Jemberu Wudu T, Mourits Monique, Rushton Jonathan, Hogeveen Henk
Business Economics Group, Wageningen University, Hollandseweg 1, 6706KN Wageningen, The Netherlands; Department of Veterinary Epidemiology and Public Health, Faculty of Veterinary Medicine, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
Business Economics Group, Wageningen University, Hollandseweg 1, 6706KN Wageningen, The Netherlands.
Prev Vet Med. 2016 Sep 15;132:67-82. doi: 10.1016/j.prevetmed.2016.08.008. Epub 2016 Aug 25.
Foot and mouth disease (FMD) occurs endemically in Ethiopia. Quantitative insights on its national economic impact and on the costs and benefits of control options are, however, lacking to support decision making in its control. The objectives of this study were, therefore, to estimate the annual costs of FMD in cattle production systems of Ethiopia, and to conduct an ex ante cost-benefit analysis of potential control alternatives. The annual costs of FMD were assessed based on production losses, export losses and control costs. The total annual costs of FMD under the current status quo of no official control program were estimated at 1354 (90% CR: 864-2042) million birr. The major cost (94%) was due to production losses. The costs and benefits of three potential control strategies: 1) ring vaccination (reactive vaccination around outbreak area supported by animal movement restrictions, 2) targeted vaccination (annual preventive vaccination in high risk areas plus ring vaccination in the rest of the country), and 3) preventive mass vaccination (annual preventive vaccination of the whole national cattle population) were compared with the baseline scenario of no official control program. Experts were elicited to estimate the influence of each of the control strategies on outbreak incidence and number of cases per outbreak. Based on these estimates, the incidence of the disease was simulated stochastically for 10 years. Preventive mass vaccination was epidemiologically the most efficient control strategy by reducing the national outbreak incidence below 5% with a median time interval of 3 years, followed by targeted vaccination strategy with a corresponding median time interval of 5 years. On average, all evaluated control strategies resulted in positive net present values. The ranges in the net present values were, however, very wide, including negative values. The targeted vaccination strategy was the most economic strategy with a median benefit cost ratio of 4.29 (90%CR: 0.29-9.63). It was also the least risky strategy with 11% chance of a benefit cost ratio of less than one. The study indicates that FMD has a high economic impact in Ethiopia. Its control is predicted to be economically profitable even without a full consideration of gains from export. The targeted vaccination strategy is shown to provide the largest economic return with a relatively low risk of loss. More studies to generate data, especially on production impact of the disease and effectiveness of control measures are needed to improve the rigor of future analysis.
口蹄疫（FMD）在埃塞俄比亚呈地方流行。然而，缺乏关于其对国家经济影响以及控制措施成本效益的定量见解，无法为口蹄疫控制决策提供支持。因此，本研究的目的是估计埃塞俄比亚牛生产系统中口蹄疫的年度成本，并对潜在控制方案进行事前成本效益分析。口蹄疫的年度成本基于生产损失、出口损失和控制成本进行评估。在没有官方控制计划的当前现状下，口蹄疫的年度总成本估计为13.54亿比尔（90%置信区间：8.64 - 20.42亿比尔）。主要成本（94%）归因于生产损失。将三种潜在控制策略的成本效益：1）环形疫苗接种（在疫情爆发地区周围进行反应性疫苗接种，并辅以动物移动限制）、2）针对性疫苗接种（在高风险地区进行年度预防性疫苗接种，在该国其他地区进行环形疫苗接种）以及3）预防性大规模疫苗接种（对全国所有牛群进行年度预防性疫苗接种）与没有官方控制计划的基线情景进行了比较。通过专家估计每种控制策略对疫情发生率和每次疫情病例数的影响。基于这些估计，对该疾病的发生率进行了为期10年的随机模拟。预防性大规模疫苗接种在流行病学上是最有效的控制策略，可将全国疫情发生率降低至5%以下，中位时间间隔为3年，其次是针对性疫苗接种策略，相应的中位时间间隔为5年。平均而言，所有评估的控制策略都产生了正的净现值。然而，净现值的范围非常广泛，包括负值。针对性疫苗接种策略是最经济的策略，中位效益成本比为4.29（90%置信区间：0.29 - 9.63）。它也是风险最小的策略，效益成本比小于1的概率为11%。该研究表明，口蹄疫在埃塞俄比亚具有很高的经济影响。预计即使不完全考虑出口收益，对口蹄疫的控制在经济上也是有利可图的。针对性疫苗接种策略显示出能提供最大的经济回报，且损失风险相对较低。需要开展更多研究以生成数据，特别是关于该疾病对生产的影响以及控制措施的有效性的数据，以提高未来分析的严谨性。
