Form Approved
OMB No. 0920-1011
Exp. Date 03/31/2017
Evaluation of Dog Bite Surveillance and Rabies Vaccine Systems in Haiti – Public Health Official
Semi-Structured Key Stakeholder Interview Questions
Public Health Officials
ORGANIZATIONAL DESCRIPTION & TRAINING
Education: □ Undergraduate Degree □ Master’s Degree □ Professional Degree
□ Other ____________________________________________________
Position / Title: ______________________________________________
Years in Service at Center _____________________________________
What are your job duties? (Use questions below to guide discussion. Note main content of discussion)
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What disease conditions do you oversee? __________________________________
How many bite reports do you investigate per month? _______________________
How long does bite investigation take? ____________________________________
How many rabies suspect animals do you investigate per month? ______________
How many suspect human rabies cases do you investigate per month? __________
Do you evaluate animals for signs of disease? Yes, No
Do you submit animals to a laboratory for rabies testing? Yes, No
How many per month? __________________
Which laboratory? ______________________
*Ask for an organizational chart
Who in your organization is responsible for investigation of dogs involved in bite events?
I am responsible
If another person, may we contact them to discuss bite surveillance activities?
Name: ___________________________
Position Title: _____________________
What are their qualifications?______________________________________________________
What are their job duties?_________________________________________________________
What percentage of their job activities are rabies related? _______________________________
How many dog bite reports did DELR receive from January 1, 2015 – July 1, 2015?
Number: ___________
*Can we have a list of all bite reports by hospital in your commune?
Are persons at the commune and department health posts, who are responsible for dog bite investigations, required to be vaccinated against rabies?
Yes [1] No [2] Don’t know [6]
Do persons responsible for dog bite investigations receive training in safe dog capture?
Yes [1] No [2] Don’t know [6]
Do persons responsible for dog bite investigations receive training in dog sedation?
Yes [1] No [2] Don’t know [6]
Do persons responsible for dog bite investigations receive training to euthanize dogs?
Yes [1] No [2] Don’t know [6]
Do persons responsible for dog bite investigations receive training in rabies sample collection?
Yes [1] No [2] Don’t know [6]
What equipment do you provide for persons responsible for assessment of rabies suspect dogs? (READ ALL, mark all that apply)
Leather gloves
Control Pole
Syringe Pole
Gun
Machete
Leashes
Muzzles
Nets
Face shields
Syringes
Medications for sedation
Medications for euthanasia
Other supplies, please list: ______________________________________________________________________________________________________________________________________________________________________________
Are there facilities in Haiti to confine a dog for up to 14 days?
Yes [1] No [2] Don’t Know [6]
*if yes, please request a list of locations for these facilities
Inter-Ministerial Collaborations
For which zoonotic diseases does MSPP formally collaborate with MARNDR?
Which mechanisms does DELR use to formally report dog bites to MARNDR? (READ ALL, mark all that apply. Ask for names of persons responsible for reporting)
No formal mechanisms exist
In person
By phone
By text message
By email
By Fax
By electronic surveillance platform
Through a shared electronic system
Other: ______________________________________________________________
Which mechanisms does DELR use to formally report animal rabies cases to MARNDR? (READ ALL, mark all that apply, record names of persons responsible for reporting)
No formal mechanisms exist
In person
By phone
By text message
By email
By Fax
By electronic surveillance platform
Through a shared electronic system
Other: ______________________________________________________________
Which mechanisms does DELR use to formally report human rabies cases to MARNDR? (READ ALL, mark all that apply, record names of persons responsible for reporting)
No formal mechanisms exist
In person
By phone
By text message
By email
By Fax
By electronic surveillance platform
Through a shared electronic system
Other: ______________________________________________________________
Please describe the National Sentinel Surveillance System in terms of structural organization and operation: (allow time for them to talk, record notes below)
What Ministry/Department oversees the NSSS? ______________________________________
How many disease conditions are considered reportable through NSSS? ___________________
Who oversees the following reportable conditions (name, title, and contact information)
Dog bites
Name: ________________________________
Title: _________________________________
Contact information: ____________________ _________________________
Rabies Vaccine Usage
Name: ________________________________
Title: _________________________________
Contact information: ____________________ _________________________
Encephalitis
Name: ________________________________
Title: _________________________________
Contact information: ____________________ _________________________
Human Rabies
Name: ________________________________
Title: _________________________________
Contact information: ____________________ _________________________
DOG BITE SURVEILLANCE: REPORTING PRACTICES
What is the case definition for a reportable bite?
