Estimating the global burden of endemic canine rabies.
Estimating the global burden of endemic canine rabies.
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DOI：
10.1371/journal.pntd.0003709
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发表时间：
2015-04
影响因子：
3.8
通讯作者：
Global Alliance for Rabies Control Partners for Rabies Prevention
中科院分区：
文献类型：
--
作者：
Hampson K;Coudeville L;Lembo T;Sambo M;Kieffer A;Attlan M;Barrat J;Blanton JD;Briggs DJ;Cleaveland S;Costa P;Freuling CM;Hiby E;Knopf L;Leanes F;Meslin FX;Metlin A;Miranda ME;Müller T;Nel LH;Recuenco S;Rupprecht CE;Schumacher C;Taylor L;Vigilato MA;Zinsstag J;Dushoff J;Global Alliance for Rabies Control Partners for Rabies Prevention
狂犬病在低收入国家是一种众所周知的报告不足和被忽视的疾病。本研究旨在评估狂犬病在全球和各国国内犬群中传播的公共卫生和经济负担，从而客观评估这种可预防疾病在流行国家的成本。我们建立了狂犬病死亡率和狂犬病预防和控制措施之间的关系，并将其纳入模型框架。我们使用的数据来自广泛的文献检索和问卷调查的疾病发病率，控制干预措施和预防措施在这个框架内估计疾病负担。狂犬病对公共卫生部门预算、当地社区和畜牧业经济产生了影响，世界上最贫穷地区的狂犬病风险最高。这项研究估计，全球犬狂犬病每年造成约59，000（95%置信区间：25- 159，000）例人类死亡，超过370万（95% CI：160 - 1040万）残疾调整生命年（DADs）和86亿美元（95% CI：29 - 215亿）经济损失。经济负担的最大组成部分是由于过早死亡（55%），其次是接触后预防的直接费用（PEP，20%）和寻求PEP时的收入损失（15.5%），兽医部门因狗接种疫苗（1.5%）而产生的费用有限，牲畜损失给社区带来的额外费用（6%）。这项研究表明，对狗接种疫苗的投资，减少疾病负担的唯一最有效的方法，一直是不够的，PEP的可用性和可负担性需要改善。医疗和兽医部门的合作投资可以大大减少目前狂犬病对受影响社区的巨大和不必要的负担。需要改进监测，以减少负担估计的不确定性，并监测控制工作的影响。狂犬病是一种致命的病毒性疾病，主要通过受感染的动物（主要是家犬）叮咬传播给人类。这种疾病是完全可以预防的，通过及时管理暴露后预防（PEP）咬伤的受害者，并可以控制通过大规模接种家犬。然而，狂犬病在发展中国家仍然非常普遍，影响到获得医疗保健机会有限的人群。在这些地区，这种疾病的报告也严重不足，因为大多数受害者死于家中。这导致狂犬病预防在公共卫生议程中的优先地位不足。为了解决缺乏狂犬病影响信息的问题，在这项研究中，我们汇编了现有数据，以提供全球犬狂犬病对健康和经济影响的可靠估计。最重要的影响包括：因狂犬病过早死亡造成的人的生命损失（每年约59，000人）和生产力损失，以及一旦发生接触后获得PEP的费用。狂犬病的最大风险落在世界上最贫穷的地区，那里的家犬疫苗接种没有得到广泛实施，PEP的获得也非常有限。更加关注大规模的狗疫苗接种可以从源头上消除这种疾病，减少对昂贵的PEP的需求，并防止对高危社区造成巨大且不必要的死亡负担。
Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries. We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000) human deaths, over 3.7 million (95% CIs: 1.6-10.4 million) disability-adjusted life years (DALYs) and 8.6 billion USD (95% CIs: 2.9-21.5 billion) economic losses annually. The largest component of the economic burden is due to premature death (55%), followed by direct costs of post-exposure prophylaxis (PEP, 20%) and lost income whilst seeking PEP (15.5%), with only limited costs to the veterinary sector due to dog vaccination (1.5%), and additional costs to communities from livestock losses (6%). This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to monitor the impacts of control efforts. Rabies is a fatal viral disease largely transmitted to humans from bites by infected animals—predominantly from domestic dogs. The disease is entirely preventable through prompt administration of post-exposure prophylaxis (PEP) to bite victims and can be controlled through mass vaccination of domestic dogs. Yet, rabies is still very prevalent in developing countries, affecting populations with limited access to health care. The disease is also grossly underreported in these areas because most victims die at home. This leads to insufficient prioritization of rabies prevention in public health agendas. To address this lack of information on the impacts of rabies, in this study, we compiled available data to provide a robust estimate of the health and economic implications of dog rabies globally. The most important impacts included: loss of human lives (approximately 59,000 annually) and productivity due to premature death from rabies, and costs of obtaining PEP once an exposure has occurred. The greatest risk of developing rabies fell upon the poorest regions of the world, where domestic dog vaccination is not widely implemented and access to PEP is most limited. A greater focus on mass dog vaccination could eliminate the disease at source, reducing the need for costly PEP and preventing the large and unnecessary burden of mortality on at-risk communities.
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影响因子：
3.8
作者：
Ly, Sowath;Buchy, Philippe;Heng, Nay Yim;Ong, Sivuth;Chhor, Nareth;Bourhy, Herve;Vong, Sirenda
通讯作者：
Vong, Sirenda
影响因子：
168.9
作者：
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通讯作者：
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影响因子：
5.7
作者：
Lembo, Tiziana;Hampson, Katie;Cleaveland, Sarah
通讯作者：
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影响因子：
9.8
作者：
Hampson K;Dushoff J;Cleaveland S;Haydon DT;Kaare M;Packer C;Dobson A
通讯作者：
Dobson A
DOI：
10.1073/pnas.0609122104
发表时间：
2007-05-01
影响因子：
11.1
作者：
Hampson, Katie;Dushoff, Jonathan;Dobson, Andy
通讯作者：
Dobson, Andy