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在菲律宾宿务消除狂犬病:健康经济数据评估。

Towards Canine Rabies Elimination in Cebu, Philippines: Assessment of Health Economic Data.

机构信息

Global Alliance for Rabies Control Inc., Laguna, Philippines.

Asian Development Bank, Manila, Philippines.

出版信息

Transbound Emerg Dis. 2017 Feb;64(1):121-129. doi: 10.1111/tbed.12350. Epub 2015 Apr 17.

Abstract

Rabies is endemic in the Philippines. In 2010, with support from the Bill and Melinda Gates Foundation, a canine rabies elimination project was initiated in the Philippine Archipelago of Visayan. We conducted an analysis of dog vaccination and human PEP costs for dog bite patients in a highly urbanized area and a low-income rural municipality in Cebu Province, Philippines, from 2010 to 2012. Our findings indicated that eliminating rabies in dogs through mass vaccination is more cost-effective than treating rabies exposures in humans. The average costs (in USD) per human life saved through PEP were $1620.28 in Cebu City and $1498 in Carmen. Costs per dog vaccinated ranged from $1.18 to $5.79 in Cebu City and $2.15 to $3.38 in Carmen. Mass dog vaccination campaigns conducted in each village were more cost-effective than fixed-site campaigns. The costs of dog vaccination can be reduced further through bulk vaccine purchase by the national government or large donor agency, for example the BMGF. As communities achieve canine rabies elimination, more judicious use of PEP will result in significant public savings. The study affirms the willingness of local governments to invest and reassure donors of their cooperation and resource contribution to sustain disease elimination efforts.

摘要

狂犬病在菲律宾流行。2010 年,在比尔及梅琳达·盖茨基金会的支持下,菲律宾米沙鄢群岛启动了一项犬狂犬病消除项目。我们对 2010 年至 2012 年期间在菲律宾宿务省一个高度城市化地区和一个低收入农村市的犬咬伤患者的犬类疫苗接种和人类 PEP 成本进行了分析。我们的研究结果表明,通过大规模疫苗接种消除犬类狂犬病比治疗人类狂犬病暴露更具成本效益。通过 PEP 每挽救一条生命的平均成本(以美元计)在宿务市为 1620.28 美元,在卡门为 1498 美元。在宿务市,每只接种疫苗的狗的成本从 1.18 美元到 5.79 美元不等,在卡门为 2.15 美元到 3.38 美元不等。在每个村庄进行的大规模犬只疫苗接种运动比固定地点的疫苗接种运动更具成本效益。通过国家政府或大型捐助机构(如盖茨基金会)批量购买疫苗,可以进一步降低犬只疫苗接种的成本。随着社区实现犬类狂犬病消除,更明智地使用 PEP 将为公众节省大量资金。该研究证实了地方政府愿意投资,并向捐助者保证他们的合作和资源贡献,以维持疾病消除工作。

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