Evaluation of cost-effective strategies for rabies post-exposure vaccination in low-income countries

Hampson, K. , Cleaveland, S. and Briggs, D. (2011) Evaluation of cost-effective strategies for rabies post-exposure vaccination in low-income countries. PLoS Neglected Tropical Diseases, 5(3), e982. (doi:10.1371/journal.pntd.0000982)

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Publisher's URL: http://dx.doi.org/10.1371/journal.pntd.0000982

Abstract

<b>Background:</b> Prompt post-exposure prophylaxis (PEP) is essential in preventing the fatal onset of disease in persons exposed to rabies. Unfortunately, life-saving rabies vaccines and biologicals are often neither accessible nor affordable, particularly to the poorest sectors of society who are most at risk and upon whom the largest burden of rabies falls. Increasing accessibility, reducing costs and preventing delays in delivery of PEP should therefore be prioritized.<p></p> <b>Methodology/Principal Findings:</b> We analyzed different PEP vaccination regimens and evaluated their relative costs and benefits to bite victims and healthcare providers. We found PEP vaccination to be an extremely cost-effective intervention (from $200 to less than $60/death averted). Switching from intramuscular (IM) administration of PEP to equally efficacious intradermal (ID) regimens was shown to result in significant savings in the volume of vaccine required to treat the same number of patients, which could mitigate vaccine shortages, and would dramatically reduce the costs of implementing PEP. We present financing mechanisms that would make PEP more affordable and accessible, could help subsidize the cost for those most in need, and could even support new and existing rabies control and prevention programs.<p></p> <b>Conclusions/Significance:</b> We conclude that a universal switch to ID delivery would improve the affordability and accessibility of PEP for bite victims, leading to a likely reduction in human rabies deaths, as well as being economical for healthcare providers.<p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleaveland, Professor Sarah and Hampson, Dr Katie
Authors: Hampson, K., Cleaveland, S., and Briggs, D.
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:Copyright © 2011 The Authors
First Published:First published in PLoS Neglected Tropical Diseases 5(3):e982
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
508041Understanding how a complex intervention works: designing large-scale vaccination programsDaniel HaydonMedical Research Council (MRC)G0901135/91914RI BIODIVERSITY ANIMAL HEALTH & COMPMED