Cost-Effectiveness Evaluation of a Novel Integrated Bite Case Management Program for the Control of Human Rabies, Haiti 2014-2015.
Am J Trop Med Hyg
; 96(6): 1307-1317, 2017 Jun.
Article
em En
| MEDLINE
| ID: mdl-28719253
ABSTRACT
AbstractHaiti has the highest burden of rabies in the Western hemisphere, with 130 estimated annual deaths. We present the cost-effectiveness evaluation of an integrated bite case management program combining community bite investigations and passive animal rabies surveillance, using a governmental perspective. The Haiti Animal Rabies Surveillance Program (HARSP) was first implemented in three communes of the West Department, Haiti. Our evaluation encompassed all individuals exposed to rabies in the study area (N = 2,289) in 2014-2015. Costs (2014 U.S. dollars) included diagnostic laboratory development, training of surveillance officers, operational costs, and postexposure prophylaxis (PEP). We used estimated deaths averted and years of life gained (YLG) from prevented rabies as health outcomes. HARSP had higher overall costs (range $39,568-$80,290) than the no-bite-case-management (NBCM) scenario ($15,988-$26,976), partly from an increased number of bite victims receiving PEP. But HARSP had better health outcomes than NBCM, with estimated 11 additional annual averted deaths in 2014 and nine in 2015, and 654 additional YLG in 2014 and 535 in 2015. Overall, HARSP was more cost-effective (US$ per death averted) than NBCM (2014, HARSP $2,891-$4,735, NBCM $5,980-$8,453; 2015, HARSP $3,534-$7,171, NBCM $7,298-$12,284). HARSP offers an effective human rabies prevention solution for countries transitioning from reactive to preventive strategies, such as comprehensive dog vaccination.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Raiva
/
Mordeduras e Picadas
/
Administração de Caso
Tipo de estudo:
Evaluation_studies
/
Health_economic_evaluation
Limite:
Animals
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Humans
País como assunto:
Caribe
/
Haiti
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article