Worldwide Veterinary Service

BackgroundRabies causes over 60,000 deaths annually, primarily among children, with dog bites responsible for nearly all human cases. Although mass dog vaccination is effective in low-resource settings, structured campaigns have rarely been implemented in refugee camps, where unmanaged dog populations and limited access to post-exposure prophylaxis heighten rabies risk. This study aimed to demonstrate the possibility of delivering systematic mass dog vaccination within a short operational timeframe in a humanitarian setting and to assess community perceptions of rabies risk and prevention.Methodology/principal findingsIn May 2025, a four-day mass dog vaccination campaign was conducted across the Kutupalong-Balukhali refugee settlement in Cox’s Bazar, Bangladesh, with real-time data collection to guide operations. Post-vaccination dog sight surveys assessed operational coverage, while community surveys evaluated knowledge, attitudes and practices (KAP) regarding rabies. Of the 2,275 dogs encountered, 1,781 (78.3%) were vaccinated, with 86.4% classified as unowned community dogs. The overall proportion of marked dogs across all surveyed zones was 71.5% (95% CI: 66.8–75.9%). In the community survey, 34.6% of 1,311 adult respondents (gender-adjusted) had heard of rabies, and 41.2% correctly identified dog bites as the primary route of transmission. Regarding appropriate post-bite care, 25.9% knew to both wash the wound and seek medical care. Approximately 8.7% of households experienced a dog bite in the preceding year, corresponding to a minimum annual incidence of 13.3 bites per 1,000 persons, equating to over 15,000 bites per year.Conclusions/significanceThis study represents the first structured mass dog vaccination campaign in a refugee setting, demonstrating that rabies control can be effectively implemented even in complex humanitarian contexts. The campaign’s success offers a replicable model for integrating zoonotic disease prevention into emergency health responses, underscoring the critical need to safeguard displaced populations from preventable diseases.

Veterinary professionals often experience emotional distress after clinical incidents, affecting well-being and job performance. This study explores the adaptation and implementation of the Resilience In Stressful Events (RISE) program, originally developed for human healthcare, to support veterinary clinicians. RISE provides peer support through trained responders, focusing on emotional care rather than event details. Findings indicate that the RISE program is both acceptable and feasible for veterinary settings, with minor adaptations, such as including veterinary examples, to fit veterinary specific needs. The study highlights the importance of structured support systems in improving the mental health and retention of veterinary professionals, suggesting that programs like RISE could play a crucial role in enhancing clinician wellbeing and care quality.

Disease surveillance activities are usually resource-constrained and should be optimised to generate the most informative scientific findings, and to make the best use of time, finances, and personnel. India has a high population density, diverse geography and climatic conditions, and difficult terrain. With respect to malaria, Plasmodium falciparum and Plasmodium vivax are endemic, with substantial variability of transmission across the country. While for P. vivax, drug efficacy appears to be homogeneous within the country, for P. falciparum malaria, the drug resistance pattern varies from the northeastern region to the central region. Accounting for these complexities, we develop a decision-making framework guided by geospatial modelling outputs to identify prospective study sites for surveillance of molecular markers of antimalarial drug resistance in P. falciparum malaria in India. We first retrieve existing data on the prevalence of validated markers of resistance to artesunate and sulfadoxine-pyrimethamine from the World Wide Antimalarial Resistance Network (WWARN) Surveyor database. We then incorporate these data into a geostatistical model to estimate the prevalence of these markers across India and identify areas with high median estimated marker prevalence and high uncertainty. Finally, we create an interactive dashboard using the RShiny software package to simplify the process of selecting sites for future molecular surveillance. Our framework helps to ensure that operational decision-making is supported by data and modelling outputs. We demonstrate the utility of our framework by selecting sites for molecular surveillance of P. falciparum malaria in India.

