WORLDWIDE VETERINARY SERVICE Mission Rabies Epi Guide December 2013 This document contains standard operating procedures for use in Mission Rabies projects. It includes step-by-step guides for data collection using EpiCollect and implementation of population surveys and surveillance in the field.
Contents Exhaustive counts... 2 Vaccination Campaign... 3 The Vaccination Team... 3 EpiCollect... 4 Summary... 4 EpiCollect Overview... 4 Mission Rabies EpiCollect Projects... 4 Getting started with EpiCollect... 6 The Vaccination Project form... 8 FAQs... 8 The Post-Vaccination Survey... 9 Rabies Surveillance... 12 The EpiCollect Website... 14 Getting started... 14 1
Exhaustive counts Summary Allow us to estimate dog population and target resources appropriately Should be performed before any major vaccination drive Performed in a randomly selected group of wards spread throughout the area to be vaccinated Method Two people go into the selected ward and record everydog sighted. They should travel through every accessible part of the ward, including beaches, markets, mosques and wooded areas. This can be done by a combination of motorbike/rickshaw and on-foot and should be performed in the early morning when dogs are most active. Only travel on each street once and try to avoid counting the same dogs twice. At the ward boundary only count dogs that are within the ward do not record those sighted outside of the ward at the boundary edge. 2
The Vaccination Team Vaccination Campaign Each vaccination team is made up of: Local guide - Direct the team to the assigned vaccination area and inform of administrative boundaries. Act as a translator/interpreter in the local language where necessary. Team Leader (local Indian Vet or Mission Rabies staff) - Oversee the work of the team and ensure the team work in accordance with Mission Rabies guidelines, including taking adequate breaks and finishing on-time. Act as a point of contact with the local guide. Two international volunteers - May include vaccine administration, entering information in EpiCollect, cool-box management, distribution of educational materials and MR wrist-bands, applying MR collars to owned dogs - Will NOT include using nets to catch dogs, manually removing dogs from nets Dog handlers 4-6 per team (often a mixture of experienced and inexperienced dog catchers) - Catching and restraining dogs for vaccination Additional Indian support volunteers (if man-power allows) - EpiCollect, cool-box management, distributing educational material to the public, marking dogs with paint. 3
EpiCollect Summary EpiCollect is a free mobile phone application which can be used to collect data on smart phones and then uploaded through WiFi/3G to a central server for analysis. Custom forms are created online and loaded onto the phones as Projects. It is important that the correct project is loaded as this determines what form is used and where the data is sent. Information gathered can include GPS, multiple choice questions (sex, ownership etc), free text and a photo. EpiCollect Overview Load the appropriate project onto the phone before going into the field Enter details of every dog vaccinated (including GPS location) Once you return to the hotel connect to WiFi and synchronize your data with the server to upload your work 4 A
Mission Rabies EpiCollect Projects There are three different EpiCollect projects for each team. It is important you select the correct project each time you use EpiCollect: 1) Vaccination project Use in the field to record a) information about every dog vaccinated (GPS, sex, ownership, health etc.) b) all dogs collected for neutering (select in vaccination status question) - Project name is MRABC followed by the name of the location e.g MRABCRanchi 2) Surgery project - Use in the operating theatre - Record all dogs undergoing surgery - A photo of every dog can be logged - Project name is same as above, with Surgery at the end. e.g. MRABCRanchiSurgery 3) Post Vaccination project - Use by Post-vaccination survey team - Team use paper records in the field - Record in EpiCollect once totals have been added up - Project name is MRPostVacc for all sites 5
Getting started with EpiCollect There are two versions: EpiCollect+ - new (all Mission Rabies projects now use this version) EpiCollect - old 1. Download the app Most Mission Rabies phones already have EpiCollect+ installed, but if it isn t you ll need to download it. Search in the Google Play store for Epicollect+ and installing the app. It can be also found at: https://play.google.com/store/apps/details?id=uk.ac.i mperial.epi_collect2 2. Download a project The first time a project is used on a phone it needs to be downloaded. The project name is unique for each Mission Rabies team and will be given to you by the Mission Rabies UK team. It needs to be entered exactly into the Load project screen. 3. Changing project Multiple projects can be loaded to a phone. You can navigate between projects on the home screen. 6
