Transmission dynamics and economics of rabies control in dogs and humans in an African city
- 1 September 2009
- journal article
- research article
- Published by Proceedings of the National Academy of Sciences in Proceedings of the National Academy of Sciences
- Vol. 106 (35), 14996-15001
- https://doi.org/10.1073/pnas.0904740106
Abstract
Human rabies in developing countries can be prevented through interventions directed at dogs. Potential cost-savings for the public health sector of interventions aimed at animal-host reservoirs should be assessed. Available deterministic models of rabies transmission between dogs were extended to include dog-to-human rabies transmission. Model parameters were fitted to routine weekly rabid-dog and exposed-human cases reported in N′Djaména, the capital of Chad. The estimated transmission rates between dogs (βd) were 0.0807 km2/(dogs·week) and between dogs and humans (βdh) 0.0002 km2/(dogs·week). The effective reproductive ratio (Re) at the onset of our observations was estimated at 1.01, indicating low-level endemic stability of rabies transmission. Human rabies incidence depended critically on dog-related transmission parameters. We simulated the effects of mass dog vaccination and the culling of a percentage of the dog population on human rabies incidence. A single parenteral dog rabies-mass vaccination campaign achieving a coverage of least 70% appears to be sufficient to interrupt transmission of rabies to humans for at least 6 years. The cost-effectiveness of mass dog vaccination was compared to postexposure prophylaxis (PEP), which is the current practice in Chad. PEP does not reduce future human exposure. Its cost-effectiveness is estimated at US $46 per disability adjusted life-years averted. Cost-effectiveness for PEP, together with a dog-vaccination campaign, breaks even with cost-effectiveness of PEP alone after almost 5 years. Beyond a time-frame of 7 years, it appears to be more cost-effective to combine parenteral dog-vaccination campaigns with human PEP compared to human PEP alone.Keywords
This publication has 22 references indexed in Scilit:
- Owner Valuation of Rabies Vaccination of Dogs, ChadEmerging Infectious Diseases, 2008
- Rabies Diagnosis for Developing CountriesPLoS Neglected Tropical Diseases, 2008
- Synchronous cycles of domestic dog rabies in sub-Saharan Africa and the impact of control effortsProceedings of the National Academy of Sciences of the United States of America, 2007
- Human Benefits of Animal Interventions for Zoonosis ControlEmerging Infectious Diseases, 2007
- Cost‐description of a pilot parenteral vaccination campaign against rabies in dogs in N'Djaména, ChadTropical Medicine & International Health, 2006
- Field trials of a very potent rabies DNA vaccine which induced long lasting virus neutralizing antibodies and protection in dogs in experimental conditionsVaccine, 2006
- Overview of rabies in the AmericasVirus Research, 2005
- Incidence of canine rabies in N'Djaména, ChadPreventive Veterinary Medicine, 2003
- Immunization coverage required to prevent outbreaks of dog rabiesVaccine, 1996
- Mass Vaccination Campaign Against Rabies: Are Dogs Correctly Protected? The Peruvian ExperienceClinical Infectious Diseases, 1988