Cost comparison of rabies pre-exposure vaccination with post-exposure treatment in Thai children
Cost comparison of rabies pre-exposure vaccination with post-exposure treatment in Thai children
复制标题
DOI：
10.1016/j.vaccine.2005.03.059
复制
发表时间：
2006-02-27
期刊：
影响因子：
5.5
通讯作者：
Wilde, H
中科院分区：
文献类型：
--
作者：
Chulasugandha, P;Khawplod, P;Wilde, H
泰国是一个犬狂犬病流行的国家，每年有超过1000只动物被诊断患有狂犬病[1]。每年有超过345，000人因可能的狂犬病暴露而接受治疗[2]。缺乏对疾病负担的认识，社会、文化和传统信仰在犬狂犬病控制失败中起重要作用。不幸的是，卫生保健预算越来越多地分配给人类暴露后的治疗，而不是消除犬动物媒介中的狂犬病。15岁以下的儿童占狗咬伤受害者和人类狂犬病死亡人数的一半，但没有关于狗咬伤流行率的准确数据。一直主张对儿童进行大规模接触前免疫接种，但财政和后勤障碍阻碍了实施。本研究分析了暴露前疫苗接种（PREP）作为人类狂犬病预防策略的直接医疗成本，以及泰国儿童暴露后预防（PEP）的成本。目前正在使用三种暴露前和暴露后疫苗方案，这对成本计算产生了影响。研究发现，当狗咬伤发生率为2-30%时，两种策略（儿童PREP或暴露后PEP）的成本变得相等;具体取决于使用的暴露后治疗方案（PEP）。(c)2005爱思唯尔有限公司保留所有权利。
Thailand is a canine rabies endemic country with an annual prevalence above 1000 reported animals diagnosed rabid [1]. Over 345,000 humans are treated for possible rabies exposures annually [2]. Lack of perception of the disease burden, social, cultural and traditional beliefs play in important role in the failure of canine rabies control. It is unfortunate that health care budgets are increasingly allocated to human post-exposure treatment rather than to the eradication of rabies in the canine animal vector. Children under the age of 15 years represent up to one-half of dog bite victims and of human rabies deaths, but accurate data of dog bite prevalence are not available [3-6]. Large scale pre-exposure immunization of children has been advocated but financial and logistic barriers have hindered implementation. This study analyzes direct medical costs of pre-exposure vaccination (PREP) as a human rabies preventive strategy, against the cost of post-exposure prophylaxis (PEP) in Thai children. Three pre- and post-exposure vaccine regimens are in use and this impacts on cost calculations. It was found that costs of both strategies, PREP of children or PEP of exposed, become equal when the dog bite incidence is 2-30%; depending on which post-exposure treatment regimens (PEP) are used. (c) 2005 Elsevier Ltd. All rights reserved.