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| Indexado |
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| 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
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.
| 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 |
| 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 |
| 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). |