Acta tropica · 2026
Surveillance, territory, and interculturality: Challenges in managing a rabies outbreak among the Maxakali.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Júnior Dilceu Silveira Tolentino, de Faria Mateus Aparecido, Marques Maryana Santos Vasconcelos, de Oliveira Roberto Carlos, de Assis Eliseu Miranda
Аннотация
INTRODUCTION: In 2022, a human rabies outbreak in the Pradinho Village (Maxakali people, Bertópolis, Minas Gerais, Brazil) highlighted structural vulnerabilities and the need for integrated One Health responses in remote indigenous territories.
OBJECTIVE: To describe the outbreak and the post-outbreak period, synthesizing challenges and lessons learned from a One Health perspective to improve prevention, surveillance, and response.
METHODS: Descriptive outbreak report/case study with a mixed-methods approach, using surveillance records, field reports, and secondary data (April-May/2022). The information was organized by thematic axes and analyzed through exhaustive reading and thematic analysis, with triangulation between sources and ethical review of secondary data without individual identification.
RESULTS: Four pediatric cases were confirmed (ages 4-12 years; 2 male/2 female), all with exposure to bats and 100% lethality. The following were identified: (i) weaknesses in human surveillance; (ii) insufficient animal surveillance/control, with a lack of systematic monitoring of bats; (iii) logistical and access barriers; (iv) intercultural challenges affecting risk communication and adherence; (v) intersectoral fragmentation and decreased intensity of post-outbreak actions; and (vi) gaps in prophylaxis and the need for pre-exposure strategies for at-risk groups.
CONCLUSIONS: The outbreak reinforces the urgency of institutionalizing sustainable intersectoral routines, decentralizing inputs and capacities (including diagnosis and cold chain network), adapting risk communication in an intercultural manner, and integrating human-animal-environmental surveillance. The lessons are transferable to other indigenous populations and remote territories with high human-wildlife interaction and access barriers.
OBJECTIVE: To describe the outbreak and the post-outbreak period, synthesizing challenges and lessons learned from a One Health perspective to improve prevention, surveillance, and response.
METHODS: Descriptive outbreak report/case study with a mixed-methods approach, using surveillance records, field reports, and secondary data (April-May/2022). The information was organized by thematic axes and analyzed through exhaustive reading and thematic analysis, with triangulation between sources and ethical review of secondary data without individual identification.
RESULTS: Four pediatric cases were confirmed (ages 4-12 years; 2 male/2 female), all with exposure to bats and 100% lethality. The following were identified: (i) weaknesses in human surveillance; (ii) insufficient animal surveillance/control, with a lack of systematic monitoring of bats; (iii) logistical and access barriers; (iv) intercultural challenges affecting risk communication and adherence; (v) intersectoral fragmentation and decreased intensity of post-outbreak actions; and (vi) gaps in prophylaxis and the need for pre-exposure strategies for at-risk groups.
CONCLUSIONS: The outbreak reinforces the urgency of institutionalizing sustainable intersectoral routines, decentralizing inputs and capacities (including diagnosis and cold chain network), adapting risk communication in an intercultural manner, and integrating human-animal-environmental surveillance. The lessons are transferable to other indigenous populations and remote territories with high human-wildlife interaction and access barriers.