2 research outputs found
Estimating the global burden of endemic canine rabies
Background: Rabies is a notoriously underreported and neglected disease of lowincome
countries. This study aims to estimate the public health and economic burden
of rabies circulating in domestic dog populations, globally and on a country-by-country
basis, allowing an objective assessment of how much this preventable disease costs
endemic countries.<p></p>
Methodology/Principal Findings: We established relationships between rabies mortality
and rabies prevention and control measures, which we incorporated into a model
framework. We used data derived from extensive literature searches and
questionnaires on disease incidence, control interventions and preventative measures
within this framework to estimate the disease burden. The burden of rabies impacts on
public health sector budgets, local communities and livestock economies, with the
highest risk of rabies in the poorest regions of the world. This study estimates that
globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-
159,000) human deaths, over 3.7 million (95% CIs: 1.6-10.4 million) disability-adjusted
life years (DALYs) and 8.6 billion USD (95% CIs: 2.9-21.5 billion) economic losses
annually. The largest component of the economic burden is due to premature death
(55%), followed by direct costs of post-exposure prophylaxis (PEP, 20%) and lost
income whilst seeking PEP (15.5%), with only limited costs to the veterinary sector due
to dog vaccination (1.5%), and additional costs to communities from livestock losses
(6%).<p></p>
Conclusions/Significance: This study demonstrates that investment in dog vaccination,
the single most effective way of reducing the disease burden, has been inadequate
and that the availability and affordability of PEP needs improving. Collaborative
investments by medical and veterinary sectors could dramatically reduce the current
large, and unnecessary, burden of rabies on affected communities. Improved
surveillance is needed to reduce uncertainty in burden estimates and to monitor the
impacts of control efforts.<p></p>