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Mshelbwala PP, Rupprecht CE, Osinubi MO, Njoga EO, Orum TG, Weese JS, Clark NJ. Factors influencing canine rabies vaccination among dog-owning households in Nigeria. One Health 2024; 18:100751. [PMID: 38827784 PMCID: PMC11141449 DOI: 10.1016/j.onehlt.2024.100751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/06/2024] [Indexed: 06/05/2024] Open
Abstract
Rabies perpetuates in Nigeria despite initiatives like the Regional Disease Surveillance System Enhancement Project, with evidence indicating suboptimal canine vaccination rates as a contributing factor. To inform effective planning of mass dog vaccination campaigns, it is crucial to understand the factors associated with variation in canine vaccination rates. We conducted a cross-sectional study in 2022 to understand factors associated with canine vaccination. We used stratified random sampling of the streets and dog-owning households to survey 4162 households from three states and the Federal Capital Territory (FCT). We then built a joint probabilistic model to understand factors associated with dog vaccination and non-vaccination. First, we modelled rabies knowledge as a latent variable indirectly measured with several targeted survey questions. This method allowed a respondent's unobserved understanding of rabies to be estimated using their responses to a collection of survey questions that targeted different aspects of rabies epidemiology and took various possible response distributions (i.e., ordinal, categorical, binary). Second, we modelled factors influencing pet owners' decisions to vaccinate their dogs against rabies and barriers to dog vaccination among dog owners whose dogs were not vaccinated against rabies. Posterior distributions revealed that the probability of dog vaccination was positively associated with the owner's latent knowledge of rabies, civil servant service employment, residence in the FCT, ownership of a single dog, providing care to dogs, and a preference for contemporary treatment following a dog bite. Conversely, non-vaccination was positively associated with private employment, residing in Anambra and Enugu states, owning multiple dogs, allowing dogs to search for leftovers, and a preference for traditional treatment after a dog bite. Cost was the primary barrier against vaccination for dog owners in Anambra and Enugu, while mistrust posed a major challenge for those in the FCT. Owners in areas with veterinary establishments cited cost as a barrier, while those without a veterinary establishment cited access as the primary barrier. Our study underscores the need to enhance rabies knowledge, tailor vaccination campaigns to specific demographics, address financial and access barriers, and combat hesitancy to improve rabies vaccination rates in Nigeria.
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Affiliation(s)
- Philip P. Mshelbwala
- Faculty of Veterinary Medicine, University of Abuja, Nigeria
- Department of Primary Industries, NSW, Australia
- School of Veterinary Science, The University of Queensland, Australia
| | - Charles E. Rupprecht
- College of Forestry, Wildlife & Environment, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | | | - Emmanuel O. Njoga
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Nigeria, Nigeria
| | - Terese G. Orum
- Regional Disease Surveillance System Enhancement Project, Abuja, Nigeria
| | - J. Scott Weese
- Department of Pathobiology, Ontario Veterinary College, Guelph, Canada
| | - Nicholas J. Clark
- School of Veterinary Science, The University of Queensland, Australia
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Jane Ling MY, Halim AFNA, Ahmad D, Ramly N, Hassan MR, Syed Abdul Rahim SS, Saffree Jeffree M, Omar A, Hidrus A. Rabies in Southeast Asia: a systematic review of its incidence, risk factors and mortality. BMJ Open 2023; 13:e066587. [PMID: 37164462 PMCID: PMC10173986 DOI: 10.1136/bmjopen-2022-066587] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVE Rabies is a neglected zoonotic disease that can infect all mammals, including humans. We aimed to summarise the current knowledge of the incidence, risk factors and mortality of rabies in Southeast Asia. DESIGN Systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. DATA SOURCES Scopus, Web of Science and PubMed were searched from 1 January 2012 to 21 February 2023. ELIGIBILITY CRITERIA Original English language articles published between 2012 and 2023 were included. DATA EXTRACTION AND SYNTHESIS Nine independent reviewers extracted data and assessed the risk of bias. The quality appraisal of included articles was carried out using the Mixed Methods Appraisal Tool. RESULTS A total of eight articles were included in this analysis. In Vietnam, the incidence of rabies ranged from 1.7 to 117.2 per 100 000 population. The cumulative incidence in Sarawak was estimated at 1.7 per 100 000 population. In Indonesia, 104 human rabies cases were reported from 2008 to 2010, while in Thailand, a total of 46 rabies cases were reported in Thailand from 2010 to 2015. In the Philippines, the incidence of rabies ranged from 0.1 to 0.3 per 100 000 population. An increased risk of rabies virus infection was associated with a high population density, illiteracy, seasonal patterns and dog butchers. The case fatality rate was 100%. CONCLUSION This study included research from Southeast Asia, which may not represent rabies infection in other regions or continents. In addition, the role of publication bias should be acknowledged as grey literature was not included. The occurrence of rabies in Southeast Asia is due to the high number of unvaccinated stray and pet dogs, working hazards (dog butchers in Vietnam), the unavailability of the rabies vaccine in rural regions and misinformation about the significance of seeking treatment after dog bites. PROSPERO REGISTRATION NUMBER CRD42022311654.