What is the case definition for a rabid animal?
What is the case definition for human encephalitis?
What is the case definition for human rabies?
Which of the following are reportable bites to the NSSS?
Dog bites
Cat bites
Rat bites
Goat bites
Cow bites
Snake bites
Mongoose bites
Bat bites
Is there a standardized form to report dog bites to MSPP/NSSS/DELR?
1. Yes 2. No 9. I don’t know
*if yes, please ask for a copy of a blank reporting form
If there is a bite surveillance form, is it available in paper or electronic format? (circle all that apply)
1. Paper 2. Electronic 9. I don’t know
From where do you receive reports of dog bites? (READ ALL RESPONSES, mark all answers that are affirmative)
Directly from medical providers
From Rabies Health Officers (MARNDR)
From Departmental health officers
From Commune Health Officers
From Commune Sanitation Officers
From Veterinarians
From the public
I don’t know
Other, please describe: _______________________________________________
How do you receive reports of dog bites? (READ ALL RESPONSES, mark all answers)
Phone Calls
A Standardized Form
Email/Faxes
A Web-based system
I don’t know
Other, please describe: __________________________________________________
Please describe the flow of bite reports, from the time they are recorded at a health facility, to when they are entered into NSSS. If a document exists that describes the flow of data request a copy.
List the institutions who should receive a copy of the bite report form (ie commune health department, department health office, DELR).
Are bite report forms submitted to these institutions simultaneous or step-wise? Describe reporting flow.
Under what circumstances do bite reports need to be submitted? (READ ALL, choose the one best)
1. Always 3. Only if the bite is severe 5. Only when giving PEP
2. Never 4. Only if I know the animal has rabies 6. I don’t know
7. Other _______________________________________________________________
When a dog bite report is completed, which organizations should receive a copy of the form? (READ ALL, mark all that apply)
Commune health department
Departmental health office
Ministry of Health (MSPP)
DPSPE – Zoonotic Disease Unit
DELR
Department of Epidemiology and Laboratory Resources (DELR)
Ministry of Agriculture (MARNDR)
Hospitals
We do not report dog bites
Other: ____________________________________________________________
How soon after notification of a bite victim should the bite report form be submitted to DELR/NSSS? (READ ALL, choose the one best.)
Immediately
By the end of my shift
By the end of the day
By the end of the week
By the end of the month
It doesn’t matter when I report
I do not report
Other: ________________________________________________________________
What methods are available for submission of bite report forms? (READ ALL, mark all that apply)
Phone calls
Mailed reports
Hand delivered reports
Faxed reports
Emailed reports
Electronic surveillance platform
Other: ____________________________________________________________________
Are the forms used to track the bite victim’s treatment outcomes?
1. Yes 2. No 9. I don’t know
Are the forms analyzed to create epidemiologic summaries of bite events?
1. Yes 2. No 9. I don’t know
Does MSPP/DELR share summaries of bite reports with departmental or commune health departments?
1. Yes 2. No 9. I don’t know
Are there any other uses for bite reports? [OPEN ANSWER]
Are there any other tools or documents you use to record or track bite events?
BARRIERS TO REPORTING
Are there aspects of the bite form that are difficult to fill out? If yes, please explain.
