Premium
Cost‐Effectiveness of Mass Dog Vaccination Campaigns against Rabies in Flores Island, Indonesia
Author(s) -
Wera E.,
Mourits M. C. M.,
Siko M. M.,
Hogeveen H.
Publication year - 2017
Publication title -
transboundary and emerging diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.392
H-Index - 63
eISSN - 1865-1682
pISSN - 1865-1674
DOI - 10.1111/tbed.12590
Subject(s) - rabies , vaccination , herd immunity , population , medicine , rabies vaccine , environmental health , veterinary medicine , demography , virology , rabies virus , sociology
Summary A dynamic deterministic simulation model was developed to determine the cost‐effectiveness of different mass dog vaccination strategies against rabies in a dog population representative of a typical village on Flores Island. Cost‐effectiveness was measured as public cost per averted dog‐rabies case. Simulations started with the introduction of one infectious dog into a susceptible dog population of 399 dogs and subsequently ran for a period of 10 years. The base scenario represented a situation without any control intervention. Evaluated vaccination strategies were as follows: annual vaccination campaigns with short‐acting vaccine (immunity duration of 52 weeks) (AV_52), annual campaigns with long‐acting vaccine (immunity duration of 156 weeks) (AV_156), biannual campaigns with short‐acting vaccine (BV_52) and once‐in‐2‐years campaigns with long‐acting vaccine (O2V_156). The effectiveness of the vaccination strategies was simulated for vaccination coverages of 50% and 70%. Cumulative results were reported for the 10‐year simulation period. The base scenario resulted in three epidemic waves, with a total of 1274 dog‐rabies cases. The public cost of applying AV_52 at a coverage of 50% was US$5342 for a village. This strategy was unfavourable compared to other strategies, as it was costly and ineffective in controlling the epidemic. The costs of AV_52 at a coverage of 70% and AV_156 at a coverage of 70% were, respectively, US$3646 and US$3716, equivalent to US$3.00 and US$3.17 per averted dog‐rabies case. Increasing the coverage of AV_156 from 50% to 70% reduced the number of cases by 7% and reduced the cost by US$1452, resulting in a cost‐effectiveness ratio of US$1.81 per averted dog‐rabies case. This simulation model provides an effective tool to explore the public cost‐effectiveness of mass dog vaccination strategies in Flores Island. Insights obtained from the simulation results are useful for animal health authorities to support decision‐making in rabies‐endemic areas, such as Flores Island.