The document summarizes the evolution and results of Tunisia's National Program for Rabies Control. It finds that:
1) Rabies is endemic in Tunisia, primarily spread by dogs. A national program was established in 1983 to control rabies through dog vaccination campaigns, human post-exposure prophylaxis, and rabies surveillance.
2) The program successfully reduced rabies incidence between 1983-1988 and 1993-2010. However, cases have increased again from 2012-2015, calling for improvements to the program, including increasing dog vaccination coverage and public education.
3) The Pasteur Institute Rabies Laboratory plays a key role in epidemiological surveillance and evaluation of control efforts in Tunisia. It
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Tunisia's National Rabies Control Program
1. RABIES IN TUNISIARABIES IN TUNISIA
Evolution and result ofEvolution and result of
« National Program of Rabies Control »« National Program of Rabies Control »
Kharmachi H.,
“National Reference Rabies Laboratory”, Institut Pasteur de Tunis – Tunisia”
With collaboration of the team of « National Commission of Rabies Control »:
Zaouia I., Khoufi S., Hrabech K., Mejri M., Turki I., Oukaïli K., Kortas J.
and the team of “National Reference Rabies Laboratory”:
Ben Maïz S., Bouslama Z., Ben Salem J., Basdouri N. and Handous M.
2. ContentsContents
Epidemiology of Rabies in Tunisia
Animal Rabies
Human Rabies
National Program of Rabies Control
Role of I.P.T. in the epidemiological surveillance
Impact of Control measures on the evolution
of rabies
Conclusion
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4. Epidemiology of Rabies in TunisiaEpidemiology of Rabies in Tunisia
Rabies is Enzootic and Endemic
Dog = « Reservoir and Vector » of Rabies
Other Domestic Animals = Victims
Wild Animals : Rares cases
Human = MAIN VICTIM of the disease
8. Ref: Amouri IK, Kharmachi H, Djebbi A, Saadi M, Hogga N, Zakour LB, Ghram A.
Molecular characterization of rabies virus isolated from dogs in Tunisia: evidence of two phylogenetic variants.
Virus Res. (2011 Jun); 158(1-2):246-50.
Mokola
0.05
Animal Rabies:
Genotype1: Canine rabies strain = Two Phylogenic variants:
12. Rabies is Notifiable Disease:
Since 1969 (law 69/53 of 29/7/1969)
All cases are confirmed by Laboratory:
Rabies laboratory of IPT
Since 1961
Human (and Animal) rabies diagnosis
Only One laboratory for diagnostic in the country :
Methods used: FAT + RTCITFAT + RTCIT
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Human RabiesHuman Rabies
15. National Program of RabiesNational Program of Rabies
Control (NPRC)Control (NPRC)
Strategy:
◦ Mass vaccination of dogs: Ministry of Agriculture
◦ Prevention of Human Rabies: Ministry of Health
◦ Control of dog population : Ministry of Interior
Management: by National Multidisciplinary
Commission of Rabies Control
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16. Mass Vaccination Campain:Mass Vaccination Campain: every yearevery year
+ Public education & public awareness+ Public education & public awareness
Rabies is FatalVaccinate me you protect meVaccinate me you protect me
& you will be protected& you will be protected
17. PostPost--exposure Prophylaxyexposure Prophylaxy
Structures
◦ Number of centers: 206206 specific centres
(+emergency hospital services) = 310310 (total PEP c.)
◦ Localisation : All regions of country
◦ Management : Ministry of health (free of charge)
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18. Role of Pasteur InstituteRole of Pasteur Institute
Rabies LaboratoryRabies Laboratory
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26. ConclusionConclusion
Rabies is endemic and enzootic in Tunisia
National Rabies Control Program reduces rabies incidence
during many years (1983 to 1988 and 1993 to 2010)
Actually: Increase in the incidence (2012 to 2015)
NRCP need improvements:
Improvement of vaccination coverage of dogs:
- Actually 50%-60%;
- Objective: to reach75% of canine population
Better management of dog’s polpulation
Improvement public education and awerness about rabies
Rigourous application for recommendations of PEP protocols
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27. ConclusionConclusion
Pasteur Institute Rabies Laboratory (National Reference
Laboratory of Rabies) plays a leading role in
epidemiological surveillance of rabies in Tunisia
NRLR contributes in the national commission to evaluate
the actions of rabies control.
NRLR conducts applied research program to propose
solutions to improve control of rabies
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