{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:48:16Z","timestamp":1790725696898,"version":"4.1.0"},"reference-count":46,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","license":[{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>The successful prevention, control, and elimination of dog-mediated rabies is challenging due to insufficient resource availability and inadequate placement. An integrated dog bite case management (IBCM) system plus dog vaccination can help address these challenges. Based on data from the IBCM system in Haiti, we conducted a cost-effectiveness evaluation of a newly established IBCM system plus sustained vaccination and compared it with 1) a no bite-case management (NBCM) and 2) a non\u2013risk-based (NRB) program, where bite victims presenting at a health clinic would receive post-exposure prophylaxis regardless of risk assessment. We also provide cost-effectiveness guidance for an ongoing IBCM system and for sub-optimal dog vaccination coverages, considering that not all cost-effective interventions are affordable. Cost-effectiveness outcomes included average cost per human death averted (USD\/death averted) and per life-year gained (LYG). The analysis used a governmental perspective. Considering a sustained 5-year implementation with 70% dog vaccination coverage, IBCM had a lower average cost per death averted (IBCM: $7,528, NBCM: $7,797, NRB: $15,244) and cost per LYG (IBCM: $152, NBCM: $158, NRB: $308) than NBCM and NRB programs. As sensitivity analysis, we estimated cost-effectiveness for alternative scenarios with lower dog-vaccination coverages (30%, 55%) and lower implementation costs. Our results suggest that better health and cost-effectiveness outcomes are achieved with the continued implementation of an IBCM program ($118 per life-year saved) compared with a newly established IBCM program ($152 per life-year saved). Our results suggest that IBCM is more cost-effective than non-integrated programs to eliminate dog-mediated human rabies.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0308","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T13:39:40Z","timestamp":1684157980000},"page":"205-213","source":"Crossref","is-referenced-by-count":9,"title":["Cost-Effectiveness Analysis of Integrated Bite Case Management and Sustained Dog Vaccination for Rabies Control"],"prefix":"10.4269","volume":"109","author":[{"given":"Emma","family":"Taylor","sequence":"first","affiliation":[{"name":"School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquin M.","family":"Prada","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Del Rio Vilas","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo A.","family":"Undurraga","sequence":"additional","affiliation":[{"name":"Escuela de Gobierno, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile;"},{"name":"Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago, Chile;"},{"name":"CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Wallace","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel L.","family":"Horton","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"J Appl Microbiol","first-page":"31S","article-title":"Risk factors associated with travel to rabies endemic countries","volume":"94","author":"Fooks","year":"2003"},{"key":"b2","series-title":"Nat Rev Dis Primers","first-page":"17091","article-title":"Rabies","volume":"3","author":"Fooks","year":"2017"},{"key":"b3","series-title":"Expert Rev Vaccines","first-page":"629","article-title":"Current status of human rabies prevention: remaining barriers to global biologics accessibility and disease elimination","volume":"18","author":"Rupprecht","year":"2019"},{"key":"b4","series-title":"Lancet Infect Dis","first-page":"327","article-title":"Rabies re-examined","volume":"2","author":"Rupprecht","year":"2002"},{"key":"b5","series-title":"Emerg Infect Dis","first-page":"1","article-title":"Role of oral rabies vaccines in the elimination of dog-mediated 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