Investigating the Impact That Diagnostic Screening with Lateral Flow Devices Had on the Rabies Surveillance Program...

Area of Science:

• Veterinary Public Health
• Infectious Disease Surveillance
• Diagnostic Technologies

Background:

• Global efforts to eliminate canine-mediated human rabies necessitate improved surveillance systems.
• Lateral flow devices (LFDs) are increasingly adopted for rabies diagnosis, despite known limitations.
• Previous research suggested LFDs could bolster surveillance program robustness.

Purpose of the Study:

• To evaluate the effectiveness of implementing the ADTEC LFD as a diagnostic screening tool in Zanzibar.
• To assess the impact of LFDs on the scale and reach of rabies surveillance.
• To determine the accuracy of LFDs in a real-world field setting.

Main Methods:

• Developed and implemented a best-practice standard operating procedure for ADTEC LFD use.
• Conducted in-field diagnostic screening of 83 samples over 22 months.
• Performed subsequent laboratory confirmation for all screened samples.

Main Results:

• Only one false-negative result was detected across 83 samples.
• Routine LFD use led to a four-fold monthly increase in rabies diagnoses.
• A three-fold annual increase in sampled wards was observed.

Conclusions:

• LFDs can significantly improve rabies surveillance robustness by increasing sample volume and geographic coverage.
• Standardized protocols aligned with international best practices are crucial for judicious LFD implementation.
• LFDs show promise for enhancing diagnostic screening in remote areas, supporting rabies elimination goals.