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Affiliation(s)
- Miaw Yn Jane Ling
- Department of Public Health Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | | | - Dzulfitree Ahmad
- Department of Public Health Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | - Nurfatehar Ramly
- Department of Public Health Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | | | | | - Azizan Omar
- Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Aizuddin Hidrus
- Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
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Merga BT, Ayana GM, Negash B, Alemu A, Abdurke M, Abdu A, Balis B, Bekana M, Fekadu G, Raru TB. Health-care Workers’ Willingness to Pay for COVID-19 Vaccines in Eastern Ethiopia: Using Contingent Valuation Method. CLINICOECONOMICS AND OUTCOMES RESEARCH 2022; 14:395-404. [PMID: 35615661 PMCID: PMC9126155 DOI: 10.2147/ceor.s361199] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/09/2022] [Indexed: 12/01/2022] Open
Abstract
Background Health-care workers (HCWs) are among the highest risk groups for COVID-19 infection. The vaccine is found to be vital for HCWs, their household contacts, and their patients to protect against COVID-19 infection and maintain the safety of health systems. The actual willingness to pay for COVID-19 vaccination and associated factors remain uncertain among health-care workers in Ethiopia. Therefore, studying health-care workers’ willingness to pay (WTP) for COVID-19 vaccination helps to have an insight on valuation of the vaccine. Methods Institution-based cross-sectional study was conducted among 403 randomly selected health-care workers working in health facilities in eastern Ethiopia from February 3 to March 20, 2021. Pretested structured questionnaire was used to collect data. Binary logistic regression analysis was fitted to test the associations between outcome and explanatory variables. A p-value of <0.05 with 95% confidence interval was used to declare statistical significance. Results The magnitude of willingness to pay for a COVID-19 vaccine was 42.8%. The median amounts of money respondents willing to pay was 400 ETB (US$ 10.04). Sex (male, AOR = 2.33; 95% CI: 1.39, 3.93), monthly income (>7000 ETB, AOR = 1.22; 95% CI: 1.11, 2.51), affordability (AOR = 1.99; 95% CI: 1.18, 3.35), fear of side effects (AOR = 3.75; 95% CI: 2.13, 6.60), support vaccinations (AOR = 2.97; 95% CI: 1.65, 5.35), the likelihood of getting COVID-19 infection (AOR = 2.11; 95% CI: 1.26, 3.52) were independent determinants of WTP for a COVID-19 vaccine. Conclusion Health-care workers’ willingness to pay for COVID-19 vaccination was found to be low. Detailed health education and training about COVID-19 vaccines are required regarding their side effects, and efficacy to make an informed decision to enhance the willingness to pay for the vaccine. Moreover, the government should consider providing COVID vaccines free of charge for low-income groups and at an affordable price for those who could pay.
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Affiliation(s)
- Bedasa Taye Merga
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Bedasa Taye Merga, School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O.Box: 235, Harar, Ethiopia, Email
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Correspondence: Galana Mamo Ayana, School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O.Box: 235, Harar, Ethiopia, Email
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Abdurke
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ahmedmenewer Abdu
- Department of Laboratory Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Miressa Bekana
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gelana Fekadu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Temam Beshir Raru
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Sallam M, Anwar S, Yufika A, Fahriani M, Husnah M, Kusuma HI, Raad R, Khiri NME, Abdalla RYA, Adam RY, Ismaeil MIH, Ismail AY, Kacem W, Teyeb Z, Aloui K, Hafsi M, Dahman NBH, Ferjani M, Deeb D, Emad D, Sami FS, Abbas KS, Monib FA, R S, Panchawagh S, Sharun K, Anandu S, Gachabayov M, Haque MA, Emran TB, Wendt GW, Ferreto LED, Castillo-Briones MF, Inostroza-Morales RB, Lazcano-Díaz SA, Ordóñez-Aburto JT, Troncoso-Rojas JE, Balogun EO, Yomi AR, Durosinmi A, Adejumo EN, Ezigbo ED, Arab-Zozani M, Babadi E, Kakemam E, Ullah I, Malik NI, Dababseh D, Rosiello F, Enitan SS. Willingness-to-pay for COVID-19 vaccine in ten low-middle-income countries in Asia, Africa and South America: A cross-sectional study. NARRA J 2022; 2:e74. [PMID: 38450393 PMCID: PMC10914042 DOI: 10.52225/narra.v2i1.74] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 03/23/2022] [Indexed: 03/08/2024]
Abstract
Vaccine hesitancy is considered as one of the greatest challenges to control the ongoing coronavirus disease 2019 (COVID-19) pandemic. A related challenge is the unwillingness of the general public to pay for vaccination. The objective of this study was to determine willingness-to-pay (WTP) for COVID-19 vaccine among individuals from ten low- middle-income countries (LMICs) in Asia, Africa, and South America. Data were collected using an online questionnaire distributed during February - May 2021 in ten LMICs (Bangladesh, Brazil, Chile, Egypt, India, Iran, Nigeria, Pakistan, Sudan, and Tunisia). The major response variable of in this study was WTP for a COVID-19 vaccine. The assessment of COVID-19 vaccine hesitancy was based on items adopted from the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) vaccine hesitancy scale constructs. In this study, 1337 respondents included in the final analysis where the highest number of respondents was from India, while the lowest number was from Egypt. A total of 88.9% (1188/1337) respondents were willing to pay for the COVID-19 vaccination, and 11.1% (149/1337) were not. The average WTP for COVID-19 vaccination was 87.9 US dollars ($), (range: $5-$200). The multivariate model analysis showed that the country, monthly household income, having a history of respiratory disease, the agreement that routine vaccines recommended by health workers are beneficial and having received the flu vaccination within the previous 12 months were strongly associated with the WTP. Based on the country of origin, the highest mean WTP for COVID-19 vaccine was reported in Chile, while the lowest mean WTP for the vaccine was seen among the respondents from Sudan. The availability of free COVID-19 vaccination services appears as a top priority in the LMICs for successful control of the ongoing pandemic. This is particularly important for individuals of a lower socio- economic status. The effects of complacency regarding COVID-19 extends beyond vaccine hesitancy to involve less willingness to pay for COVID-19 vaccine and a lower value of WTP for the vaccine.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Amanda Yufika
- Department of Family Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Marhami Fahriani
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Milda Husnah
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
- Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Darussalam Banda Aceh, Aceh, Indonesia
| | - Hendrix I. Kusuma
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
- Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Darussalam Banda Aceh, Aceh, Indonesia
- Faculty of Tarbiyah and Teacher Training, Universitas Islam Negeri Ar-Raniry, Banda Aceh, Aceh, Indonesia
| | - Rawan Raad
- Faculty of Medicine and General Surgery, Sudan University of Science and Technology, Khartoum, Sudan
| | | | | | | | | | - Asma Y. Ismail
- Department of Internal Medicine, Faculty of Medicine, Sudan International University, Khartoum, Sudan
| | - Wajdi Kacem
- Department of Emergency Medicine, Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia
| | - Zeineb Teyeb
- Department of Internal Medicine, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Khaoula Aloui
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
| | - Montacer Hafsi
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
| | | | - Manel Ferjani
- Faculty of Dental Medicine Monastir, University of Monastir, Monastir, Tunisia
| | - Dalia Deeb
- Faculty of Medicine, Zagazig University, El-sharkia, Egypt
| | - Dina Emad
- Faculty of Medicine, Ain Shams university Nasr City, Cairo, Egypt
| | - Farah S. Sami
- Faculty of Medicine, Ain Shams university Nasr City, Cairo, Egypt
