Investigation And Analysis Of The Burden Of Rabies In Jiangsu Province

Objectives: Rabies is an acute infectious disease caused by Rabies Virus(RV).Rabies virus invades human body mainly through damaged skin or mucosa.Its clinical manifestations are typically feared of water,wind,progressive paralysis,pharyngeal muscle spasm,etc.Rabies is one of the diseases with the highest mortality rate.As long as symptoms occur,almost 100% of all deaths occur.Post-exposure prophylactic(PEP)is the only effective way to prevent rabies after a dog bite.The production of vaccines exist to prevent human rabies and canine rabies,however 59,000 people still die of rabies every year in the world,resulting in an economic burden of about US$6.8 billion,which brings serious disease burden to patients,families and society.Through the literature research,questionnaire collection,monitoring data collection,statistic software analysis to comprehensive analysis and evaluation for rabies burden,to help the public health administrative department to understand the allocation of resources for local rabies exposure population health service.Materials and Methods: Analyze the clinical and epidemiological characteristics of all cases of Rabies which reported in Jiangsu province from 2008 to 2018.Investigate and calculate the direct economic burden of Rabies cases and use the multiple linear regression method to analyze influence factors of dog hurt exposure issued direct medical cost.Through DALYs and human capital method to estimate the dog hurt exposed economic burden.The Self-rating Depression Scale(SDS)and the Self-rating Anxiety Scale(SAS)were used to understand the psychological effects of rabies exposure on the population.Results: From 2008 to 2018,the number of Rabies cases in Jiangsu Province was 565,the median age of Rabies cases was 55 years and male accounted for 67.6%.the annual incidence rate fluctuated between 0.03/100,000 and 0.11/100,000.The life loss caused by Rabies is estimated to be 11822.43 years.The average life loss per year is 1182.24 years,and the average life loss per year per 100,000 people is 1.49 years.The total economic loss(including direct and indirect)was RMB 380.36 million,with an average loss of RMB 417.80 per case.The annual indirect economic burden of the entire population of rabies deaths in Jiangsu Province is RMB 52.56 million,of which 45-59 years old group has the highest proportion,accounting for 56% of the total indirect economic burden,followed by 30-44 years old group,accounting for 23 %;the direct medical expenses of rabies exposure patients accounted for the highest proportion of vaccination costs,which was 60.79%,and the cost of wound disposal and immunoglobulin accounted for 6.30% and 17.89%,respectively.Regional,household annual income and the presence or absence of commercial insurance had statistically significant effects on the direct economic burden of exposed patients.Age may be a factor in vaccination;Indirect economic loss caused by lost of working of the total population after exposure was RMB 69.46 million;The SDS score of the exposed population was 44.01±10.16,and the SAS score was 35.62±5.50.The SDS score and SAS score of Yancheng were significantly higher than that of Suzhou(P<0.001),and there were no significant differences in SDS scores and SAS scores before and after exposure.Conclusion: The cases of rabies in Jiangsu Province are mainly male-occupied farmers;the burden of disease caused by rabies is heavier,and the direct medical expenses account for a large proportion of direct economic burden,of which vaccines and immunoglobulin account for the majority.The direct economic burden of exposed patients in northern Jiangsu,families with low annual income and commercial insurance is higher than that in southern Jiangsu,households with higher annual income,and no commercial insurance.There is no obvious depression and anxiety in the exposed population of rabies.