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Transbound Emerg Dis. 2017 Jun;64(3):951-958. doi: 10.1111/tbed.12463. Epub 2016 Feb 24.

Towards Canine Rabies Elimination in South-Eastern Tanzania: Assessment of Health Economic Data.

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National Wildlife Research Center, USDA APHIS Wildlife Services, Fort Collins, CO, USA.
Global Alliance for Rabies Control, Manhattan, KS, USA.
Ifakara Health Institute, Dar es Salaam, Tanzania.
World Health Organization, Dar es Salaam, Tanzania.
Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania.
Tanzania Ministry of Livestock Development and Fisheries, Dar es Salaam, Tanzania.
The Wistar Institute, Philadelphia, PA, USA.
Department of Microbiology, Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa.


An estimated 59 000 people die annually from rabies, keeping this zoonosis on the forefront of neglected diseases, especially in the developing world. Most deaths occur after being bitten by a rabid dog. Those exposed to a suspect rabid animal should receive appropriate post-exposure prophylaxis (PEP) or risk death. However, vaccination of dogs to control and eliminate canine rabies at the source has been implemented in many places around the world. Here, we analysed the vaccination and cost data for one such campaign in the area surrounding and including Dar es Salaam, Tanzania and estimated the cost per dog vaccinated. We also estimated the cost of human PEP. We found that the cost per dog vaccinated ranged from $2.50 to $22.49 across districts and phases, with the phase average ranging from $7.30 to $11.27. These figures were influenced by over purchase of vaccine in the early phases of the programme and the significant costs associated with purchasing equipment for a programme starting from scratch. The cost per human PEP course administered was approximately $24.41, with the average patient receiving 2.5 of the recommended four vaccine doses per suspect bite. This study provides valuable financial insights into programme managers and policymakers working towards rabies elimination.


dog vaccination; health economics; neglected diseases; post-exposure prophylaxis; rabies; zoonosis

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