What are some reasons that you have heard for NOT reporting a bite event to MSPP/ DELR (READ ALL ANSWERS, circle if answer is affirmative)
I did not know I was required to report bite events
I did not have time to fill out the form
I did not have time to send in the report
This health department does not report bite events
I did not have any bite surveillance forms
I do think reporting bites is important
Other reason, please describe: ________________________________________________________________________________________________________________________________________________
What are some reasons that have caused you to NOT report a bite event to the MARNDR Rabies Surveillance Officers (READ ALL ANSWERS, circle if answer is affirmative)
I did not know of this program
This program does not operate in my department
I did not have time to call the officer
I did not know how to contact the officer
This health department does not report bite events
I am not pleased with the work the surveillance officers have done in the past
Other reason, please describe: ______________________________________________________________________________________________________________________________________________
DOG BITE SURVEILLANCE: INVESTIGATIONS
Who are the people or organizations responsible for investigating dogs that have bitten people? (READ ALL, mark all that apply)
Commune sanitation officers (if yes: always, sometimes, or rarely responsible?)
Commune surveillance officers (if yes: always, sometimes, or rarely responsible?)
Departmental health officers (if yes: always, sometimes, or rarely responsible?)
MARNDR rabies officers (if yes: always, sometimes, or rarely responsible?)
No one
Other (describe): _________________________________________________________
I do not know
What are some of the reasons to investigate dogs involved in bite events? (DO NOT READ, mark all that apply)
To assess the dog for rabies virus infection
To remove the aggressive dog from the community
To identify other persons who may have been bitten by the same dog
To determine if the persons bitten need rabies vaccine
Because it is my job
Dogs are not routinely investigated after a bite event
Other reasons: __________________________________________________________________
Should investigators look for other people who may have been bitten by the same dog?
Yes
No
Sometimes (describe): ____________________________________________________________________________________________________________________________________________
During an investigation of a dog bite, what should the investigators do to the dog? (READ ALL, mark all that apply)
Nothing is done to the dog
The dog is assessed for signs of illness
Healthy dogs are placed in observation for a certain number of days
Sick dogs are killed with a machete, stone, or stick
Sick dogs are sedated and euthanized with veterinary medications
Submit rabies suspect dogs to MARNDR for rabies testing
I don’t know
Other: _______________________
When department and commune health offices identify a rabid dog, who should they report it to? (READ ALL, mark all that apply)
commune health department
departmental health office
MSSP
DPSPE – Zoonotic Disease Unit
DELR
departmental agriculture office
MARNDR
I don’t know
We do not report rabid animals to anyone
When department and commune health offices identify a person with rabies, who should they report it to? (READ ALL, mark all that apply)
commune health department
departmental health office
MSSP
DPSPE – Zoonotic Disease Unit
DELR
Departmental agriculture office
MARNDR
I don’t know
We do not report rabid animals to anyone
POST EXPOSURE PROPHYLAXIS
Where does your institution get rabies vaccine from? (READ ALL, mark all that apply)
International donations from governments
International donations from Non-Government Organizations (WHO, PAHO, World Bank, etc)
Purchased by Haitian Government
Vaccine manufacturers
Private companies
Private Pharmacies
I do not know
We do not carry rabies vaccine
Other: ___________________________________________________________
How much does rabies vaccine cost bite victims? (READ ALL, mark all that apply)
It is free to all dog bite victims
Sliding scale, based on how much the bite victim can afford
Specify Total Cost One Vaccine Dose: $_______________
I do not know
Does your institution currently have rabies vaccine available for bite victims?
1. Yes 2. No 9. I don’t know
Other ________________________________________________________
In the last six months, has your institution experienced a shortage of rabies vaccine?
Yes (describe circumstance): _________________________________________
No
Don’t know
Is there a standardized form to report rabies vaccine use to MSPP/DELR?
