Cost-effectiveness Analysis of Integrated Bite Case Management and Sustained Dog Vaccination for Rabies Control

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dc.catalogadorcrc
dc.contributor.authorTaylor, Ema
dc.contributor.authorPrada, Joaquin M.
dc.contributor.authorDel Rio Vilas, Victor
dc.contributor.authorUndurraga Fourcade, Eduardo Andrés
dc.contributor.authorWallace, Ryan
dc.contributor.authorHorton, Daniel L.
dc.date.accessioned2023-06-02T19:55:12Z
dc.date.available2023-06-02T19:55:12Z
dc.date.issued2023
dc.description.abstractThe successful prevention, control, and elimination of dog-mediated rabies is challenging due to insuffi cient 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 inter ventions 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 pro grams. 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.
dc.fechaingreso.objetodigital2023-06-02
dc.fuente.origenORCID
dc.identifier.doi10.4269/ajtmh.22-0308
dc.identifier.eissn1476-1645
dc.identifier.issn0002-9637
dc.identifier.urihttp://europepmc.org/abstract/med/37188344
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/70513
dc.identifier.urihttps://doi.org/10.4269/ajtmh.22-0308
dc.information.autorucEscuela de Gobierno; Undurraga Fourcade, Eduardo Andres;0000-0002-4425-1253;12868
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final9
dc.pagina.inicio1
dc.revistaThe American Journal of Tropical Medicine and Hygiene
dc.rightsacceso abierto
dc.subject.ddc570
dc.subject.deweyBiologíaes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleCost-effectiveness Analysis of Integrated Bite Case Management and Sustained Dog Vaccination for Rabies Control
dc.typepreprint
sipa.codpersvinculados12868
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