Investigator(s)
| WHO Technical Officer |
Katrin Bote WHO SEARO -Neglected Tropical Diseases Katrin Bote 
|
| Principal Investigator |
Zinia T Nujum Government Medical College - Teaching and Research Institute, Kollam, Paripally 691574, Kerala, India Zinia T Nujum
|
Title(s) and abstract
| Scientific title | Implementation of Integrated Bite Case Management (IBCM) as part of a one health program for Rabies at Primary health care level in Kerala: Costeffectiveness, challenges and solutions |
| Public title | Implementation of Integrated Bite Case Management (IBCM) as part of a one health program for Rabies at Primary health care level in Kerala: Costeffectiveness, challenges and solutions |
| Background | One Health approach is the most cost-effective way to eliminate rabies globally. The One Health Program can be made more cost-effective if an integrated method of surveillance and management of animal exposure is implemented in a coordinated manner by the human and animal health departments. This method of surveillance is most useful for exposures from dogs and ensures that people exposed to dogs are assessed for risk of rabies based on the dog’s health status. The decision to vaccinate is taken based on this risk assessment and the severity of exposure by the human doctor in consultation with a veterinary doctor. |
| Objectives | In this project we are attempting to collaborate with Mission Rabies, India the organization which was instrumental in the elimination efforts in Goa along with a global partnership with expertise in IBCM, to work with the state directorate of health services to implement IBCM at primary health care level in a selected district in Kerala. |
| Study Methods | The implementation will be done in a graded manner using a stepped wedge design of a pragmatic cluster randomized controlled trial in six blocks of the district of Thiruvananthapuram in Kerala. The effectiveness of the program will be measured using specific indicators. The usefulness in terms of costeffectiveness will be assessed using data from this implementation research and modelling approaches. An individual-based stochastic modelling will be done as an epidemiological model to inform a static decision tree model for economic evaluation. This research will also enable the identification of challenges in terms of acceptability, adoption, appropriateness, feasibility, fidelity, penetration, and sustainability during the implementation of IBCM along with feasible solutions, through qualitative approaches to research. |
| Expected outcomes and use of results | We aim to provide a better direction to scale up the program in other districts of the state and nation. There is an anticipated resistance among health professionals and beneficiaries, to reducing the number of doses of vaccine and shortening the vaccination course. We attempt to achieve this objective through a noninferiority trial of this one-week course of vaccination compared to the 28-day course, which is the policy and practice now. |
| Keywords | rabies, zoonotic disease, IBCM, One Health |
Research Details
| Student research | No |
| Start Date | 01-Jan-2024 |
| End Date | 31-Dec-2024 |
| Key Implementing Institution | Government Medical College, Kollam, Paripally 691574, Kerala, India |
| Multi-country research | No |
| Nationwide research | No |
| India | |
| Research Domain(s) | Communicable Disease Research |
| Research field(s) | Immunization/Vaccine Preventable Disease |
| Involves human subjects | Yes |
| Operational Research | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | No |