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Strategies to inTerrupt RAbies Transmission for the Elimination Goal by 2030 In China (STRATEGIC): a modelling study
Qiulan Chen1, Qiuping Liu2, Chao Gong2
1Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
BMC Medicine
|March 17, 2023
Summary
Mass dog vaccination combined with integrated bite case management (IBCM) can eliminate human rabies deaths in China by 2033. This strategy is more cost-effective than current approaches, averting thousands of deaths.
Area of Science:
- Epidemiology
- Public Health
- Veterinary Medicine
Background:
- Global goal to eliminate dog-mediated human rabies by 2030 (Zero-by-30).
- Effectiveness and cost-effectiveness of rabies control strategies (post-exposure prophylaxis (PEP), dog vaccination, integrated bite case management (IBCM)) lack evidence in China.
- Need to evaluate future rabies burdens and control strategy costs in China.
Purpose of the Study:
- Estimate future dog-mediated human rabies deaths in China over the next decade.
- Provide quantitative evidence on the cost-effectiveness of different rabies control strategies in China.
Main Methods:
- Utilized decision-analytic modeling based on China's national human rabies surveillance data.
- Estimated rabies death trends until 2035.
- Simulated and compared the consequences and costs of various strategies: status quo, improved PEP access, mass dog vaccination, and IBCM.
Main Results:
- Status quo predicts stable rabies deaths (308 in 2030).
- Improved PEP access alone shows limited impact.
- 70% dog vaccination coverage could eliminate deaths by 2033, preventing ~3,265 extra deaths (2024-2035).
- Mass dog vaccination with IBCM reduces total costs significantly (from $12.53 to $8.73 billion USD) and avoids unnecessary PEP use.
Conclusions:
- Combined mass dog vaccination and IBCM strategy can eliminate Chinese rabies deaths by 2033.
- This integrated "One Health" approach is the most cost-effective, averting more deaths and reducing overall costs.
- Collaboration between health and veterinary sectors is crucial for successful implementation.