| | | | | | - Subramaniam R
- Department of Public Health Dentistry, Indira Gandhi Institute of Dental Sciences, Kothamangalam, India
| | - Suhrud Panchawagh
- Department of General Medicine, Smt. Kashibai Navale Medical College and General Hospital, Pune, India
| | - Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Sunil Anandu
- Division of Veterinary Parasitology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | - Md A. Haque
- Department of Orthopedic Surgery, Yan an Jospital Affiliated to Kunming Medical University, Kunming, Kunming, Yunnan, China
| | - Talha B. Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
| | - Guilherme W. Wendt
- Department of Life Sciences, Faculty of Medicine, Western Paraná State University, Brazil
| | - Lirane ED. Ferreto
- Department of Public Health and Postgraduate Program in Applied Health Sciences, Faculty of Medicine, Western Paraná State University, Brazil
| | | | | | | | | | | | - Emmanuel O. Balogun
- Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Akele R. Yomi
- Medical Laboratory Science Department, College of Medicine and Health Science, Afe Babalola University, Ado Ekiti, Nigeria
| | | | - Esther N. Adejumo
- Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria
| | - Eyiuche D. Ezigbo
- Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Edris Kakemam
- Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Najma I. Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Deema Dababseh
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Francesco Rosiello
- Department of Public Health and Infectious Disease, Sapienza-University of Rome, Rome, Italy
| | - Seyi S. Enitan
- Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria
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Mapatse M, Sabeta C, Fafetine J, Abernethy D. Knowledge, attitudes, practices (KAP) and control of rabies among community households and health practitioners at the human-wildlife interface in Limpopo National Park, Massingir District, Mozambique. PLoS Negl Trop Dis 2022; 16:e0010202. [PMID: 35255083 PMCID: PMC8929695 DOI: 10.1371/journal.pntd.0010202] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/17/2022] [Accepted: 01/25/2022] [Indexed: 12/25/2022] Open
Abstract
Background Rabies is a viral zoonotic disease that kills more than 26,000 people each year in Africa. In Mozambique, poverty and inadequate surveillance result in gross underreporting and ineffective control of the disease in animals and people. Little is known of the role of human attitudes and behaviour in prevention or control of rabies, thus this study was undertaken to assess the knowledge, attitudes and practices amongst selected households and health practitioners in one affected area, the Limpopo National Park (LNP), Massingir district. Methodology A cross-sectional study was conducted among 233 households in eight villages in LNP and among 42 health practitioners from eight health facilities in Massingir district between 2016 and 2018. Consenting household representatives aged 18 years or over were purposively selected. A KAP survey was administered to obtain information on dog ownership and knowledge of rabies, host species affected, modes of transmission, symptoms, recommended treatment and preventive methods. Similar to household study participants, health practitioners were purposively selected and completed the questionnaire during the investigators’ visit. The questionnaire sought information on knowledge of rabies, management of bite wounds, vaccination sites and schedules of pre- and post-exposure prophylaxis. Descriptive and inferential data analyses were performed using SPSS software version 18.0. Results Approximately twenty per cent (18.9%; 95% CI: 14.3–24.3) and 13.3% (95% CI: 9.4–18.1) of households had good knowledge and practices of rabies, respectively. For health practitioners, only 16.7% (95% CI: 7.5–31.9) had good knowledge, whilst 33.3% (95% CI: 20.0–49.7) adopted adequate attitudes/practices towards the disease. Conclusions/Significance In conclusion, both households and health practitioners displayed poor levels of knowledge and adopted bad attitudes and practices towards rabies. The former, had more gaps in their attitudes and practices towards the disease. Village location and education level (P < .05) and similarly, sex and occupation, were found to be statistically associated with good knowledge of rabies among households as compared to HPs. Overall, a lack of community-based education and professional retraining courses contribute significantly to poor awareness of rabies in the LNP of Mozambique. Enhancing public health knowledge should consequently reduce dog-mediated human rabies deaths in this country. In Mozambique, rabies is maintained primarily by the domestic dog, the principal vector and host species responsible for the majority of human cases dating back to the early 1900s. Control of animal rabies has historically been undertaken by government veterinary authorities, with limited involvement of the health and environment sectors. In the Massingir District in general, and in Limpopo National Park (LNP) in particular, parenteral dog rabies mass-vaccination campaigns and the provision of post-exposure prophylaxis are inconsistent. Limited resources for dog vaccination campaigns, insufficient veterinary field staff, inefficient disease notification procedures and inadequate training of health practitioners constraint effective rabies control across the country. Awareness of good practices regarding management of bite wounds among local community members and health practitioners is crucial to reducing rabies deaths. The results obtained in this study will inform government policy on practical interventions in the control of dog and human rabies.
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Affiliation(s)
- Milton Mapatse
- Veterinary Faculty, University Eduardo Mondlane, Maputo, Mozambique
- * E-mail:
| | - Claude Sabeta
- Agricultural Research Council-Onderstepoort Veterinary Institute, OIE Rabies Reference Laboratory, Pretoria, South Africa
| | - José Fafetine
- Veterinary Faculty, University Eduardo Mondlane, Maputo, Mozambique
- Centre of Biotechnology (CB-UEM), Maputo, Mozambique
| | - Darrell Abernethy
- Centre for Veterinary Wildlife Studies, University of Pretoria, Pretoria, South Africa
- Aberystwyth School of Veterinary Science, Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
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6
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Filla C, Rajeev M, Randriana Z, Hanitriniana C, Rafaliarison RR, Edosoa GT, Andriamananjara M, Razafindraibe NP, Nely J, Ferreira A, Yang AL, Daniel F, Clarke TA, Farris Z, Stone T, Lastdrager J, Rajaonarivelo T, Hampson K, Metcalf CJE, Valenta K. Lessons Learned and Paths Forward for Rabies Dog Vaccination in Madagascar: A Case Study of Pilot Vaccination Campaigns in Moramanga District. Trop Med Infect Dis 2021; 6:tropicalmed6020048. [PMID: 33921499 PMCID: PMC8167587 DOI: 10.3390/tropicalmed6020048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/25/2022] Open
Abstract
Canine rabies causes an estimated 60,000 human deaths per year, but these deaths are preventable through post-exposure prophylaxis of people and vaccination of domestic dogs. Dog vaccination campaigns targeting 70% of the population are effective at interrupting transmission. Here, we report on lessons learned during pilot dog vaccination campaigns in the Moramanga District of Madagascar. We compare two different vaccination strategies: a volunteer-driven effort to vaccinate dogs in two communes using static point vaccination and continuous vaccination as part of routine veterinary services. We used dog age data from the campaigns to estimate key demographic parameters and to simulate different vaccination strategies. Overall, we found that dog vaccination was feasible and that most dogs were accessible to vaccination. The static-point campaign achieved higher coverage but required more resources and had a limited geographic scope compared to the continuous delivery campaign. Our modeling results suggest that targeting puppies through community-based vaccination efforts could improve coverage. We found that mass dog vaccination is feasible and can achieve high coverage in Madagascar; however, context-specific strategies and an investment in dog vaccination as a public good will be required to move the country towards elimination.