1. Yes 2. No 3. I don’t know
*if yes, please request a blank copy of the form
If there is a rabies vaccine form, is it available in paper or electronic format? (circle all that apply)
1. Paper 2. Electronic 9. I don’t know
When do institutions need to fill out a rabies vaccine form? (READ ALL, choose the one best)
1. After every dose administered 2. After the course is completed 3. Never
Other _______________________________________________________________
How soon after giving a rabies vaccine should the vaccine form be submitted to DELR? (READ ALL, choose the one best)
Immediately
Report by the end of my shift
Report by the end of the day
Report by the end of the week
Report by the end of the month
It doesn’t matter when I report
Report after the person completes the course of vaccination
I do not report
I don’t know
Which organizations should receive a copy of the rabies vaccine form? (READ ALL, mark all that apply)
Commune health department
Departmental health office
Ministry of Health (MSPP)
DPSPE – Zoonotic Disease Unit
DELR
Hospitals
We do not report dog bites
Other: ____________________________________________________________
Which methods are available for submission of vaccine forms to DELR? (READ ALL, mark all that apply)Hand deliver
Phone Calls
Email/Faxes
A Web-based system
I don’t know
Other, please describe: _________________________________________________
Are the forms used to track the bite victim’s vaccination schedule?
1. Yes 2. No 9. I don’t know
Are the forms required to be submitted to DELR to receive more vaccine?
1. Yes 2. No 9. I don’t know
Does MSPP/DELR share summaries of rabies vaccine forms with health department?
1. Yes 2. No 9. I don’t know
Where you do distribute rabies vaccine to? (READ ALL, mark all that apply)
Departmental health department
Commune health departments
Non-government organizations (MSF, etc)
Private hospitals
Government run hospitals
Other: __________________________________________________
Are there any other uses for rabies vaccine forms? [OPEN ANSWER]
Are there any other tools or documents you use to record or track rabies vaccine usage?
Please describe how rabies vaccine usage is tracked
Please describe how rabies vaccine is distributed
Please describe how rabies vaccine institutions request rabies vaccine
Where does your institution get rabies immune globulin from? (READ ALL, mark all that apply)
International donations from governments
International donations from Non-Government Organizations (WHO, PAHO, World Bank, etc)
Purchased by Haitian Government
Vaccine manufacturers
Private companies
Private Pharmacies
I do not know
We do not carry rabies vaccine
Other: ___________________________________________________________
What type of rabies immune globulin do you use?
Human RIG
Equine RIG
Other: ___________________________________
How much does rabies immune globulin cost bite victims? (READ ALL, mark all that apply)
It is free to all dog bite victims
Sliding scale, based on how much the bite victim can afford
Specify Cost per Vial: $_______________
I do not know
Does your institution currently have rabies immune globulin available for bite victims?
1. Yes 2. No 9. I don’t know
In the last six months, has your institution experienced a shortage of rabies immune globulin?
Yes (describe circumstance): _________________________________________
No
Don’t know
When a provider gives rabies immune globulin does this need to be reported to anyone?
1. Yes 2. No 3. Don’t know
If Yes, who should rabies immune globulin usage be reported to? ________________________________________________________________________
PEP PROTOCOLS
When should the bite wound be washed with disinfectants (ie soap) and water?
