Estimating the global burden of endemic canine rabies.

<h4>Background</h4>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 a...

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Main Authors: Katie Hampson, Laurent Coudeville, Tiziana Lembo, Maganga Sambo, Alexia Kieffer, Michaël Attlan, Jacques Barrat, Jesse D Blanton, Deborah J Briggs, Sarah Cleaveland, Peter Costa, Conrad M Freuling, Elly Hiby, Lea Knopf, Fernando Leanes, François-Xavier Meslin, Artem Metlin, Mary Elizabeth Miranda, Thomas Müller, Louis H Nel, Sergio Recuenco, Charles E Rupprecht, Carolin Schumacher, Louise Taylor, Marco Antonio Natal Vigilato, Jakob Zinsstag, Jonathan Dushoff, Global Alliance for Rabies Control Partners for Rabies Prevention
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-04-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://doi.org/10.1371/journal.pntd.0003709
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author Katie Hampson
Laurent Coudeville
Tiziana Lembo
Maganga Sambo
Alexia Kieffer
Michaël Attlan
Jacques Barrat
Jesse D Blanton
Deborah J Briggs
Sarah Cleaveland
Peter Costa
Conrad M Freuling
Elly Hiby
Lea Knopf
Fernando Leanes
François-Xavier Meslin
Artem Metlin
Mary Elizabeth Miranda
Thomas Müller
Louis H Nel
Sergio Recuenco
Charles E Rupprecht
Carolin Schumacher
Louise Taylor
Marco Antonio Natal Vigilato
Jakob Zinsstag
Jonathan Dushoff
Global Alliance for Rabies Control Partners for Rabies Prevention
author_facet Katie Hampson
Laurent Coudeville
Tiziana Lembo
Maganga Sambo
Alexia Kieffer
Michaël Attlan
Jacques Barrat
Jesse D Blanton
Deborah J Briggs
Sarah Cleaveland
Peter Costa
Conrad M Freuling
Elly Hiby
Lea Knopf
Fernando Leanes
François-Xavier Meslin
Artem Metlin
Mary Elizabeth Miranda
Thomas Müller
Louis H Nel
Sergio Recuenco
Charles E Rupprecht
Carolin Schumacher
Louise Taylor
Marco Antonio Natal Vigilato
Jakob Zinsstag
Jonathan Dushoff
Global Alliance for Rabies Control Partners for Rabies Prevention
author_sort Katie Hampson
collection DOAJ
description <h4>Background</h4>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.<h4>Methodology/principal findings</h4>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%).<h4>Conclusions/significance</h4>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.
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spelling doaj-art-55d13cbc1d8a46e9956fc5963a1e9e7f2025-08-20T03:46:23ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352015-04-0194e000370910.1371/journal.pntd.0003709Estimating the global burden of endemic canine rabies.Katie HampsonLaurent CoudevilleTiziana LemboMaganga SamboAlexia KiefferMichaël AttlanJacques BarratJesse D BlantonDeborah J BriggsSarah CleavelandPeter CostaConrad M FreulingElly HibyLea KnopfFernando LeanesFrançois-Xavier MeslinArtem MetlinMary Elizabeth MirandaThomas MüllerLouis H NelSergio RecuencoCharles E RupprechtCarolin SchumacherLouise TaylorMarco Antonio Natal VigilatoJakob ZinsstagJonathan DushoffGlobal Alliance for Rabies Control Partners for Rabies Prevention<h4>Background</h4>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.<h4>Methodology/principal findings</h4>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%).<h4>Conclusions/significance</h4>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.https://doi.org/10.1371/journal.pntd.0003709
spellingShingle Katie Hampson
Laurent Coudeville
Tiziana Lembo
Maganga Sambo
Alexia Kieffer
Michaël Attlan
Jacques Barrat
Jesse D Blanton
Deborah J Briggs
Sarah Cleaveland
Peter Costa
Conrad M Freuling
Elly Hiby
Lea Knopf
Fernando Leanes
François-Xavier Meslin
Artem Metlin
Mary Elizabeth Miranda
Thomas Müller
Louis H Nel
Sergio Recuenco
Charles E Rupprecht
Carolin Schumacher
Louise Taylor
Marco Antonio Natal Vigilato
Jakob Zinsstag
Jonathan Dushoff
Global Alliance for Rabies Control Partners for Rabies Prevention
Estimating the global burden of endemic canine rabies.
PLoS Neglected Tropical Diseases
title Estimating the global burden of endemic canine rabies.
title_full Estimating the global burden of endemic canine rabies.
title_fullStr Estimating the global burden of endemic canine rabies.
title_full_unstemmed Estimating the global burden of endemic canine rabies.
title_short Estimating the global burden of endemic canine rabies.
title_sort estimating the global burden of endemic canine rabies
url https://doi.org/10.1371/journal.pntd.0003709
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