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Affiliation(s)
- Caitlynn Filla
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; (C.F.); (K.V.)
| | - Malavika Rajeev
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; (A.L.Y.); (C.J.E.M.)
- Correspondence: mailto:
| | - Zoavina Randriana
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Chantal Hanitriniana
- Mention Zoologie et Biodiversité Animale, Faculté des Sciences, Université d’Antananarivo, Antananarivo 101, Madagascar;
| | - Radoniaina R. Rafaliarison
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Glenn Torrencelli Edosoa
- Chargé des Maladies Tropicales Négligées Organisation Mondiale de la Santé Madagascar, Antananarivo 101, Madagascar;
| | - Mamitiana Andriamananjara
- Direction des Services Vétérinaires Ministère Chargé de l’Agriculture et de l’Élevage, Antananarivo 101, Madagascar; (M.A.); (N.P.R.)
| | - Nivohanitra P. Razafindraibe
- Direction des Services Vétérinaires Ministère Chargé de l’Agriculture et de l’Élevage, Antananarivo 101, Madagascar; (M.A.); (N.P.R.)
| | - José Nely
- Service contre les Maladies Endémo-épidémiques et Tropicales Négligées Ministère de la Santé Publique, Antananarivo 101, Madagascar;
| | - Angelique Ferreira
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
- Travelling Animal Doctors, Newark, DE 19711-2916, USA; (T.S.); (J.L.)
| | - Annie L. Yang
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; (A.L.Y.); (C.J.E.M.)
| | - Fenomanana Daniel
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Tara A. Clarke
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
- Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC 27695-8107, USA
| | - Zachary Farris
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
- Department of Health and Exercise Science, Appalachian State University, Boone, NC 28608, USA
| | - Terry Stone
- Travelling Animal Doctors, Newark, DE 19711-2916, USA; (T.S.); (J.L.)
| | - Jochem Lastdrager
- Travelling Animal Doctors, Newark, DE 19711-2916, USA; (T.S.); (J.L.)
| | - Tsiky Rajaonarivelo
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Katie Hampson
- Boyd Orr Centre for Population and Ecosystem Health Institute of Biodiversity, Animal Health and Comparative Medicine University of Glasgow, Glasgow G12 8QQ, UK;
| | - C. Jessica E. Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; (A.L.Y.); (C.J.E.M.)
| | - Kim Valenta
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; (C.F.); (K.V.)
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
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Harapan H, Wagner AL, Yufika A, Setiawan AM, Anwar S, Wahyuni S, Asrizal FW, Sufri MR, Putra RP, Wijayanti NP, Salwiyadi S, Maulana R, Khusna A, Nusrina I, Shidiq M, Fitriani D, Muharrir M, Husna CA, Yusri F, Maulana R, Rajamoorthy Y, Groneberg DA, Müller R, Mudatsir M. Acceptance and willingness to pay for a hypothetical vaccine against monkeypox viral infection among frontline physicians: A cross-sectional study in Indonesia. Vaccine 2020; 38:6800-6806. [PMID: 32861468 PMCID: PMC9628749 DOI: 10.1016/j.vaccine.2020.08.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 08/01/2020] [Accepted: 08/14/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND A clinical trial is ongoing to evaluate the safety and efficacy of a monkeypox vaccine among healthcare workers (HCWs). The critical question that needs to be addressed is whether HCWs are willing to accept and purchase this vaccine. The objective of this study was to evaluate the acceptance and willingness to pay (WTP) for the vaccine among HCWs. METHODS From May to July 2019, a cross-sectional study was conducted among registered general practitioners (GPs) in Indonesia. A contingent valuation method was employed to evaluate the WTP. Besides acceptance and WTP, various explanatory variables were also collected and assessed. A logistic regression and a multivariable linear regression were used to explore the explanatory variables influencing acceptance and WTP, respectively. RESULTS Among 407 respondents, 391 (96.0%) expressed acceptance of a free vaccination. The mean and median WTP was US$ 37.0(95%CI:US$ 32.76-US$ 41.23) and US$ 17.90(95%CI:US$ 17.90-US$ 17.90), respectively. In an unadjusted analysis, those 30 years old or younger had 2.94 times greater odds of vaccine acceptance compared to those who were older (95%CI: 1.07-8.08). Location of alma mater, type of workplace, length of individual medical experience, and monthly income of GPs were all significantly associated with WTP. CONCLUSION Although the vast majority of GPs would accept a freely provided vaccine, they were also somewhat price sensitive. This finding indicates that partial subsidy maybe required to achieve high vaccine coverage, particularly among GPs at community health centres or those with a shorter duration of medical practice.
