| BackgrounRabies is one of the most feared infectious diseases and is invariably fatal.Although many studies have reported on the cost-effectiveness of post-exposure prophylaxis(PEP)or pre-exposure prophylaxis(PREP)of human and/or dogs,the results from these studies were conflicting and inconclusive.The aim of this study is to evaluate the cost effectiveness of various immunization strategies of human and/or dog based on systematic review and meta-analysis.MethodsEconomic analyses of rabies vaccination were identified through searches of CNKI,Wanfang,VIP,Pub Med,Web of Science,Health STAR,LILACS and National Health Service Economic Evaluation databases from their establishment until December 2017.The result of the economic evaluation of the included studies was evaluated by total incremental net benefit(TINB)with 95% confidence intervals.The quality of the included studies was evaluated in accordance with the Consolidated Health Economic Evaluation Reporting Standards(CHEERS)statement.All costing data from the included studies were converted into US dollars via purchasing power parities(PPP)in the year 2016 using CCEMG–EPPI-Center Cost Converter.ResultsA total of 16 published studies were selected for inclusion with 2 Chinese ones and 14 English ones.Eleven articles adopted societal perspective.One article were classified as excellent quality,ten as good quality and five as moderate quality.The implementation of rabies vaccination was a cost-effective health intervention(TINB= 404,95% CI 220-587)compared with no vaccination.The study showed that rabies vaccination is cost-effective.PEP is and will remain the main prevention strategy to avert rabies deaths.A combination of PEP and canine vaccination at a coverage of 70% results in a slightly higher cost effectiveness ratio but this strategy would be able to prevent all human deaths due to rabies.Conclusion Human health benefits are higher from combined dog vaccination and PEP for a long term. |
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