Always
Sometimes
Never
Don’t know
Other: ____________________________________________________
When should Rabies Immune Globulin be administered to bite victims? (DO NOT READ, circle ONE best answer)
Always
Sometimes (describe) ________________________________________
Never
Don’t know
Other: ____________________________________________________
When should Rabies Vaccine be administered to bite victims? (DO NOT READ, circle ONE best answer)
Always
Sometimes (describe) ________________________________________
Never
Don’t know
Other: ____________________________________________________
Which rabies vaccine schedules are used (list days administered)? (DO NOT READ, circle all that apply)
0, 3, 7, 14, 28
0, 3, 7, 14
2-1-1 (2x0, 7, 21)
Don’t know
Other _____________________________________________________
Which routes of rabies vaccine administration are used? (DO NOT READ, circle all that apply)
Intramuscular
Intradermal
Subcutaneous
Don’t know
Other ___________________________________________________
Who is responsible to ensure that the bite victim completes the full course of rabies vaccination? (READ ANSWERS, mark all that apply)
The bite victim or the victim’s family
The Hospital
The commune health department
The departmental health office
MSPP
DPSPE – Zoonotic Disease Unit
DELR
No one is responsible
I don’t know
Other:____________________________________________________
Rabies Knowledge and Surveillance Attitudes
Which of the following animals can get rabies? (READ ALL, mark all that apply)
Cows Yes [1] No [2]
Goats Yes [1] No [2]
Pigs Yes [1] No [2]
Snakes Yes [1] No [2]
Dogs Yes [1] No [2]
Cats Yes [1] No [2]
Birds Yes [1] No [2]
Fish Yes [1] No [2]
What are the signs that a dog might have rabies? (Circle all that the interviewee states)
Lethargy [1] Lack of muscle control [5] Difficulty Breathing [9]
Fever [2] Weakness [6] Excessive Salivation [10]
Vomiting [3] Paralysis [7] Abnormal Behavior [11]
Anorexia [4] Seizures [8] Aggression [12]
Have you ever seen a rabid dog?
Yes [1] No [2] Unknown [3]
Have you ever seen a person with encephalitis?
Yes [1] No [2] Unknown [3]
How many cases of encephalitis were reported in Haiti in 2014?
Number: _________________
Have you ever seen a person with rabies?
Yes [1] No [2] Unknown [3]
How many rabies victims were reported in Haiti in 2014?
Number: _________________
Do you agree or disagree with these statements:
Rabies is a significant problem in dogs in Haiti
Agree [1] Disagree [2]
Rabies is a significant problem in people in Haiti
Agree [1] Disagree [2]
Rabies is easily diagnosed in a person based on clinical signs
Agree [1] Disagree [2]
All dog bite victims should receive rabies vaccination
Agree [1] Disagree [2]
Only persons bitten by sick dogs should receive rabies vaccination
Agree [1] Disagree [2]
Washing the wound, in the absence of vaccination, will prevent a person from getting rabies
Agree [1] Disagree [2]
Rabies vaccination consists of only one shot
Agree [1] Disagree [2]
Bite events are quickly investigated by:
MSPP: Agree [1] Disagree [2] NA [3]
Commune Health Officer: Agree [1] Disagree [2] NA [3]
Sanitation Officer: Agree [1] Disagree [2] NA [3]
MARNDR: Agree [1] Disagree [2] NA [3]
Other:________________ Agree [1] Disagree [2] NA [3]
Results of animal investigations are routinely reported back to me when conducted by:
MSPP: Agree [1] Disagree [2] NA [3]
Commune Health Officer: Agree [1] Disagree [2] NA [3]
Sanitation Officer: Agree [1] Disagree [2] NA [3]
MARNDR: Agree [1] Disagree [2] NA [3]
Other:________________ Agree [1] Disagree [2] NA [3]
It is important to report dog bites to MSPP/NSSS/DELR because it can save lives
Agree [1] Disagree [2]
I have contacted the Ministry of Agriculture to evaluate a dog bite
Agree [1] Disagree [2]
Were you happy working with them (if yes or no, why)
Yes (describe): _______________________________________________________
No (describe): ________________________________________________________
What are the three most urgent issues needing to be addressed to improve bite surveillance in Haiti:
What are the three most urgent issues needing to be addressed to improve PEP surveillance in Haiti:
What are the three most urgent issues needing to be addressed to improve human rabies surveillance in Haiti:
File Type | application/msword |
File Title | Emergency Epidemic Investigations |
Author | lmp2 |
Last Modified By | Eaton, Danice (CDC/OPHSS/CSELS) |
File Modified | 2015-10-31 |
File Created | 2015-10-30 |