The Effectiveness of Rabies Control Program in West Bandung Regency, West Java, Indonesia

摘要

Rabies is one of the most important zoonotic disease in Indonesia that need to be eliminate. The rabies control/elimination program has been undertaken by local government to achieve 2023 West Java Province rabies free. The aim of this study is to measure the effectiveness of rabies control program in West Bandung Regency. We modified RabiesEcon, the mathematical of dog-dog and dog-human rabies transmission to simulate rabies control program in West Bandung Regency. The human population data, dog population and the rabies control program (dog vaccination, postexposure prophylaxis (PEP) and dog population control program data) are using to this model based on the data from local government. We build 3 optional control program: no vaccination (Scenario 1), annual vaccination of 70% of dogs population (Scenario 2) (Based on WHO recommendation for rabies elimination) and 35% of dogs vaccinated program biannually (Scenario 3). We estimate the number of preventable dog rabies and the cost of DALY averted due to this disease. We estimate the accumulative rabies cases in 5 years' period of the program will be reduce by 97% and 94% when Scenario 1 and 2 was implemented in West Bandung Regency. Human death rabies can be averted approximately 28 cases from this program and the cost per death that can be averted are US$ 7,896-10,007 cumulatively and cost per DALY averted are approximately US$ 246-270. Human rabies could be eliminated on the second year, meanwhile dog rabies on the third year of the program. Annual vaccination program of 70% of dog population is the best option to be implemented to prevent the human cases and the economically lost from this disease. We strongly recommend the implementation of this rabies control program in West Bandung Regency.