title: Cost-Effectiveness of Mass Dog Vaccination Campaigns against Rabies in Flores Island, Indonesia.
abstract: 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.
authors.affiliation: Animal Health Study Program, Kupang State Agricultural Polytechnic (Politeknik Pertanian Negeri Kupang), Penfui Kupang, West Timor, Indonesia.|Business Economics Group, Wageningen University, Wageningen, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Wera
authors.affiliation: Business Economics Group, Wageningen University, Wageningen, The Netherlands.
authors.forename: M C M
authors.initials: MCM
authors.lastname: Mourits
authors.affiliation: Husbandry and Animal Health Department of Sikka Regency (Dinas Peternakan dan Kesehatan Hewan Kabupaten Sikka), Maumere, Flores, Indonesia.
authors.forename: M M
authors.initials: MM
authors.lastname: Siko
authors.affiliation: Business Economics Group, Wageningen University, Wageningen, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Hogeveen
mesh_terms: D000818:Animals; D003362:Cost-Benefit Analysis; D004283:Dog Diseases / Q000517:prevention & control*; D004285:Dogs; D007214:Indonesia; D032541:Mass Vaccination / Q000191:economics / Q000379:methods / Q000662:veterinary*; D011818:Rabies / Q000517:prevention & control / Q000662:veterinary*; D011819:Rabies Vaccines / Q000145:classification / Q000191:economics*
chemical_list: D011819:Rabies Vaccines
keywords: Flores Island; cost-effectiveness analysis; dog; rabies; simulation model; vaccination strategies