Estimating the global burden of endemic canine rabies

Hampson, K. et al. (2015) Estimating the global burden of endemic canine rabies. PLoS Neglected Tropical Diseases, 9(4), e0003709. (doi:10.1371/journal.pntd.0003709) (PMID:25881058) (PMCID:PMC4400070)

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Abstract

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>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lembo, Dr Tiziana and Taylor, Dr Louise and Hampson, Dr Katie
Authors: Hampson, K., Coudeville, L., Lembo, T., Sambo, M., Kieffer, A., Attlan, M., Barrat, J., Blanton, J. D., Briggs, D. J., Cleaveland, S., Costa, P., Freuling, C. M., Hiby, E., Knopf, L., Leanes, F., Meslin, F.-X., Metlin, A., Miranda, M. E., Müller, T., Nel, L. H., Recuenco, S., Rupprech, C. E., Schumacher, C., Taylor, L., Vigilato, M. A. N., Zinsstag, J., and Dushoff, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
Journal Name:PLoS Neglected Tropical Diseases
Publisher:Public Library of Science
ISSN:1935-2727
ISSN (Online):1935-2735
Copyright Holders:Free of copyright
First Published:First published in PLoS Neglected Tropical Diseases 9(4):e0003709
Publisher Policy:Reproduced under the Creative Commons CC0 public domain dedication

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
569041Hierarchical epidemiology: the spread and persistence of infectious diseases in complex landscapesKatie HampsonWellcome Trust (WELLCOME)095787/Z/11/ZRI BIODIVERSITY ANIMAL HEALTH & COMPMED