Quantifying the burden of vampire bat rabies in Peruvian livestock
Quantifying the burden of vampire bat rabies in Peruvian livestock
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DOI：
10.1371/journal.pntd.0006105
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发表时间：
2017-12-01
影响因子：
3.8
通讯作者：
Streicker, Daniel G.
中科院分区：
文献类型：
--
作者：
Benavides, Julio A.;Paniagua, Elizabeth Rojas;Streicker, Daniel G.
研究背景了解传染病负担对于合理分配预防和控制资源是必要的。在拉丁美洲，狂犬病是对人类健康和农业最重要的人畜共患疾病之一，但疾病负担归因于其主要宿主--普通吸血蝙蝠（Desmodus rotundus），方法学/主要发现我们使用问卷调查来量化40个农业社区的牲畜死亡漏报情况，这些社区的卫生资源和吸血蝙蝠狂犬病（VBR）的流行病学历史不同在秘鲁南部的阿普里马克、阿亚库乔和库斯科地区。认为VBR不存在于其社区的农民报告牲畜死于疾病的可能性是认为VBR存在的农民的三分之一，并且报告不足的情况随着距离报告办公室的距离而增加。使用广义混合效应模型，捕捉报告中的空间自相关性，我们预测4.6（95%CI：4.4-8.2）狂犬病病例报告的情况下，并确定地理区域的潜在更大的VBR负担比官方报告。空间校正模型估计，2014年我们研究地区的VBR导致505-724头牛死亡（421-444头死亡/100，000头牛），成本为121，797 - 171，992美元。成本效益分析有利于接种疫苗的所有牛在目前的做法，部分疫苗接种或停止接种所有together.ConclusionsOur研究代表了第一次估计的负担VBR在拉丁美洲纳入报告率的数据。我们证实了长期以来怀疑的VBR对小规模农民的成本，并表明为牲畜接种疫苗是减轻VBR负担的具有成本效益的解决方案。更一般地说，结果强调，忽视获得卫生资源的地理差异可能会使疾病负担和风险的估计产生偏差。
BackgroundKnowledge of infectious disease burden is necessary to appropriately allocate resources for prevention and control. In Latin America, rabies is among the most important zoonoses for human health and agriculture, but the burden of disease attributed to its main reservoir, the common vampire bat (Desmodus rotundus), remains uncertain.Methodology/Principal findingsWe used questionnaires to quantify under-reporting of livestock deaths across 40 agricultural communities with differing access to health resources and epidemiological histories of vampire bat rabies (VBR) in the regions of Apurimac, Ayacucho and Cusco in southern Peru. Farmers who believed VBR was absent from their communities were one third as likely to report livestock deaths from disease as those who believed VBR was present, and under-reporting increased with distance from reporting offices. Using generalized mixed-effect models that captured spatial autocorrelation in reporting, we project 4.6 (95% CI: 4.4-8.2) rabies cases per reported case and identify geographic areas with potentially greater VBR burden than indicated by official reports. Spatially-corrected models estimate 505-724 cattle deaths from VBR in our study area during 2014 (421-444 deaths/100,000 cattle), costing US$121,797-171,992. Cost benefit analysis favoured vaccinating all cattle over the current practice of partial vaccination or halting vaccination all together.ConclusionsOur study represents the first estimate of the burden of VBR in Latin America to incorporate data on reporting rates. We confirm the long-suspected cost of VBR to small-scale farmers and show that vaccinating livestock is a cost-effective solution to mitigate the burden of VBR. More generally, results highlight that ignoring geographic variation in access to health resources can bias estimates of disease burden and risk.