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Affiliation(s)
- Harapan Harapan
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia; Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia; Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Amanda Yufika
- Department of Family Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
| | - Abdul M Setiawan
- Department of Microbiology, Faculty of Medicine and Health Sciences, Maulana Malik Ibrahim State Islamic University of Malang, Malang, East Java 65144, Indonesia
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
| | - Sri Wahyuni
- Faculty of Medicine, Universitas Malikussaleh, Lhokseumawe, Aceh 24531, Indonesia
| | | | - Muhammad R Sufri
- Banda Aceh Port Health Office, Ministry of Health, Aceh Besar, Aceh 23352, Indonesia
| | - Reza P Putra
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
| | | | - Salwiyadi Salwiyadi
- Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh 23111, Indonesia
| | - Razi Maulana
- Department of Obstetrics and Gynecology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh 23111, Indonesia
| | | | - Ina Nusrina
- Department of Health Service, District Health Office, Aceh Besar, Aceh 23912, Indonesia
| | - Muhammad Shidiq
- Nusa Jaya Community Health Center, Halmahera Timur, North Maluku 97863, Indonesia
| | - Devi Fitriani
- Teunom Community Health Center, Aceh Jaya, Aceh 23653, Indonesia
| | - Muharrir Muharrir
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
| | - Cut A Husna
- Department of Microbiology, Universitas Malikussaleh, Lhokseumawe, Aceh 24531, Indonesia
| | - Fitria Yusri
- Faculty of Medicine, Universitas Malikussaleh, Lhokseumawe, Aceh 24531, Indonesia
| | - Reza Maulana
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
| | - Yogambigai Rajamoorthy
- Department of Economics, Faculty of Accountancy and Management, Universiti Tunku Abdul Rahman, Kajang, Selangor 43200, Malaysia
| | - David Alexander Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - Ruth Müller
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany; Unit of Medical Entomology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Mudatsir Mudatsir
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia; Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia; Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
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8
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Harapan H, Wagner AL, Yufika A, Winardi W, Anwar S, Gan AK, Setiawan AM, Rajamoorthy Y, Sofyan H, Vo TQ, Hadisoemarto PF, Müller R, Groneberg DA, Mudatsir M. Willingness-to-pay for a COVID-19 vaccine and its associated determinants in Indonesia. Hum Vaccin Immunother 2020; 16:3074-3080. [PMID: 32991230 DOI: 10.1080/21645515.2020.1819741] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
How countries, particularly low- and middle-income economies, should pay the coronavirus disease 2019 (COVID-19) vaccine is an important and understudied issue. We undertook an online survey to measure the willingness-to-pay (WTP) for a COVID-19 vaccine and its determinants in Indonesia. The WTP was assessed using a simple dichotomous contingent valuation approach and a linear regression model was used to assess its associated determinants. There were 1,359 respondents who completed the survey. In total, 78.3% (1,065) were willing to pay for the COVID-19 vaccine with a mean and median WTP of US$ 57.20 (95%CI: US$ 54.56, US$ 59.85) and US$ 30.94 (95%CI: US$ 30.94, US$ 30.94), respectively. Being a health-care worker, having a high income, and having high perceived risk were associated with higher WTP. These findings suggest that the WTP for a COVID-19 vaccine is relatively high in Indonesia. This WTP information can be used to construct a payment model for a COVID-19 vaccine in the country. Nevertheless, to attain higher vaccine coverage, it may be necessary to partially subsidize the vaccine for those who are less wealthy and to design health promotion materials to increase the perceived risk for COVID-19 in the country.
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Affiliation(s)
- Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala , Banda Aceh, Indonesia.,Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala , Banda Aceh, Indonesia.,Department of Microbiology, School of Medicine, Universitas Syiah Kuala , Banda Aceh, Indonesia
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan , Ann Arbor, MI, USA
| | - Amanda Yufika
- Department of Family Medicine, School of Medicine, Universitas Syiah Kuala , Banda Aceh, Indonesia
| | - Wira Winardi
- Department of Pulmonology and Respiratory Medicine, School of Medicine, Universitas Syiah Kuala , Banda Aceh, Indonesia
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala , Banda Aceh, Indonesia
| | - Alex Kurniawan Gan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala , Banda Aceh, Indonesia
| | - Abdul M Setiawan
- Department of Microbiology, Faculty of Medicine and Health Sciences, Maulana Malik Ibrahim State Islamic University of Malang , Malang, Indonesia
| | - Yogambigai Rajamoorthy
- Department of Economics, Faculty of Accountancy and Management, Universiti Tunku Abdul Rahman , Kajang, Malaysia
| | - Hizir Sofyan
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala , Banda Aceh, Indonesia
| | - Trung Quang Vo
- Department of Economic and Administrative Pharmacy, Faculty of Pharmacy, Pham Ngoc Thach University of Medicine , Ho Chi Minh City, Vietnam
| | | | - Ruth Müller
- Department Biomedical Sciences, Institute of Tropical Medicine , Antwerp, Belgium.,Department of Tropical Medicine and Public Health, The Institute of Occupational, Social and Environmental Medicine, Goethe University , Frankfurt, Germany
| | - David A Groneberg
- Department of Tropical Medicine and Public Health, The Institute of Occupational, Social and Environmental Medicine, Goethe University , Frankfurt, Germany
| | - Mudatsir Mudatsir
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala , Banda Aceh, Indonesia.,Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala , Banda Aceh, Indonesia.,Department of Microbiology, School of Medicine, Universitas Syiah Kuala , Banda Aceh, Indonesia
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9
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Lwapa Embele Isenge F, Masumu Mulumbu J, Matala Mfwamba F, Mukoko Ndonzuau F, Mbao V, Lefèvre M, Moyse E, Antoine-Moussiaux N. Application of discrete choice experiment to analyze the demand for village chicken paid vaccination service against Newcastle disease in DR Congo. Prev Vet Med 2020; 182:105097. [PMID: 32712413 DOI: 10.1016/j.prevetmed.2020.105097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 11/17/2022]
Abstract
Newcastle disease (ND) is a highly contagious viral disease that can affect a large number of avian species and cause severe economic loss in many countries. This disease is a major constraint for rural chicken production in most developing countries. In this country, ND is known since the 1940s. It exists in enzootic form in almost all provinces of the country. No systematic long-term control measures have been taken against this devastating disease in village poultry. A discrete choice experiment was carried out to analyze the demand for paid vaccination services, by first identifying the preferences of 320 village chicken keepers from eight sites, four of which had benefitted from such a paid chicken vaccination program against ND and four of which did not. The preference was for a vaccination service carried out following imposed calendar. The public veterinarian was the most preferred professional to ensure the paid vaccination of village chickens. The results led to the design of a profile of paid vaccination service tailored to chicken keepers' expectations. The public veterinarian would supervise vaccination activities, which would be implemented by trained community-based health workers, through collective campaigns at fixed periods in the year. The acceptable price (equivalent to 0.10 US dollar per dose) would allow the service to be set in a sustainable way and might be increased if trust in the delivered service may be built further.
