Rat Fall Surveillance Coupled with Vector Control and Community Education as a Plague Prevention Strategy in the West Nile Region, Uganda
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
The American Society of Tropical Medicine and Hygiene
Abstract
Plague, primarily a disease of rodents, is most frequently transmitted by fleas and causes potentially fatal
infections in humans. In Uganda, plague is endemic to the West Nile region. Primary prevention for plague includes control
of rodent hosts or flea vectors, but targeting these efforts is difficult given the sporadic nature of plague epizootics in the
region and limited resource availability. Here, we present a community-based strategy to detect and report rodent deaths
(rat fall), an early sign of epizootics. Laboratory testing of rodent carcasses is used to trigger primary and secondary
prevention measures: indoor residual spraying (IRS) and community-based plague education, respectively. During the
first 3 years of the program, individuals from 142 villages reported 580 small mammal deaths; 24 of these tested
presumptive positive for Yersinia pestis by fluorescence microscopy. In response, for each of the 17 affected communities,
village-wide IRS was conducted to control rodent-associated fleas within homes, and community sensitization was
conducted to raise awareness of plague signs and prevention strategies. No additional presumptive Y. pestis-positive
carcasses were detected in these villages within the 2-month expected duration of residual activity for the insecticide
used in IRS. Despite comparatively high historic case counts, no human plague cases were reported from villages
participating in the surveillance program; five cases were reported from elsewhere in the districts. Weevaluate community participation and timeliness of response, report the frequency of human plague cases in participating and surrounding villages, and evaluate whether a program such as this could provide a sustainable model for plague prevention in endemic areas.
Description
Keywords
Rat, Vector Control, Community Education, Plague, West Nile Region
Citation
Boegler, K. A., Atiku, L. A., Enscore, R. E., Apangu, T., Mpanga, J. T., Acayo, S., ... & Eisen, R. J. (2018). Rat fall surveillance coupled with vector control and community education as a plague prevention strategy in the West Nile Region, Uganda. The American journal of tropical medicine and hygiene, 98(1), 238.doi:10.4269/ajtmh.17-0502