A Cost-Effectiveness Analysis of Pre-Exposure Prophylaxis to Avert Rabies Deaths in School-Aged Children in India.
A Cost-Effectiveness Analysis of Pre-Exposure Prophylaxis to Avert Rabies Deaths in School-Aged Children in India.
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DOI：
10.3390/vaccines11010088
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发表时间：
2022-12-30
期刊：
影响因子：
7.8
通讯作者：
Utarini A
中科院分区：
文献类型：
--
作者：
Royal A;John D;Bharti O;Tanwar R;Bhagat DK;Padmawati RS;Chaudhary V;Umapathi R;Bhadola P;Utarini A
在印度，儿童占狂犬病死亡总人数的一半。为了在印度有效实施暴露前预防（PrEP），需要探索最先进的狂犬病死亡率避免策略。本研究报告了各种PrEP和暴露后预防（PEP）策略的经济评估，以避免印度学龄儿童的狂犬病死亡。已经为5-15岁年龄组的儿童开发了一个决策树模型，以评估各种PrEP + PEP和仅PEP方案。选择在第0天和第7天给予的2部位皮内给药方案作为干预[PrEP（I）]。ICER是从准社会和准卫生系统的角度计算的，用于基础病例分析、沿着单向敏感性和每种方案的情景分析。在2020年，实施PrEP（I）后，每百万人口避免的增量DURs介于451至85，069之间。从准社会的角度来看，与PEP方案相比，ICER的范围为384-352美元/避免的DALY（非显性）。据报道，从准社会和准卫生系统的角度来看，与PEP方案相比，PrEP（I）是“非常具有成本效益的”，并将死亡率降低了89.9%。这项研究的结论是，PrEP（I）方案是一种具有成本效益和挽救生命的策略，可以避免印度学龄儿童因狂犬病而导致的痛苦死亡。
Children contribute to one-half of the total painful rabies mortalities in India. The state-of-the-art rabies mortality averting strategies need exploration for the effective implementation of pre-exposure prophylaxis (PrEP) in India. This study reports on the economic evaluation of various PrEP and post-exposure prophylaxis (PEP) strategies to avert rabies mortalities in school-aged children in India. A decision tree model has been developed for children in the age group of 5–15 years to evaluate various PrEP + PEP and PEP only regimens. The 2-site intradermal regimen administered on day zero and seven was chosen as the intervention [PrEP (I)]. ICER was calculated from the quasi-societal and quasi-health systems’ perspectives for the base case analysis, along with one-way sensitivity, and scenario analyses for each regimen. The incremental DALYs averted per million population with the implementation of PrEP (I) ranged between 451 and 85,069 in 2020. The ICER was reported in the range of USD 384–352/DALY averted (non-dominant) in comparison to PEP regimens from a quasi-societal perspective. PrEP (I) is reported to be ‘very cost effective’ in comparison with PEP regimens from the quasi-societal and quasi-health systems’ perspectives and reduce deaths by up to 89.9%. This study concludes that the PrEP (I) regimen is a cost-effective and life-saving strategy to avert painful mortalities due to rabies in school-aged children in India.
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影响因子：
3.8
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
通讯作者：
Global Alliance for Rabies Control Partners for Rabies Prevention
影响因子：
8.4
作者：
Quiambao, Beatriz;Varghese, Lijoy;Preiss, Scott
通讯作者：
Preiss, Scott
影响因子：
4.5
作者：
Ock, Minsu;Park, Bomi;Jo, Min-Woo
通讯作者：
Jo, Min-Woo
影响因子：
4.8
作者：
Bharti, Omesh Kumar;Madhusudana, Shampur Narayan;Belludi, Ashwin Yajaman
通讯作者：
Belludi, Ashwin Yajaman
影响因子：
5.5
作者：
Chulasugandha, P;Khawplod, P;Wilde, H
通讯作者：
Wilde, H