Costs and effectiveness of alternative dog vaccination strategies to improve dog population coverage in rural and urban settings during a rabies outbreak
Costs and effectiveness of alternative dog vaccination strategies to improve dog population coverage in rural and urban settings during a rabies outbreak
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DOI：
10.1016/j.vaccine.2020.06.006
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发表时间：
2020-09-03
期刊：
影响因子：
5.5
通讯作者：
Wallace，Ryan M.
中科院分区：
文献类型：
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作者：
Undurraga，Eduardo A.;Millien，Max F.;Wallace，Ryan M.
犬狂犬病消除计划通常依赖于在中心点位置进行胃肠外疫苗接种;然而，养狗实践，难以接触的亚群，资源限制和物流可能会影响一个国家达到世界动物卫生组织（OIE）和世界卫生组织（WHO）建议的70%覆盖率目标的能力。在这里，我们报告了2016年海地西部省Croix-des-Bouquets公社城市和城郊地区犬狂犬病爆发期间不同犬疫苗接种策略的成本效益。三种策略，移动的静态点（MSP），移动的静态点与捕获-疫苗接种-释放（MSP + CVR），和门到门接种口服疫苗（DDV + ORV），在五个随机分配的网站，并评估自由漫游犬疫苗接种覆盖率和总人口覆盖率。在疫苗注射运动期间，共有7065只狗接受狂犬病疫苗注射。总体而言，MSP、DDV + ORV和MSP + CVR的自由漫游犬疫苗接种覆盖率估计分别为52%（47%-56%）、53%（47%-60%）和65%（61%-69%）（MSP和DDV + ORV差异显著，p < 0.01）。犬的总疫苗接种覆盖率为：MSP为33%（95% CI：26%-43%），MSP + CVR为49%（95% CI：40%-61%），DDV + ORV为78%（77%-80%）（差异显著，p < 0.001）。总体而言，最便宜的运动是MSP，估计费用约为每天2039美元（总计4078美元），最昂贵的是DDV + ORV，费用为每天3246美元（总计6492美元）。尽管ORV诱饵的成本相对较高，但DDV和ORV组合是我们研究中最具成本效益的策略（每只接种犬1.97美元），这主要是由于疫苗接种者针对不易接近的犬的效率提高。MSP和MSP + CVR每只接种犬的成本分别为2.20美元和2.28美元。我们希望这项研究的结果将支持设计和实施有效的狗疫苗接种运动，以实现到2030年消除狗介导的人类狂犬病死亡的目标。
Dog-rabies elimination programs have typically relied upon parenteral vaccination at central-point locations; however, dog-ownership practices, accessibility to hard-to-reach sub-populations, resource limitations, and logistics may impact a country’s ability to reach the 70% coverage goal recommended by the World Organization for Animal Health (OIE) and World Health Organization (WHO). Here we report the cost-effectiveness of different dog-vaccination strategies during a dog-rabies outbreak in urban andperi-urban sections of Croix-des-Bouquets commune of the West Department, Haiti, in 2016. Three strategies, mobile static point (MSP), mobile static point with capture-vaccinate-release (MSP + CVR), and door-to-door vaccination with oral vaccination (DDV + ORV), were applied at five randomly assigned sites and assessed for free-roaming dog vaccination coverage and total population coverage. A total of 7065 dogs were vaccinated against rabies during the vaccination campaign. Overall, free-roaming dog vaccination coverage was estimated at 52% (47%-56%) for MSP, 53% (47%-60%) for DDV + ORV, and 65% (61%-69%) for MSP + CVR (differences with MSP and DDV + ORV significant at p < 0.01). Total dog vaccination coverage was 33% (95% CI: 26%-43%) for MSP, 49% (95% CI: 40%-61%) for MSP + CVR and 78% (77%-80%) for DDV + ORV (differences significant at p < 0.001). Overall, the least expensive campaign was MSP, with an estimated cost of about $2039 per day ($4078 total), and the most expensive was DDV + ORV with a cost of $3246 per day ($6492 total). Despite the relative high cost of an ORV bait, combining DDV and ORV was the most cost-effective strategy in our study ($1.97 per vaccinated dog), largely due to increased efficiency of the vaccinators to target less accessible dogs. Costs per vaccinated dog were $2.20 for MSP and $2.28 for MSP + CVR. We hope the results from this study will support the design and implementation of effective dog vaccination campaigns to achieve the goal of eliminating dog-mediated human rabies deaths by 2030.