4. Add a test entry The first time you use a project upload a test entry to check it is working. Enter test in the ward section and test and your name in the comment section. 5. Navigation Navigate through the form using the arrow buttons. Some questions require an answer before you can progress. 6. Synchronizing data Once you return to the hotel after every vaccination session it is important that you connect to the WiFi and synchronize the data to minimize the risk of loss. 7
The Vaccination Project form 1. GPS Location We would like GPS on every dog vaccinated to allow us to map our work. It may take several attempts to secure a GPS location but if it is taking a long time just move on and log the ward number. 2. Ward Enter the number of ward the ward you are vaccinating in. This can change as you move through the city, so ask the local guide to inform you when the ward changes and check frequently. 3. Ownership status Many free-roaming dogs will have an owner in some capacity, however presented by owner should only be selected if the dog has been presented by someone saying they are the owner. All other dogs are recorded as free-roaming If presented by owner is selected the next question will allow you to record if a MR collar was put on the animal. 4. Age All puppies will be vaccinated. If the animal looks approximately younger than 3 months choose less than 3 months. In all other cases choose more than 3 months. If in doubt, ask the vet. 5. Sex Male/female 6. Vaccination and marking Choose the option that applies. For example there are options for if the animal has been marked, but wasn t vaccinated, or if it was taken for neutering. If a dog is taken for neutering this should be selected here. 7. Health status If any gross disease is present select sick here and the next question will prompt you to further define this and take a photo if you wish. If you are unsure ask the vet. The form will allow you to take a photo of the animal please only take one photo of each animal, for example of a wound if present. 8 8. Neuter status Look for an ear notch or if the tip is removed to indicate that the dog is neutered. 9. Comments Record specific further information relating to an individual animal (illness, treatment etc). If nothing abnormal this can be left blank.
FAQs Can EpiCollect+ be used on iphones? Unfortunately at the moment EpiCollect+ can only be used on android phones What if I can t get a GPS? Ideally we would like GPS information on as many cases as possible as this allows us to map the data more accurately. If this is not possible don t worry, just ensure the ward number is entered correctly and we will be able to locate the animal on a map later. 9
The Post-Vaccination Survey Summary In order to protect a community against rabies we need to vaccinate at least 70% of dogs in that area. The post vaccination survey is essential to our work. It enables: Calculation of an accurate dog population size Estimation of vaccination coverage Post vaccination surveys should be conducted within three days of a vaccination team visiting that ward. The Post vaccination team Motorcyclist will drive the motorbike following a route set by the checkpoint co-ordinator Counter this person will ride on the back of the motorbike and will count and record the number of marked and unmarked dogs that are seen. Method Use ward maps to navigate your route Start at one end of the ward. Move in a zig-zag pattern to reach the opposite side of the ward by covering all accessible streets. Count all roaming dogs on the street and follow consistent method check under cars, but don t search out dogs. Do not go into buildings or purposefully go to places that you know have been visited by the vaccination teams. Try not to count the same dogs twice. In the field use the post-vaccination paper record to tally every dog you see in one of the columns: marked with paint collar (only dogs wearing a Mission Rabies collar) un-marked Dogs that have both paint AND a Mission Rabies collar are only recorded in the collar column. If you are unsure if a dog is marked or not it should be recorded under the un-marked group. 10
