Evaluation of Cost-Effective Strategies for Rabies Post-Exposure Vaccination in Low-Income Countries 英文参考文献.docVIP

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Evaluation of Cost-Effective Strategies for Rabies Post-Exposure Vaccination in Low-Income Countries 英文参考文献.doc

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Evaluation of Cost-Effective Strategies for Rabies Post-Exposure Vaccination in Low-Income Countries 英文参考文献

EvaluationofCost-EffectiveStrategiesforRabiesPost- ExposureVaccinationinLow-IncomeCountries KatieHampson1*,SarahCleaveland1,DeborahBriggs2 1Boyd Orr Centre for Population and Ecosystem Health, Institute for Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom,2GlobalAllianceforRabiesControl,Manhattan,Kansas,UnitedStatesofAmerica Abstract Background: Prompt post-exposure prophylaxis (PEP) is essential in preventing the fatal onset of disease in persons exposed to rabies. Unfortunately, life-saving rabies vaccines and biologicals are often neither accessible nor affordable, particularly to the poorest sectors of society who are most at risk and upon whom the largest burden of rabies falls. Increasingaccessibility,reducingcostsandpreventingdelaysindeliveryofPEPshouldthereforebeprioritized. Methodology/PrincipalFindings:WeanalyzeddifferentPEPvaccinationregimensandevaluatedtheirrelativecostsand benefitstobitevictimsandhealthcareproviders.WefoundPEPvaccinationtobeanextremelycost-effectiveintervention (from$200tolessthan$60/deathaverted).Switchingfromintramuscular(IM)administrationofPEPtoequallyefficacious intradermal(ID)regimenswasshowntoresultinsignificantsavingsinthevolumeofvaccinerequiredtotreatthesame numberofpatients,whichcouldmitigatevaccineshortages,andwoulddramaticallyreducethecostsofimplementingPEP. WepresentfinancingmechanismsthatwouldmakePEPmoreaffordableandaccessible,couldhelpsubsidizethecostfor thosemostinneed,andcouldevensupportnewandexistingrabiescontrolandpreventionprograms. Conclusions/Significance: We conclude that a universal switch to ID delivery would improve the affordability and accessibilityofPEPforbitevictims,leadingtoalikelyreductioninhumanrabiesdeaths,aswellasbeingeconomicalfor healthcareproviders. Citation:HampsonK,CleavelandS,BriggsD(2011)EvaluationofCost-EffectiveStrategiesforRabiesPost-ExposureVaccinationinLow-IncomeCountries.PLoS NeglTropDis5(3):e982.doi:10.1371/journal.pntd.0000982 Editor:J