利用疫苗控制非疫区马流感的应急模型的经济分析。

An economic analysis of a contingency model utilising vaccination for the control of equine influenza in a non-endemic country.

机构信息

Centre for Applied One Health Research and Policy Advice, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR.

Epicentre, School of Veterinary Science, Massey University, Palmerston North, New Zealand.

出版信息

PLoS One. 2019 Jan 24;14(1):e0210885. doi: 10.1371/journal.pone.0210885. eCollection 2019.

DOI:10.1371/journal.pone.0210885

PMID:30677067

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6345452/

Abstract

BACKGROUND

Equine influenza (EI) is an infectious respiratory disease of horses that has never been reported in New Zealand (NZ). However, the 2007 EI outbreak in Australia, previously EI free, spurred the NZ government and stakeholders into evaluating alternative EI control strategies in order to economically justify any future decision to eradicate or manage EI. To build on the policy debate, this paper presents an epinomic (epidemiologic and economic) modelling approach to evaluate alternative control strategies. An epidemiologic model to determine how alternative EI control strategies influence the distribution of EI. Model results were then input into a cost-benefit analysis framework, to identify the return and feasibility of alternative EI eradication strategies in NZ.

METHODS

The article explores nine alternative eradication scenarios and two baseline strategies. The alternative scenarios consisted of three vaccination strategies (suppressive, protective or targeted) starting at three time points to reflect the commercial breeding-cycle. These alternatives were compared to two breeding-cycle adjusted baselines: movement restriction in the breeding season (August to January) or non-breeding season (February to July). The economic loss parameters were incursion response, impact to the commercial racing industry (breeding, sales and racing), horse morbidity and mortality, and compensation to industry participants.

RESULTS AND CONCLUSIONS

Results suggest that the economic viability of the EI eradication programme is dependent on when within the breeding-cycle the EI outbreak occurs. If an outbreak were to occur, the return on each dollar invested for protective or suppressive vaccination strategies would be between NZD$3.67 to NZD$4.89 and between NZD$3.08 to NZD$3.50 in the breeding and non-breeding seasons, respectively. Therefore, protective or suppressive vaccination strategies could be prioritised, regardless of season. As multiple industry stakeholders benefit from these strategies, the study will enable policy development and to better formulate a user-pays eradication programme.

摘要

背景

马流感（EI）是一种传染性呼吸道疾病，在新西兰（NZ）从未有过报告。然而，2007 年澳大利亚爆发的 EI，此前无 EI，促使 NZ 政府和利益相关者评估替代的 EI 控制策略，以便从经济上证明任何未来消灭或管理 EI 的决定是合理的。为了进一步推动政策辩论，本文提出了一种 epi （流行病学和经济学）建模方法来评估替代的控制策略。一个流行病学模型来确定替代的 EI 控制策略如何影响 EI 的分布。然后，将模型结果输入成本效益分析框架，以确定替代的 EI 根除策略在 NZ 的回报和可行性。

方法

本文探讨了 9 种替代根除方案和 2 种基线策略。替代方案包括三种疫苗接种策略（抑制性、保护性或靶向性），从三个时间点开始，以反映商业繁殖周期。这些替代方案与两种繁殖周期调整的基线进行了比较：繁殖季节（8 月至 1 月）或非繁殖季节（2 月至 7 月）的运动限制。经济损失参数包括入侵反应、对商业赛马业（繁殖、销售和赛马）的影响、马的发病率和死亡率以及对行业参与者的补偿。

结果与结论

结果表明，EI 根除计划的经济可行性取决于 EI 爆发发生在繁殖周期的何时。如果爆发，保护性或抑制性疫苗接种策略的每一美元投资回报率将分别为新西兰元 3.67 至 4.89 元和繁殖和非繁殖季节的新西兰元 3.08 至 3.50。因此，无论季节如何，都可以优先考虑保护性或抑制性疫苗接种策略。由于多个行业利益相关者受益于这些策略，该研究将有助于政策制定和更好地制定用户付费根除计划。