Target sample size Depending on the number of dogs in a ward, a certain proportion must be counted to get an accurate estimate of vaccination coverage. A target sample size is calculated using an estimated dog population size in an area. This estimate can either be generated using previous Mission Rabies figures or exhaustive dog counts done before the start of vaccination. The target sample size is the minimum number of dogs that must be counted in a ward IN TOTAL EpiCollect Recording After every post-vaccination survey, once you return to the hotel, enter the data from each ward into a separate post-vaccination form on EpiCollect. Open the EpiCollect app Load the MRPostVacc project Enter the totals from each column into a post vaccination survey form for each ward. This includes: GPS (this is to log the CITY - it doesn t matter if this is at the hotel!!) Ward number Ward vaccination date (last date a vaccination team visited that ward) Target sample size (only if known can leave blank) Number of dogs with paint Number of dogs with Mission Rabies collar Number of unmarked dogs Sync the forms by going to List Post_Vacc_Survey and then send data to remote server(s) 11
Rabies Surveillance Structure At present there is no set protocol for management of suspected rabid dogs within the community. This can result in animal welfare issues as a result of fear towards free roaming dogs. A Rabies Response Team would consist of people who already work within the area on vaccination and ABC projects and are trained to respond to cases of suspected rabies following a standardised protocol. The team could be contacted by a designated text number which is publicised within the community. Suspected canine rabies case within the community Text the Mission Rabies Action number Rabies Response Team travels to the location to assess the animal (consisting of local Rabies Field Marshal (vet/paravet), an animal collection vehicle, dog catchers) History taken of clinical signs/dog ownership/bite history Record details of person reporting dog. All people registered as in-contact informed to start PPE Suspect rabies Register taken of all people that have been in-contact with dog Animal transported to isolation kennels for further observation/assessment Suspect rabies Animal euthanized, brain sample taken and submitted to a predetermined lab for diagnosis In-contact register informed Not consistent with rabies Not rabies Not consistent with rabies Action as appropriate; remove animal or community continue to monitor Treated or returned to the community with community feedback Confirmed rabies Community informed, PPE altered as appropriate Recorded in database 12 Community informed, appropriate post exposure protocols continued Recorded in database
Rabies Field Marshal A permanent role is created within a munincipality who is responsible for collaborating with local organisations to: Co-ordinate canine rabies vaccination and ABC interventions Co-ordinate public awareness and rabies education campaigns Respond to reports of suspected canine rabies for assessment and if necessary removal of the animal and submission for confirmation Liaise with local medical organisations to gather data on human dog bite and rabies incidence Liaise with designated reputable laboratories for confirmation of human and canine rabies cases Keep records of human and canine rabies surveillance data Resources required Personnel rapid response team on-call (1x driver, 2x dog catchers with nets, 1x vet/paravet) Training of staff in rabid dog handling/protocol Animal transport vehicle (designated on-call) Protective clothing overalls x2, gloves, masks (with eye protection) Isolation + handling facilities (local shelter/kennels) Medical consumables needles, syringes, sedation, thiopental/phenobarbitone Tools for removal of the brain Reputable laboratory with standardized rabies diagnostic procedures Ice/cool box/packaging materials for sample transport to lab Courier service/transport protocol for transport of samples to lab 1x designated phone for response to public reports Free (?) text/call service for reporting of suspected rabid dogs Provision for community feedback/educational materials Suspected rabid dog carcass disposal protocol 13
The EpiCollect Website Getting started http://plus.epicollect.net/ Here you can create new projects and forms review and analyse data already collected First you need to create a log-in and be made an administrator to access your projects. Contact andy.gibson@wvs.org.uk to request this. 1. The Home screen Here you can create a log-in, view the different projects that you have access to on the right hand side and create new projects. Project you currently have access to Create an account 14
2. Project home screen When you click on one of your projects you come to this screen (the following example is MissionRabiesGU). Here you can create or edit forms or choose to view data that has been entered. Create a new form Review data collected on a particular form Review data 3. Tabulated data/download screen Access this screen by clicking on a form, for example vaccinations in the screen above. View data on a map Download data as an XML and import into excel spreadsheet 15
4. Map screen Here you can view the data on a map. You can filter the data by date in the bottom left corner. Filter by date to see spread in the last few days 16
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