title: Towards Canine Rabies Elimination in South-Eastern Tanzania: Assessment of Health Economic Data.
abstract: An estimated 59 000 people die annually from rabies, keeping this zoonosis on the forefront of neglected diseases, especially in the developing world. Most deaths occur after being bitten by a rabid dog. Those exposed to a suspect rabid animal should receive appropriate post-exposure prophylaxis (PEP) or risk death. However, vaccination of dogs to control and eliminate canine rabies at the source has been implemented in many places around the world. Here, we analysed the vaccination and cost data for one such campaign in the area surrounding and including Dar es Salaam, Tanzania and estimated the cost per dog vaccinated. We also estimated the cost of human PEP. We found that the cost per dog vaccinated ranged from $2.50 to $22.49 across districts and phases, with the phase average ranging from $7.30 to $11.27. These figures were influenced by over purchase of vaccine in the early phases of the programme and the significant costs associated with purchasing equipment for a programme starting from scratch. The cost per human PEP course administered was approximately $24.41, with the average patient receiving 2.5 of the recommended four vaccine doses per suspect bite. This study provides valuable financial insights into programme managers and policymakers working towards rabies elimination.
authors.affiliation: National Wildlife Research Center, USDA APHIS Wildlife Services, Fort Collins, CO, USA.|Global Alliance for Rabies Control, Manhattan, KS, USA.
authors.forename: B
authors.initials: B
authors.lastname: Hatch
authors.affiliation: National Wildlife Research Center, USDA APHIS Wildlife Services, Fort Collins, CO, USA.
authors.forename: A
authors.initials: A
authors.lastname: Anderson
authors.affiliation: Ifakara Health Institute, Dar es Salaam, Tanzania.
authors.forename: M
authors.initials: M
authors.lastname: Sambo
authors.affiliation: World Health Organization, Dar es Salaam, Tanzania.
authors.forename: M
authors.initials: M
authors.lastname: Maziku
authors.affiliation: Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania.
authors.forename: G
authors.initials: G
authors.lastname: Mchau
authors.affiliation: Tanzania Ministry of Livestock Development and Fisheries, Dar es Salaam, Tanzania.
authors.forename: E
authors.initials: E
authors.lastname: Mbunda
authors.affiliation: Ifakara Health Institute, Dar es Salaam, Tanzania.
authors.forename: Z
authors.initials: Z
authors.lastname: Mtema
authors.affiliation: Global Alliance for Rabies Control, Manhattan, KS, USA.|The Wistar Institute, Philadelphia, PA, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Rupprecht
authors.affiliation: National Wildlife Research Center, USDA APHIS Wildlife Services, Fort Collins, CO, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Shwiff
authors.affiliation: Global Alliance for Rabies Control, Manhattan, KS, USA.|Department of Microbiology, Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa.
authors.forename: L
authors.initials: L
authors.lastname: Nel
mesh_terms: D000818:Animals; D001733:Bites and Stings / Q000517:prevention & control; D004283:Dog Diseases / Q000453:epidemiology / Q000517:prevention & control*; D004285:Dogs; D017048:Health Care Costs; D006801:Humans; D058069:Neglected Diseases / Q000453:epidemiology / Q000517:prevention & control; D011818:Rabies / Q000453:epidemiology / Q000517:prevention & control / Q000662:veterinary*; D011819:Rabies Vaccines / Q000191:economics; D013636:Tanzania / Q000453:epidemiology; D014611:Vaccination / Q000191:economics; D015047:Zoonoses
chemical_list: D011819:Rabies Vaccines
keywords: dog vaccination; health economics; neglected diseases; post-exposure prophylaxis; rabies; zoonosis