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Affiliation(s)
- Francis Lwapa Embele Isenge
- Faculty of Veterinary Medicine, Université Pédagogique Nationale, Kinshasa, Congo; Fundamental and Applied Research for Animals and Health (FARAH), University of Liège, Belgium.
| | - Justin Masumu Mulumbu
- Faculty of Veterinary Medicine, Université Pédagogique Nationale, Kinshasa, Congo; Interdisciplinary Centre for Health Risk Management, Kinshasa, Congo
| | | | | | - Victor Mbao
- International Development Research Centre, Regional Office for Sub-Saharan Africa, Eaton, United Nations Crescent, Gigiri, Nairobi, Kenya
| | - Mélanie Lefèvre
- Department of Economy, Management School, University of Liège, Belgium
| | - Evelyne Moyse
- Fundamental and Applied Research for Animals and Health (FARAH), University of Liège, Belgium
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10
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Barbosa Costa G, Ludder F, Monroe B, Dilius P, Crowdis K, Blanton JD, Pieracci EG, Head JR, Gibson AD, Wallace RM. Barriers to attendance of canine rabies vaccination campaigns in Haiti, 2017. Transbound Emerg Dis 2020; 67:2679-2691. [PMID: 32438530 PMCID: PMC7754310 DOI: 10.1111/tbed.13622] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 04/04/2020] [Accepted: 05/02/2020] [Indexed: 12/11/2022]
Abstract
We conducted a cross-sectional survey to better understand the barriers to attendance at canine rabies vaccination campaigns in Haiti. A structured community-based questionnaire was conducted over a 15-day period during May-June 2017, focused on socio-economic status correlated with participation at canine rabies vaccination campaigns. Questions phrased as a bidding game were asked to determine individuals' willingness to pay (WTP) for dog rabies vaccination and willingness to walk (WTW) to fixed-point vaccination campaigns. The Kaplan-Meier estimator was applied to determine relationships between survey variables. Logistic regression was used to examine factors associated with participants' WTP and WTW. A total of 748 households from eight communities were surveyed. Respondents were predominantly female (54.4%) and had a median age of 45 years. The total number of owned dogs reported from households was 926, yielding a human-to-dog ratio in dog-owning households of 5.2:1. The majority of dogs (87.2%) were acquired for security, and 49% were allowed to roam freely; 42.0% of dog owners reported that they were unable to manage (or restrain) their dogs using a leash. Seventy per cent of dog owners were willing to pay up to 15.9 gourdes (0.25 USD) and/or walk up to 75 m to vaccinate their dogs. Households that owned free-roaming dogs, owned dogs for the purpose of companionship and owned dogs that they were unable to walk on a leash were associated with a higher WTP for vaccination. Living in Artibonite Department, having a middle or higher household income, and owning a dog for security purpose were associated with a higher WTW for vaccination. Low leash use and propensity for dogs to roam freely are barriers to successful fixed-point vaccination methods in Haiti, and alternative methods such as door to door (DD), capture-vaccinate-release (CVR) or oral vaccination should be explored. There may be some prospect for fee-for-service vaccination in Haiti; however, this programme should be introduced as a supplement, rather than a replacement for free rabies vaccination programmes so that mass dog vaccination is not discouraged.
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Affiliation(s)
- Galileu Barbosa Costa
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Participation Program, Atlanta, GA, USA
| | - Fleurinord Ludder
- Ministry of Agriculture and Natural Resources, Port-au-Prince, Haiti
| | - Benjamin Monroe
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pierre Dilius
- Ministry of Agriculture and Natural Resources, Port-au-Prince, Haiti
| | | | - Jesse D Blanton
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily G Pieracci
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer R Head
- Center for Global Health, Centers for Disease Control and Prevention Participation Program, Atlanta, GA, USA
| | - Andrew D Gibson
- Mission Rabies, Dorset, UK.,Division of Genetics and Genomics, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
| | - Ryan M Wallace
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
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11
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Ertl HC, Miranda NLJ. Rabies Prevention in Asia: Institutionalizing Implementation Capacities. RABIES AND RABIES VACCINES 2020. [PMCID: PMC7196719 DOI: 10.1007/978-3-030-21084-7_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Rabies in Asia and Africa contributes to over 99% of human rabies deaths that occur in the world today. The vast majority or 60% of these deaths are in Asia. Practically, more than four billion people in Asia or about 60% of the world’s population are at risk of getting rabies where an estimated 96% of documented human cases are from an infected dog bite. Canine-mediated rabies is one of the few communicable diseases that can possibly be eliminated by currently available vaccines and tools for veterinary and public health interventions. With a more comprehensive and integrated approach, it is expected that dog rabies will be eliminated in target areas, and there will be an eventual decline and disappearance of human rabies cases. The burden of rabies is primarily on human health but the disease control has to be focused on the animal source. The ultimate goal of a truly regional disease program is to control and eliminate dog-mediated rabies and protect and maintain rabies-free areas in Asia. Current regional efforts aim to strengthen the intercountry coordination, and technical and institutional capacities to manage dog rabies elimination programs. The regional and national implementation efforts provide strategic direction and cooperation to ensure successful implementation of rabies control measures and eventual elimination. The focus areas include human rabies prevention through pre- and postexposure prophylaxis, mass dog vaccination, surveillance and epidemiology, laboratory diagnostic capability, public awareness and risk communication, legislation, dog population management, and establishment and protection of rabies-free zones/areas. Existing mechanisms for implementation, when applied, give emphasis on One Health collaborations.
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12
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Sarker AR, Islam Z, Sultana M, Sheikh N, Mahumud RA, Islam MT, Meer RVD, Morton A, Khan AI, Clemens JD, Qadri F, Khan JAM. Willingness to pay for oral cholera vaccines in urban Bangladesh. PLoS One 2020; 15:e0232600. [PMID: 32353086 PMCID: PMC7192494 DOI: 10.1371/journal.pone.0232600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 04/17/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Cholera is a highly infectious disease and remains a serious public health burden in Bangladesh. The objective of the study was to measure the private demand for oral cholera vaccines (OCV) in Bangladesh and to investigate the key determinants of this demand, reflected in the household’s willingness to pay (WTP) for oral cholera vaccine. Methods A contingent valuation method was employed in an urban setting of Bangladesh during December 2015 to January 2016. All respondents (N = 1051) received a description of World Health Organization (WHO) prequalified OCV, Shanchol™. Interviews were conducted with either the head of households or their spouse or a major economic contributor of the households. Respondents were asked about how much at maximum they were willing to pay for OCV for their own and their household members’ protection. Results are presented as the average and median of the reported maximum WTP of the respondents with standard deviations and 95% confidence interval. Natural log-linear regression model was employed to examine the factors influencing participants’ WTP for OCV. Results About 99% of the respondents expressed WTP for OCV with a maximum mean and median WTP per vaccination (2 doses) of US$ 2.23 and US$ 1.92 respectively. On the household level with an average number of 4.62 members, the estimated mean WTP was US$ 10 (median: US$ 7.69) which represents the perceived demand for OCV of a household to vaccinate against cholera. Conclusions The demand of vaccination further indicates that there is a potential scope for recovering a certain portion of the expenditure of immunization program by introducing direct user fees for future cholera vaccination in Bangladesh. Findings from this study will be useful for the policy-makers to make decision on cost-recovery in future oral cholera vaccination programs in Bangladesh and in similar countries.