Introduction Rabies, a neglected viral zoonotic disease endemic in Uganda, is one of the country’s top seven priority zoonotic diseases. In the period 2021 to 2024, it caused 190 human deaths. Rabies requires an integrated participatory One Health approach for its control. This approach may help reduce the estimated 59,000 annual global human rabies deaths. Over 99% of these deaths are due to bites from infected dogs. Access to the highly effective post exposure prophylaxis (PEP), mass dog vaccinations and rabies surveillance are prioritised in Uganda’s National Rabies Elimination Strategy that is aligned to the global target of eliminating dog-mediated rabies by 2030. Surveillance, required to guide and evaluate rabies control, is currently weak in Uganda, resulting in few cases being recorded. This leads to a “cycle of neglect” of the disease. Medical and animal health professionals require comprehensive surveillance data to inform post-bite responses. An integrated bite case management (IBCM) system presents the opportunity for information about the bite victim and biting animal to be obtained timely to support judicious and economical use of PEP in humans and management of the biting animal. IBCM has not yet been tested in Uganda where PEP is scarce. Methods A collaborative change research approach was therefore applied to progressively develop key elements of an IBCM form over three successive multidisciplinary and multi-sectoral stakeholder meetings, which noted that to attain effective joint surveillance, both animal- and human-related information should be obtained from an animal bite incident. Results and Discussion Stakeholders identified elements that were grouped under five categories: details of the human bite victim, details of the bite incident, details of biting animal, follow-up of the biting animal and laboratory diagnosis. Four existing rabies surveillance tools in the country were assessed against these categories. The process revealed gaps in the tools currently in use by government ministries hence exposing the silo system in rabies surveillance. This paper highlights the rich content of an IBCM form designed through a stakeholder participatory process, and its advantages over existing tools regarding data collected. It is hoped that its implementation will significantly strengthen joint human and dog rabies surveillance in Uganda.

BackgroundAfrica bears the highest double burden of HIV and malaria worldwide. In 2023, an estimated 25.9 million people were living with HIV (PLHIV), and 246 million malaria cases were diagnosed in Africa. Malaria patients co-infected with HIV are considered at a higher risk of failing malaria treatment, according to the World Health Organization (WHO) guidelines. This systematic literature review aims to assess the treatment outcomes following artemisinin-based combination therapy (ACT) in PLHIV.MethodsThe literature search was conducted up to April 2022 in the following databases: MEDLINE, EMBASE, Web of Science, Cochrane Central, WHO Global Index Medicus, Clinicaltrials.gov, and the WorldWide Antimalarial Resistance Network (WWARN) Clinical Trial Library. Studies describing any malaria treatment outcomes or anti-malarial drug exposure in PLHIV treated for uncomplicated Plasmodium falciparum malaria infection were eligible for inclusion.ResultsA total of 26 articles describing 19 studies conducted between 2003 and 2017 in six countries were included in this review; it represented 2850 malaria episodes in PLHIV across various transmission settings. The most studied artemisinin-based combination was artemether-lumefantrine (in 16 studies). PLHIV were treated with various antiretroviral therapy (ART) regimens, namely efavirenz (EFV), nevirapine (NVP), atazanavir-ritonavir (ATVr), lopinavir-ritonavir (LPV/r), and/or on prophylaxis with trimethoprim-sulfamethoxazole (TS), or were untreated (in 3 studies). There was no evidence of an increased risk of recrudescence in PLHIV compared to those without HIV. When treated with artemether-lumefantrine, PLHIV receiving LPV/r had a lower risk of malaria recurrence compared to PLHIV on NVP-based or EFV-based ART, or those without HIV. LPV/r increased lumefantrine exposure and EFV-treated patients had a reduced exposure to both artemether and lumefantrine; NVP reduced artemether exposure only.ConclusionsLimited data on ACT outcomes or drug exposure in PLHIV in Africa remains a reality to date, and the effect of antivirals appears inconsistent in the literature. Considering the heterogeneity in study designs, these review’s findings support conducting an individual patient data meta-analysis to explore the impact of antiretroviral therapy on anti-malarial treatment.Trial registration: The protocol for the original search was published on PROSPERO with registration number CRD42018089860.

This article will explore how registered veterinary nurses can volunteer abroad, offering guidance on preparation, opportunities and the benefits of global impact

