Socio-spatial heterogeneity in participation in mass dog vaccination campaigns, Arequipa, Peru
To control and prevent rabies in Latin America, mass dog vaccination campaigns (MDVC) are implemented mainly through fixed-location vaccination points: owners have to bring their dogs to the vaccination points where they receive the vaccination free of charge. Dog rabies is still endemic in some Latin-American countries and high overall dog vaccination coverage and coverage evenness are desired attributes of MDVC to halt rabies virus transmission. In Arequipa, Peru, we conducted a door-to-door post-campaign survey on >6,000 houses to assess the placement of vaccination points on these two attributes. We found that the odds of participating in the campaign decreased by 16% for every 100 m from the owners house to the nearest vaccination point (p=0.041) after controlling for potential covariates. We found social determinants associated with participating in the MDVC: for each child under 5 in the household the odds of participating in the MDVC decreased by 13% (p=0.032), and for every ten more years living in the area, the odds of participating in the MDVC increased by 9% (p<0.001), after controlling for distance and other covariates. We also found significant spatial clustering of unvaccinated dogs over 500m from the vaccination points, which created pockets of unvaccinated dogs that may sustain rabies virus transmission. Understanding the barriers to dog owners participation in community-based dog-vaccination programs will be crucial to implement effective zoonotic disease preventive activities. Spatial and social elements of urbanization play an important role in coverage of MDVCs and should be considered during their planning and evaluation.