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Affiliation(s)
- Abdur Razzaque Sarker
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- University of Strathclyde, Glasgow, United Kingdom
- Bangladesh Institute of Development Studies, Dhaka, Bangladesh
- * E-mail:
| | - Ziaul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Marufa Sultana
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Nurnabi Sheikh
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Md. Taufiqul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Alec Morton
- University of Strathclyde, Glasgow, United Kingdom
| | - Ashraful Islam Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - John David Clemens
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Firdausi Qadri
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jahangir A. M. Khan
- Karolinska Institute, Solna, Stockholm, Sweden
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Pet owners' awareness on RA 9482 (Anti-Rabies Act of 2007) in Magalang, Pampanga Philippines. Heliyon 2019; 5:e01759. [PMID: 31193450 PMCID: PMC6529737 DOI: 10.1016/j.heliyon.2019.e01759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 04/24/2019] [Accepted: 05/15/2019] [Indexed: 11/20/2022] Open
Abstract
Background Rabies remains a significant public health problem in the Philippines. An acutely fatal viral infection, it results in the death of 200-300 Filipinos annually affecting mostly children less than 15 years old. The disease is endemic in Magalang which ranks fifth in the number of dog rabies positive cases among the 19 municipalities of Pampanga. In spite of the enactment of the Anti-Rabies Act of 2007 (RA 9482), the control of rabies in Magalang has been a major challenge for the municipality. Thus, this study investigated the awareness of pet owners in Magalang, Pampanga on the Anti-Rabies Act of 2007 (RA 9482). Methods This study was a cross-sectional study conducted from April-September 2017 among 380 pet owners from eight urban and rural barangays in Magalang, Pampanga. Data gathered were analyzed using STATA IC (Ver13.0); Bloom's cut-off points were used to categorize the level of knowledge of pet owners on the Anti-Rabies Act; data were further analyzed using Chi-square Test and relationship between variables was determined through logistic regression. Results Results revealed that pet owners in Magalang had poor knowledge of the Anti-Rabies Act (65.5%), and majority (71.3%) were unaware of its existence and of penalties imposed by the law to non-compliant pet owners. Moreover, results indicate that pet owners in urban places have higher odds of having above median knowledge on the law compared to those in rural places.
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14
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Harapan H, Mudatsir M, Yufika A, Nawawi Y, Wahyuniati N, Anwar S, Yusri F, Haryanti N, Wijayanti NP, Rizal R, Fitriani D, Maulida NF, Syahriza M, Ikram I, Fandoko TP, Syahadah M, Asrizal FW, Aletta A, Jamil KF, Rajamoorthy Y, Hadisoemarto PF, Wagner AL, Groneberg DA, Kuch U, Sasmono RT, Müller R, Imrie A. Community acceptance and willingness-to-pay for a hypothetical Zika vaccine: A cross-sectional study in Indonesia. Vaccine 2019; 37:1398-1406. [PMID: 30739794 DOI: 10.1016/j.vaccine.2019.01.062] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/22/2019] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Understanding people's perceptions of the economic benefits of a potential Zika vaccine (ZV) is critical to accelerating its introduction into either public sector programs or private market. The aim of this study was to assess the acceptance and willingness-to-pay (WTP) for a hypothetical ZV and the associated explanatory variables in Indonesia. METHODS We conducted a health facility-based cross-sectional study in Aceh and West Sumatra province from 1 February to 13 June 2018. Patients who visited outpatient departments, have had children or were expecting their first child, were approached and interviewed to collect information on acceptance, WTP, demographic and socio-economic variables and attitudes towards childhood vaccines. Associations of explanatory variables influencing acceptance and WTP were assessed using logistic regression and linear regression analysis, respectively. RESULTS In total, 956 respondents were included in the final analysis of acceptance, of whom 338 (35.3%) expressed their WTP. We found that 757 (79.1%) of the respondents were likely to be vaccinated and to recommend their partner to be vaccinated. Higher educational attainment, having a job, having heard about Zika and a good attitude towards childhood vaccination were associated with ZV acceptance in the univariate analyses. In the multivariate analysis, attitude towards childhood vaccination was the strongest predictor for ZV vaccination. We found the geometric mean and median of WTP was US$ 13.1 (95% CI: 11.37-15.09) and US$ 7.0 (95% CI: 4.47-10.98), respectively. In the final model, having heard about Zika, having a job, and higher income were associated with a higher WTP. CONCLUSION Although the acceptance rate of the ZV is relatively high in Indonesia, less than 40% of respondents are willing to pay, underscoring the need for a low-cost, high-quality vaccine and public sector subsidies for Zika vaccinations in the country.
