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Transmission dynamics and economics of rabies control in dogs and humans in an African city

Zinsstag, J. and Dürr, S. and Penny, M. A. and Mindekem, R. and Roth, F. and Menendez Gonzalez S., and Naissengar, S. and Hattendorf, J.. (2009) Transmission dynamics and economics of rabies control in dogs and humans in an African city. Proceedings of the National Academy of Sciences of the United States of America, Vol. 106, H. 35. pp. 14996-15001.

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Official URL: http://edoc.unibas.ch/dok/A5843364

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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'Djamena, the capital of Chad. The estimated transmission rates between dogs (beta(d)) were 0.0807 km(2)/(dogs.week) and between dogs and humans (beta(dh)) 0.0002 km(2)/(dogs.week). The effective reproductive ratio (R(e)) 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
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Former Units within Swiss TPH > Health Systems and Economics (Stoermer)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Interventions > Malaria Interventions (Lengeler)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Human and Animal Health > One Health (Zinsstag)
UniBasel Contributors:Zinsstag, Jakob Z
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:National Academy of Sciences
ISSN:0027-8424
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:14 Sep 2012 07:18
Deposited On:14 Sep 2012 06:46

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