Healthcare demand in response to rabies elimination campaigns in Latin America.
The World Health Organization, the World Organization for Animal Health, and the Food and Agriculture Organization have resolved to eliminate human rabies deaths due to dog bites by 2030, and the Vaccine Alliance (Gavi) has added human rabies vaccines to their investments for 2021-2025. Implementing...
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ftdoajarticles:oai:doaj.org/article:3e2d8023a43e4a4887dfc4e3a07ece28 2023-05-15T15:16:15+02:00 Healthcare demand in response to rabies elimination campaigns in Latin America. Jonathan Yoder Elisabeth Younce Felix Lankester Guy H Palmer 2019-09-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0007630 https://doaj.org/article/3e2d8023a43e4a4887dfc4e3a07ece28 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0007630 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007630 https://doaj.org/article/3e2d8023a43e4a4887dfc4e3a07ece28 PLoS Neglected Tropical Diseases, Vol 13, Iss 9, p e0007630 (2019) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2019 ftdoajarticles https://doi.org/10.1371/journal.pntd.0007630 2022-12-31T07:17:08Z The World Health Organization, the World Organization for Animal Health, and the Food and Agriculture Organization have resolved to eliminate human rabies deaths due to dog bites by 2030, and the Vaccine Alliance (Gavi) has added human rabies vaccines to their investments for 2021-2025. Implementing these goals cost-effectively and sustainably requires understanding the complex connections between dog rabies vaccination and human risk and response. The objective of this paper is to estimate how dog rabies vaccinations affect human rabies deaths, mediated through dog rabies cases, dog bite reporting, and post-exposure human rabies vaccination. To approach this objective, we apply multivariate regression analysis over five rabies-related outcomes: (a) dog vaccinations, (b) dog rabies cases, (c) reported human exposures, (d) human post-exposure prophylaxis (PEP) use, and (e) human rabies cases. Analysis uses aggregate annual data over 1995-2005 for seven Latin American countries that experienced dramatic declines in canine and human rabies. Among other results, we estimate the following. (i) A 10% increase in dog vaccinations decreases dog rabies cases by 2.3%. (ii) Reported exposures decline as concurrent dog rabies cases decline, but these declines are more than offset by increases in reported exposures per dog rabies case, which may result from higher rabies awareness due to anti-rabies campaigns. (iii) A 10% increase in PEP use decreases human deaths by 7%, but a 10% increase in dog vaccination induces a 2.8% decrease in PEP use. The net effect is that a 10% increase in dog vaccination reduces human deaths by 12.4% overall, although marginal effectiveness declines as dog rabies incidence declines. (iv) Increases in income and public health expenditures increase PEP demand. The findings highlight the importance of mass dog vaccination, heightened awareness, treatment access, and clinical algorithms to reduce both false negatives leading to death and false positives leading to costly unnecessary PEP prescriptions. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 13 9 e0007630 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Jonathan Yoder Elisabeth Younce Felix Lankester Guy H Palmer Healthcare demand in response to rabies elimination campaigns in Latin America. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
The World Health Organization, the World Organization for Animal Health, and the Food and Agriculture Organization have resolved to eliminate human rabies deaths due to dog bites by 2030, and the Vaccine Alliance (Gavi) has added human rabies vaccines to their investments for 2021-2025. Implementing these goals cost-effectively and sustainably requires understanding the complex connections between dog rabies vaccination and human risk and response. The objective of this paper is to estimate how dog rabies vaccinations affect human rabies deaths, mediated through dog rabies cases, dog bite reporting, and post-exposure human rabies vaccination. To approach this objective, we apply multivariate regression analysis over five rabies-related outcomes: (a) dog vaccinations, (b) dog rabies cases, (c) reported human exposures, (d) human post-exposure prophylaxis (PEP) use, and (e) human rabies cases. Analysis uses aggregate annual data over 1995-2005 for seven Latin American countries that experienced dramatic declines in canine and human rabies. Among other results, we estimate the following. (i) A 10% increase in dog vaccinations decreases dog rabies cases by 2.3%. (ii) Reported exposures decline as concurrent dog rabies cases decline, but these declines are more than offset by increases in reported exposures per dog rabies case, which may result from higher rabies awareness due to anti-rabies campaigns. (iii) A 10% increase in PEP use decreases human deaths by 7%, but a 10% increase in dog vaccination induces a 2.8% decrease in PEP use. The net effect is that a 10% increase in dog vaccination reduces human deaths by 12.4% overall, although marginal effectiveness declines as dog rabies incidence declines. (iv) Increases in income and public health expenditures increase PEP demand. The findings highlight the importance of mass dog vaccination, heightened awareness, treatment access, and clinical algorithms to reduce both false negatives leading to death and false positives leading to costly unnecessary PEP prescriptions. |
format |
Article in Journal/Newspaper |
author |
Jonathan Yoder Elisabeth Younce Felix Lankester Guy H Palmer |
author_facet |
Jonathan Yoder Elisabeth Younce Felix Lankester Guy H Palmer |
author_sort |
Jonathan Yoder |
title |
Healthcare demand in response to rabies elimination campaigns in Latin America. |
title_short |
Healthcare demand in response to rabies elimination campaigns in Latin America. |
title_full |
Healthcare demand in response to rabies elimination campaigns in Latin America. |
title_fullStr |
Healthcare demand in response to rabies elimination campaigns in Latin America. |
title_full_unstemmed |
Healthcare demand in response to rabies elimination campaigns in Latin America. |
title_sort |
healthcare demand in response to rabies elimination campaigns in latin america. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2019 |
url |
https://doi.org/10.1371/journal.pntd.0007630 https://doaj.org/article/3e2d8023a43e4a4887dfc4e3a07ece28 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 13, Iss 9, p e0007630 (2019) |
op_relation |
https://doi.org/10.1371/journal.pntd.0007630 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007630 https://doaj.org/article/3e2d8023a43e4a4887dfc4e3a07ece28 |
op_doi |
https://doi.org/10.1371/journal.pntd.0007630 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
13 |
container_issue |
9 |
container_start_page |
e0007630 |
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1766346544258220032 |