impact assessment in dog population management suggest this field is in its infancy; however this review highlights those notable exceptions. By describing those indicators and methods of measurement that have been reported thus far, and apparent barriers to efficient assessment, this review aims to support and direct future impact assessment

THE HUMORAL IMMUNITY RESPONSE OF DOG VACCINATED WITH ORAL SAG2 AND PARENTERAL RABISIN AND RABIVET SUPRA92

ABSTRACT This research aims to determine whether SAG2 oral vaccine induced antibody response as high as that of parenteral vaccine (Rabisin and Rabivet Supra 92). The experimental design applied was randomized pre and post control group design with 4 treatments (oral SAG2 vaccine, parenteral rabisin, parenteral Rabivet Supra 92 and control without vaccination) and with 9 replication. As many as 36 kampung dogs used and the anti rabies antibody was determined by enzyme-linked immunosorbent assay (ELISA) at day 0, 21, 56, 84, 119, and 147 post vaccination. The antibody titer induced by oral SAG2 vaccine raised more slowly but persisted longer than parenteral vaccine. On day 21 after vaccination, the average antibody titers induced by oral SAG2 vaccines (0.501 IU/ml) was still significantly lower than those induced by parenteral Rabisin (3.504 IU/ml) and Rabivet Supra92 (2.545 IU/ml). However, by day 119 after vaccination the average antibody titer induced by SAG2 oral vaccine (0.889 IU/ml) was significantly higher (p &lt;0.05) as compared to those of parenteral Rabisin (0.625 IU/ml) and Rabivet Supra 92 (0.223 IU/ml). The antibody response induced by SAG2 oral vaccine appears to persist longer than parenteral vaccines and it can therefore be used as an alternative vaccine to combat rabies in animals, especially for dogs kept in free range.</em