Re-evaluating the burden of rabies in Africa and Asia
OBJECTIVE: To quantify the public health and economic burden of endemic canine rabies in Africa and Asia. METHODS: Data from these regions were applied to a set of linked epidemiological and economic models. The human population at risk from endemic canine rabies was predicted using data on dog dens...
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| Format: | Article |
| Language: | English |
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The World Health Organization
2005-05-01
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| Series: | Bulletin of the World Health Organization |
| Subjects: | |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862005000500012&lng=en&tlng=en |
| _version_ | 1797284964596711424 |
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| author | Darryn L. Knobel Sarah Cleaveland Paul G. Coleman Eric M. Fèvre Martin I. Meltzer M. Elizabeth G. Miranda Alexandra Shaw Jakob Zinsstag François-Xavier Meslin |
| author_facet | Darryn L. Knobel Sarah Cleaveland Paul G. Coleman Eric M. Fèvre Martin I. Meltzer M. Elizabeth G. Miranda Alexandra Shaw Jakob Zinsstag François-Xavier Meslin |
| author_sort | Darryn L. Knobel |
| collection | DOAJ |
| description | OBJECTIVE: To quantify the public health and economic burden of endemic canine rabies in Africa and Asia. METHODS: Data from these regions were applied to a set of linked epidemiological and economic models. The human population at risk from endemic canine rabies was predicted using data on dog density, and human rabies deaths were estimated using a series of probability steps to determine the likelihood of clinical rabies developing in a person after being bitten by a dog suspected of having rabies. Model outputs on mortality and morbidity associated with rabies were used to calculate an improved disability-adjusted life year (DALY) score for the disease. The total societal cost incurred by the disease is presented. FINDINGS: Human mortality from endemic canine rabies was estimated to be 55 000 deaths per year (90% confidence interval (CI) = 24 000-93 000). Deaths due to rabies are responsible for 1.74 million DALYs lost each year (90% CI = 0.75-2.93). An additional 0.04 million DALYs are lost through morbidity and mortality following side-effects of nerve-tissue vaccines. The estimated annual cost of rabies is US$ 583.5 million (90% CI = US$ 540.1-626.3 million). Patient-borne costs for post-exposure treatment form the bulk of expenditure, accounting for nearly half the total costs of rabies. CONCLUSION: Rabies remains an important yet neglected disease in Africa and Asia. Disparities in the affordability and accessibility of post-exposure treatment and risks of exposure to rabid dogs result in a skewed distribution of the disease burden across society, with the major impact falling on those living in poor rural communities, in particular children. |
| first_indexed | 2024-03-07T17:56:20Z |
| format | Article |
| id | doaj.art-f8e49f80f5144b7aa0acefb1d321f23c |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T17:56:20Z |
| publishDate | 2005-05-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-f8e49f80f5144b7aa0acefb1d321f23c2024-03-02T12:27:49ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862005-05-01835360368S0042-96862005000500012Re-evaluating the burden of rabies in Africa and AsiaDarryn L. Knobel0Sarah Cleaveland1Paul G. Coleman2Eric M. Fèvre3Martin I. Meltzer4M. Elizabeth G. Miranda5Alexandra Shaw6Jakob Zinsstag7François-Xavier Meslin8University of EdinburghUniversity of EdinburghLondon School of Hygiene and Tropical MedicineUniversity of EdinburghCenters for Disease Control and PreventionWorld Health OrganizationAP ConsultantsSwiss Tropical InstituteWorld Health OrganizationOBJECTIVE: To quantify the public health and economic burden of endemic canine rabies in Africa and Asia. METHODS: Data from these regions were applied to a set of linked epidemiological and economic models. The human population at risk from endemic canine rabies was predicted using data on dog density, and human rabies deaths were estimated using a series of probability steps to determine the likelihood of clinical rabies developing in a person after being bitten by a dog suspected of having rabies. Model outputs on mortality and morbidity associated with rabies were used to calculate an improved disability-adjusted life year (DALY) score for the disease. The total societal cost incurred by the disease is presented. FINDINGS: Human mortality from endemic canine rabies was estimated to be 55 000 deaths per year (90% confidence interval (CI) = 24 000-93 000). Deaths due to rabies are responsible for 1.74 million DALYs lost each year (90% CI = 0.75-2.93). An additional 0.04 million DALYs are lost through morbidity and mortality following side-effects of nerve-tissue vaccines. The estimated annual cost of rabies is US$ 583.5 million (90% CI = US$ 540.1-626.3 million). Patient-borne costs for post-exposure treatment form the bulk of expenditure, accounting for nearly half the total costs of rabies. CONCLUSION: Rabies remains an important yet neglected disease in Africa and Asia. Disparities in the affordability and accessibility of post-exposure treatment and risks of exposure to rabid dogs result in a skewed distribution of the disease burden across society, with the major impact falling on those living in poor rural communities, in particular children.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862005000500012&lng=en&tlng=enRabiaRabiaPerrosCosto de la enfermedadEvaluación de la incapacidadCostos de la atención en saludProbabilidadModelos teóricosÁfricaAsia |
| spellingShingle | Darryn L. Knobel Sarah Cleaveland Paul G. Coleman Eric M. Fèvre Martin I. Meltzer M. Elizabeth G. Miranda Alexandra Shaw Jakob Zinsstag François-Xavier Meslin Re-evaluating the burden of rabies in Africa and Asia Bulletin of the World Health Organization Rabia Rabia Perros Costo de la enfermedad Evaluación de la incapacidad Costos de la atención en salud Probabilidad Modelos teóricos África Asia |
| title | Re-evaluating the burden of rabies in Africa and Asia |
| title_full | Re-evaluating the burden of rabies in Africa and Asia |
| title_fullStr | Re-evaluating the burden of rabies in Africa and Asia |
| title_full_unstemmed | Re-evaluating the burden of rabies in Africa and Asia |
| title_short | Re-evaluating the burden of rabies in Africa and Asia |
| title_sort | re evaluating the burden of rabies in africa and asia |
| topic | Rabia Rabia Perros Costo de la enfermedad Evaluación de la incapacidad Costos de la atención en salud Probabilidad Modelos teóricos África Asia |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862005000500012&lng=en&tlng=en |
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