针对提供狂犬病暴露后疫苗的政策的比较有效性和成本效益
Joel Changalucha1, Elaine Ferguson2, Martha M Luka2
1Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Tanzania; Department of Environmental Health and Ecological Science, Ifakara Health Institute, Ifakara, Tanzania.
Vaccine
|January 21, 2026
概括
坦桑尼亚面临着高狂犬病死亡率,原因是接触后预防 (PEP) 的机会有限. 改善PEP获取和实施综合咬伤病例管理 (IBCM) 可以显著减少这些可预防的死亡.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 卫生政策 卫生政策
背景情况:
- 狂犬病仍然是低收入国家的重大公共卫生威胁.
- 对暴露后预防 (PEP) 的有限准入有助于预防狂犬病死亡.
- 关于有效的PEP提供策略的证据对于政策制定至关重要.
研究的目的:
- 评估坦桑尼亚的三个暴露后预防 (PEP) 策略.
- 为了比较当前的有限访问,免费提供和综合咬伤病例管理 (IBCM) 策略.
- 评估拟议的PEP政策的健康结果和经济影响.
主要方法:
- 利用了在坦桑尼亚四个地区实施综合咬伤病例管理 (IBCM) 的数据.
- 使用决策树模型来评估健康结果和经济影响.
- 2026-2030年在坦桑尼亚的疫苗需求,成本和死亡预测.
主要成果:
- 在五年内,全国范围内预计约有59,000例狂犬病暴露.
- 目前的PEP接入导致每年约800人死亡;改进的接入将死亡减少>40%.
- 综合咬伤病例管理 (IBCM) 减少了预计的死亡人数,并且具有成本效益 (每次避免死亡181美元).
结论:
- 坦桑尼亚目前的PEP规定不足,导致可预防的狂犬病死亡.
- 免费提供PEP比目前的系统更有效.
- 实施IBCM将加强狂犬病控制,并有助于在2030年前结束人类狂犬病死亡.
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