Open AccessEstimating the Global Burden of Endemic Canine Rabies
Author(s) -
Katie Hampson,
Laurent Coudeville,
Tiziana Lembo,
Maganga Sambo,
Alexia Kieffer,
Michaël Attlan,
J Barrat,
Jesse D. Blanton,
Deborah J. Briggs,
Sarah Cleaveland,
Peter Costa,
Conrad M. Freuling,
Elly Hiby,
Lea Knopf,
Fernando Leanes,
F. X. Meslin,
Artem Metlin,
Mary Elizabeth Miranda,
Thomas Müller,
Louis Hendrik Nel,
Sergio Recuenco,
Charles E. Rupprecht,
Carolin L. Schumacher,
Louise H. Taylor,
Marco Antonio Natal Vigilato,
Jakob Zinsstag,
Jonathan Dushoff
Publication year - 2015
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0003709
Subject(s) - rabies , environmental health , disease burden , public health , vaccination , medicine , livestock , one health , psychological intervention , socioeconomics , veterinary medicine , geography , population , economics , virology , nursing , psychiatry , forestry
Background Rabies is a notoriously underreported and neglected disease of low-income 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. 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%). 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.