Impact of One-Health framework on vaccination cost-effectiveness: a case study of rabies in Ethiopia

Tariku Jibat Beyene, Meagan C. Fitzpatrick, Alison P. Galvani, Monique C.M. Mourits, Crawford W. Revie, Natalia Cernicchiaro, Michael W. Sanderson, Henk Hogeveen

Research output: Contribution to journalArticle

Abstract

Livestock losses due to rabies and health and the corresponding benefits of controlling the disease are not often considered when the cost-effectiveness of rabies control is evaluated. In this research, assessed the benefits of applying a One Health perspective that includes these losses to the case of canine rabies vaccination in Ethiopia. We constructed a dynamic epidemiological model of rabies transmission. The model was fit to district-specific data on human rabies exposures and canine demography for two districts with distinct agro-ecologies. The epidemiological model was coupled with human and livestock economic outcomes to predict the health and economic impacts under a range of vaccination scenarios. The model indicates that human exposures, human deaths, and rabies-related livestock losses would decrease monotonically with increasing vaccination coverage. In the rural district, all vaccination scenarios were found to be cost-saving compared to the status quo of no vaccination, as more money could be saved by preventing livestock losses than would be required to fund the vaccination campaigns. Vaccination coverages of 70% and 80% were identified as most likely to provide the greatest net health benefits at the WHO cost-effectiveness threshold over a period of 5 years, in urban and rural districts respectively. Shorter time frames led to recommendations for higher coverage in both districts, as did even a minor threat of rabies re-introduction. Exclusion of rabies-related livestock losses reduced the optimal vaccination coverage for the rural district to 50%. This study demonstrated the importance of including all economic consequences of zoonotic disease into control decisions. Analyses that include cattle and other rabies-susceptible livestock are likely better suited to many rural communities in Africa wishing to maximize the benefits of canine vaccination.
LanguageEnglish
Article number100103
Number of pages12
JournalOne Health
Volume8
Early online date21 Aug 2019
DOIs
Publication statusE-pub ahead of print - 21 Aug 2019

Fingerprint

Ethiopia
Rabies
Cost-Benefit Analysis
Vaccination
Livestock
Canidae
Economics
Insurance Benefits
Global Health
Immunization Programs
Zoonoses
Rural Population
Financial Management
Ecology
Demography
Costs and Cost Analysis
Health

Keywords

  • cost-effectiveness
  • Ethiopia
  • modeling
  • one-health
  • rabies

Cite this

Beyene, T. J., Fitzpatrick, M. C., Galvani, A. P., Mourits, M. C. M., Revie, C. W., Cernicchiaro, N., ... Hogeveen, H. (2019). Impact of One-Health framework on vaccination cost-effectiveness: a case study of rabies in Ethiopia. 8, [100103]. https://doi.org/10.1016/j.onehlt.2019.100103
Beyene, Tariku Jibat ; Fitzpatrick, Meagan C. ; Galvani, Alison P. ; Mourits, Monique C.M. ; Revie, Crawford W. ; Cernicchiaro, Natalia ; Sanderson, Michael W. ; Hogeveen, Henk. / Impact of One-Health framework on vaccination cost-effectiveness : a case study of rabies in Ethiopia. 2019 ; Vol. 8.
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Beyene, TJ, Fitzpatrick, MC, Galvani, AP, Mourits, MCM, Revie, CW, Cernicchiaro, N, Sanderson, MW & Hogeveen, H 2019, 'Impact of One-Health framework on vaccination cost-effectiveness: a case study of rabies in Ethiopia' vol. 8, 100103. https://doi.org/10.1016/j.onehlt.2019.100103

Impact of One-Health framework on vaccination cost-effectiveness : a case study of rabies in Ethiopia. / Beyene, Tariku Jibat; Fitzpatrick, Meagan C.; Galvani, Alison P.; Mourits, Monique C.M.; Revie, Crawford W.; Cernicchiaro, Natalia; Sanderson, Michael W.; Hogeveen, Henk.

Vol. 8, 100103, 31.12.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of One-Health framework on vaccination cost-effectiveness

T2 - a case study of rabies in Ethiopia

AU - Beyene, Tariku Jibat

AU - Fitzpatrick, Meagan C.

AU - Galvani, Alison P.

AU - Mourits, Monique C.M.

AU - Revie, Crawford W.

AU - Cernicchiaro, Natalia

AU - Sanderson, Michael W.

AU - Hogeveen, Henk

PY - 2019/8/21

Y1 - 2019/8/21

N2 - Livestock losses due to rabies and health and the corresponding benefits of controlling the disease are not often considered when the cost-effectiveness of rabies control is evaluated. In this research, assessed the benefits of applying a One Health perspective that includes these losses to the case of canine rabies vaccination in Ethiopia. We constructed a dynamic epidemiological model of rabies transmission. The model was fit to district-specific data on human rabies exposures and canine demography for two districts with distinct agro-ecologies. The epidemiological model was coupled with human and livestock economic outcomes to predict the health and economic impacts under a range of vaccination scenarios. The model indicates that human exposures, human deaths, and rabies-related livestock losses would decrease monotonically with increasing vaccination coverage. In the rural district, all vaccination scenarios were found to be cost-saving compared to the status quo of no vaccination, as more money could be saved by preventing livestock losses than would be required to fund the vaccination campaigns. Vaccination coverages of 70% and 80% were identified as most likely to provide the greatest net health benefits at the WHO cost-effectiveness threshold over a period of 5 years, in urban and rural districts respectively. Shorter time frames led to recommendations for higher coverage in both districts, as did even a minor threat of rabies re-introduction. Exclusion of rabies-related livestock losses reduced the optimal vaccination coverage for the rural district to 50%. This study demonstrated the importance of including all economic consequences of zoonotic disease into control decisions. Analyses that include cattle and other rabies-susceptible livestock are likely better suited to many rural communities in Africa wishing to maximize the benefits of canine vaccination.

AB - Livestock losses due to rabies and health and the corresponding benefits of controlling the disease are not often considered when the cost-effectiveness of rabies control is evaluated. In this research, assessed the benefits of applying a One Health perspective that includes these losses to the case of canine rabies vaccination in Ethiopia. We constructed a dynamic epidemiological model of rabies transmission. The model was fit to district-specific data on human rabies exposures and canine demography for two districts with distinct agro-ecologies. The epidemiological model was coupled with human and livestock economic outcomes to predict the health and economic impacts under a range of vaccination scenarios. The model indicates that human exposures, human deaths, and rabies-related livestock losses would decrease monotonically with increasing vaccination coverage. In the rural district, all vaccination scenarios were found to be cost-saving compared to the status quo of no vaccination, as more money could be saved by preventing livestock losses than would be required to fund the vaccination campaigns. Vaccination coverages of 70% and 80% were identified as most likely to provide the greatest net health benefits at the WHO cost-effectiveness threshold over a period of 5 years, in urban and rural districts respectively. Shorter time frames led to recommendations for higher coverage in both districts, as did even a minor threat of rabies re-introduction. Exclusion of rabies-related livestock losses reduced the optimal vaccination coverage for the rural district to 50%. This study demonstrated the importance of including all economic consequences of zoonotic disease into control decisions. Analyses that include cattle and other rabies-susceptible livestock are likely better suited to many rural communities in Africa wishing to maximize the benefits of canine vaccination.

KW - cost-effectiveness

KW - Ethiopia

KW - modeling

KW - one-health

KW - rabies

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DO - 10.1016/j.onehlt.2019.100103

M3 - Article

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