Selection of resistant malaria strains occurs when parasites are exposed to inadequate antimalarial drug concentrations. The proportion of uncomplicated falciparum malaria patients at risk of being sub-optimally dosed with the current World Health Organization (WHO) recommended artemisinin-based combination therapies (ACTs) is unknown. This study aims to estimate this proportion and the excess number of treatment failures (recrudescences) associated with sub-optimal dosing in Sub-Saharan Africa. Sub-populations at risk of sub-optimal dosing include wasted children <5 years of age, patients with hyperparasitaemia, pregnant women, people living with HIV, and overweight adults. Country-level data on population structure were extracted from openly accessible data sources. Pooled adjusted Hazard Ratios for PCR-confirmed recrudescence were estimated for each risk group from published meta-analyses using fixed-effect meta-analysis. In 2020, of the estimated 153.1 million uncomplicated P. falciparum malaria patients in Africa, the largest risk groups were the hyperparasitaemic patients (13.2 million, 8.6% of uncomplicated malaria cases) and overweight adults (10.3 million, 6.7% of uncomplicated cases). The estimated excess total number of treatment failures ranged from 0.338 million for a 98% baseline ACT efficacy to 1.352 million for a 92% baseline ACT efficacy. Our study shows that an estimated nearly 1 in 4 people with uncomplicated confirmed P. falciparum malaria in Africa are at risk of receiving a sub-optimal antimalarial drug dosing. This increases the risk of antimalarial drug resistance and poses a serious threat to malaria control and elimination efforts. Changes in antimalarial dosing or treatment duration of current antimalarials may be needed and new antimalarials development should ensure sufficient drug concentration levels in these sub-populations that carry a high malaria burden.

Sterilisation and rabies vaccination programs seek to manage free-roaming domestic dog (Canis familiaris) populations with the aim to reduce inter-species disease transmission and conflicts. As effective, permanent, remotely-administered options are not yet available for sterilisation, and oral vaccination is not yet commonly used; free-roaming dogs are typically captured for these interventions. There is a paucity of information describing how dog capture rates change over time within defined areas following repeated capture efforts. This data is needed to allow efficient dog capture programmes to be developed. Using spatial co-ordinates of dog capture, we characterise where dogs are more likely to be captured in six catch-sterilise-release campaigns, in Goa state, India. Combining capture numbers with population survey data collected in five sites, we document the increasing difficulty of catching entire (non-sterilised) dogs as sterilisation coverage increases and demonstrate how this leads to increased unit costs. Accounting for the extra resources required to capture dogs when sterilisation coverage is high will improve estimation of the resources required to manage free-roaming dog populations and assist in planning the most efficient intervention strategies.

Cord blood (CB) collected at birth has become a valuable stem cell source for hematopoietic stem cell transplantation (HSCT). However, the collection of umbilical cord blood always bears a risk of microbiological contamination, both in vaginal birth and in cesarean section. A total of 10 054 umbilical cord stem cell samples were successfully cryopreserved between 2010 and 2020, of which 783 (8%) samples were tested positive for bacterial contamination. Umbilical CB with a volume of less than 60 mL showed a bacterial contamination rate of 12%, and above 60 mL volume a rate of 6% was found demonstrating an inverse relationship between sample volume and contamination rate (correlation coefficient r = −0.9). The contamination rate was associated with the mode of delivery and showed a significantly higher contamination rate of 9.7% when compared with cesarean deliveries (1.4%). The 10-year period consistently shows an average contamination rate between 4% and 6% per year. It is conceivable that the inverse relationship between volume and contamination rate might be related to thinner veins although no scientific evidence has been provided so far. The lower contamination rate in cesarean sections appears to be related to the sterile operating setting. Overall, the rate of bacterial contamination varies and depends on the type of birth, the way of delivery, and probably the experience of the staff.

Surgical sterilisation to manage free-roaming dog populations is widely used in many countries. However, few studies have examined optimal postoperative pain management regimens at low-resource, high-throughput veterinary clinics. The aim of this study was to examine the efficacy of two intravenous analgesic regimens, preoperative administration of meloxicam and tramadol, or meloxicam alone, in free-roaming dogs undergoing sterilisation. A total of 125 dogs were included, with 64 dogs in the meloxicam-tramadol arm and 61 dogs in the meloxicam-only arm in a non-inferiority study design. Pain levels in sterilisation surgery patients were assessed at four time points after surgery using the Colorado State University Canine Acute Pain Scale, a Visual Analogue Scale and a modified version of the Glasgow Composite Measure Pain Scale - Short Form. Non-inferiority was supported for each of the main scoring outcomes using non-inferiority margins of 0.5, 5 and 0.8, respectively. One dog from the meloxicam-tramadol group and four dogs in the meloxicam-only arm required rescue analgesia, with no difference between groups (P=0.21).The study demonstrated that meloxicam was effective in controlling postoperative pain in a high proportion of dogs. The addition of tramadol alongside meloxicam treatment was not found to be of clinical benefit.