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Cost-Effectiveness Analysis of Integrated Bite Case Management and Sustained Dog Vaccination for Rabies Control
Indexado
WoS WOS:001050598400034
Scopus SCOPUS_ID:85164244911
DOI 10.4269/AJTMH.22-0308
Año 2023
Tipo artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



The successful prevention, control, and elimination of dog-mediated rabies is challenging due to insufficient resource availability and inadequate placement. An integrated dog bite case management (IBCM) system plus dog vaccination can help address these challenges. Based on data from the IBCM system in Haiti, we conducted a cost-effectiveness evaluation of a newly established IBCM system plus sustained vaccination and compared it with 1) a no bite-case management (NBCM) and 2) a non-risk-based (NRB) program, where bite victims presenting at a health clinic would receive post-exposure prophylaxis regardless of risk assessment. We also provide cost-effectiveness guidance for an ongoing IBCM system and for sub-optimal dog vaccination coverages, considering that not all cost-effective interventions are affordable. Cost-effectiveness outcomes included average cost per human death averted (USD/death averted) and per life-year gained (LYG). The analysis used a governmental perspective. Considering a sustained 5-year implementation with 70% dog vaccination coverage, IBCM had a lower average cost per death averted (IBCM: $7,528, NBCM: $7,797, NRB: $15,244) and cost per LYG (IBCM: $152, NBCM: $158, NRB: $308) than NBCM and NRB programs. As sensitivity analysis, we estimated cost-effectiveness for alternative scenarios with lower dog-vaccination coverages (30%, 55%) and lower implementation costs. Our results suggest that better health and cost-effectiveness outcomes are achieved with the continued implementation of an IBCM program ($118 per life-year saved) compared with a newly established IBCM program ($152 per life-year saved). Our results suggest that IBCM is more cost-effective than non-integrated programs to eliminate dog-mediated human rabies.

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Disciplinas de Investigación



WOS
Public, Environmental & Occupational Health
Tropical Medicine
Scopus
Sin Disciplinas
SciELO
Sin Disciplinas

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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 Taylor, Emma Mujer University of Surrey - Reino Unido
Univ Surrey - Reino Unido
2 Prada, Joaquin M. - University of Surrey - Reino Unido
Univ Surrey - Reino Unido
3 Del Rio Vilas, Victor Hombre University of Surrey - Reino Unido
3 Vilas, Victor Del Rio - Univ Surrey - Reino Unido
University of Surrey - Reino Unido
4 UNDURRAGA-FOURCADE, EDUARDO ANDRES Hombre Pontificia Universidad Católica de Chile - Chile
Centro de Investigación para la Gestión Integrada del Riesgo de Desastres (CIGIDEN) - Chile
CIFAR - Canadá
CIFAR Azrieli Global Scholars Program - Canadá
Canadian Institute for Advanced Research - Canadá
5 Wallace, Ryan Hombre National Center for Emerging and Zoonotic Infectious Diseases - Estados Unidos
CDCP - Estados Unidos
6 Horton, Daniel L. Hombre University of Surrey - Reino Unido
Univ Surrey - Reino Unido

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Financiamiento



Fuente
Fondo de Financiamiento de Centros de Investigación en Áreas Prioritarias
Canadian Institute for Advanced Research
University of Surrey
Agencia Nacional de Investigación y Desarrollo
School of Veterinary Medicine, Louisiana State University
Agencia Nacional de Investigacion y Desarrollo ANID/FONDAP CIGIDEN
Canadian Institute for Advanced Research CIFAR
University of Surrey Doctoral College Studentship
Ministry of Agriculture, Natural Resources
Port-au-Prince
Ministère de l'Agriculture, des Resources Naturelleset du Développement Rural
Department of Animal Health

Muestra la fuente de financiamiento declarada en la publicación.

Agradecimientos



Agradecimiento
E. T. was funded by the University of Surrey Doctoral College Studentship. E. A. U. was supported by The Canadian Institute for Advanced Research CIFAR and by the Agencia Nacional de Investigacion y Desarrollo ANID/FONDAP CIGIDEN (Grant no. 1522A0005) .
We thank Dr. Pierre Dilius Augustin and Dr. Joseph Haim at Ministère de l'Agriculture, des Resources Naturelleset du Développement Rural, Port-au-Prince, Haiti, and Department of Animal Health, Ministry of Agriculture, Natural Resources, and Rural Development, Port-au-Prince, Haiti, respectively, and Paige Anderton from the University of Surrey, School of Veterinary Medicine, for her contribution to this work. E. T. was funded by the University of Surrey Doctoral College Studentship. E. A. U. was supported by The Canadian Institute for Advanced Research CIFAR and by the Agencia Nacional de Investigación y Desarrollo ANID/FONDAP CIGIDEN (Grant no. 1522A0005).

Muestra la fuente de financiamiento declarada en la publicación.