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Affiliation(s)
- Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia, Australia.
| | - Mudatsir Mudatsir
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Amanda Yufika
- Department of Family Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Yusuf Nawawi
- Department of Family Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Nur Wahyuniati
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Fitria Yusri
- School of Medicine, Malikussaleh University, Lhokseumawe, Aceh, Indonesia
| | - Novi Haryanti
- Community Health Centre of Meurah Mulia, North Aceh, Aceh, Indonesia
| | | | - Rizal Rizal
- Bunda Hospital, Lhokseumawe, Aceh, Indonesia
| | - Devi Fitriani
- Community Health Centre of Teunom, Aceh Jaya, Aceh, Indonesia
| | | | - Muhammad Syahriza
- Department of Public Health and Community Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Ikram Ikram
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Try Purwo Fandoko
- Community Health Centre of Gunung, Padang Panjang, West Sumatra, Indonesia
| | - Muniati Syahadah
- Community Health Centre of Lima Kaum, Tanah Datar, West Sumatra, Indonesia
| | | | - Alma Aletta
- Department of Family Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Kurnia Fitri Jamil
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | | | | | | | - David Alexander Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - Ulrich Kuch
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | | | - Ruth Müller
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany; Unit of Medical Entomology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Allison Imrie
- School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
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15
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Baker T, Kutz S, Toews L, Edwards N, Rock M. Are we adequately evaluating subsidized veterinary services? A scoping review. Prev Vet Med 2018; 157:59-69. [DOI: 10.1016/j.prevetmed.2018.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 04/10/2018] [Accepted: 05/27/2018] [Indexed: 11/30/2022]
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Railey AF, Lembo T, Palmer GH, Shirima GM, Marsh TL. Spatial and temporal risk as drivers for adoption of foot and mouth disease vaccination. Vaccine 2018; 36:5077-5083. [PMID: 29997035 PMCID: PMC6073883 DOI: 10.1016/j.vaccine.2018.06.069] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/14/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022]
Abstract
Identifying the drivers of vaccine adoption decisions under varying levels of perceived disease risk and benefit provides insight into what can limit or enhance vaccination uptake. To address the relationship of perceived benefit relative to temporal and spatial risk, we surveyed 432 pastoralist households in northern Tanzania on vaccination for foot-and-mouth disease (FMD). Unlike human health vaccination decisions where beliefs regarding adverse, personal health effects factor heavily into perceived risk, decisions for animal vaccination focus disproportionately on dynamic risks to animal productivity. We extended a commonly used stated preference survey methodology, willingness to pay, to elicit responses for a routine vaccination strategy applied biannually and an emergency strategy applied in reaction to spatially variable, hypothetical outbreaks. Our results show that households place a higher value on vaccination as perceived risk and household capacity to cope with resource constraints increase, but that the episodic and unpredictable spatial and temporal spread of FMD contributes to increased levels of uncertainty regarding the benefit of vaccination. In addition, concerns regarding the performance of the vaccine underlie decisions for both routine and emergency vaccination, indicating a need for within community messaging and documentation of the household and population level benefits of FMD vaccination.
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Affiliation(s)
- Ashley F Railey
- Paul G. Allen School for Global Animal Health, Washington State University, USA.
| | - Tiziana Lembo
- Boyd Orr Centre for Population and Ecosystem Health; Institute of Biodiversity, Animal Health and Comparative Medicine; College of Medical, Veterinary and Life Sciences, University of Glasgow, Scotland, United Kingdom.
| | - Guy H Palmer
- Paul G. Allen School for Global Animal Health, Washington State University, USA.
| | - Gabriel M Shirima
- Nelson Mandela African Institution of Science and Technology, Tanzania.
| | - Thomas L Marsh
- Paul G. Allen School for Global Animal Health, Washington State University, USA; School of Economic Sciences, Washington State University, USA.
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17
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Barbosa Costa G, Gilbert A, Monroe B, Blanton J, Ngam Ngam S, Recuenco S, Wallace R. The influence of poverty and rabies knowledge on healthcare seeking behaviors and dog ownership, Cameroon. PLoS One 2018; 13:e0197330. [PMID: 29927935 PMCID: PMC6013156 DOI: 10.1371/journal.pone.0197330] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 04/30/2018] [Indexed: 12/25/2022] Open
Abstract
Background Rabies is a fatal encephalitis caused by lyssaviruses, with most human cases worldwide resulting from rabid dog bites. Although effective animal and human vaccines have been available for over 100 years, control efforts have not been adequately implemented on the global scale and rabies remains one of the greatest global zoonotic threats to human health. We conducted a knowledge, attitudes and practices survey in Northern Cameroon to describe dog ownership characteristics, rates of dog bites, and post-bite healthcare seeking behaviors. Methods The survey was performed in four rural Cameroonian communities. A structured community-based questionnaire was conducted over a 20-day period in April 2010, and focused on socio-economic factors correlated with gaps in rabies knowledge. Information pertaining to socio-demographics, as well as attitudes and practices with regard to animal bites and bite treatment practices were recorded. Characteristics of dog ownership such as dog confinement, resources provided to dogs, and dog vaccination status were examined. Human to dog ratios were compared on a linear scale to poverty scores by community. When applicable, 2-tailed Chi-square tests or Fisher’s exact tests were calculated to determine relationships between variables. We also used One-way Analysis of Variance (ANOVA) to identify associations between rabies knowledge and wealth with dog ownership, dog vaccination, and human healthcare seeking behaviors. Independent variables were evaluated using multivariate logistic regression analysis. Results A total of 208 households were enrolled. Respondents were predominantly male (68.3%), with a median age of 43.6 years. Eighty-four households (39.9%) reported owning a total of 141 dogs (human dog ratio 10.4:1). The majority of dogs (61%) were allowed to roam freely. A history of rabies vaccination was reported for 30.8% of owned dogs. Respondents reported 11 bites during the two years preceding the survey (annual bite incidence was 2.6% [95% CI 1.4%– 4.6%]). Only one person (9.1%) received rabies post-exposure prophylaxis (PEP), and none described symptoms of clinical illness consistent with rabies. Respondents who indicated that they would seek medical care and PEP after a dog bite had higher average wealth and rabies knowledge index scores (p = 0.01 and 0.04, respectively). Respondents who indicated that they would seek care from a traditional healer had significantly lower wealth scores, but not significantly different knowledge scores (p < 0.01 and p = 0.49, respectively). Conclusions In the communities evaluated, the majority of dogs were allowed to roam freely and had no history of rabies vaccination; factors that favor enzootic transmission of canine rabies virus. We also identified a strong relationship between poverty and dog ownership. Bite events were relatively common among respondents, and very few victims reported utilizing health services to treat wounds. Increased wealth and knowledge were significantly associated with increased likelihood that a respondent would seek medical care and post-exposure prophylaxis. These findings indicate the need for educational outreach to raise awareness of dog rabies and proper prevention measures.
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Affiliation(s)
- Galileu Barbosa Costa
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- ORISE Fellow, Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Laboratório de Vírus, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail: ,
| | - Amy Gilbert
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- National Wildlife Research Center, US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, Fort Collins, Colorado, United States of America
| | - Benjamin Monroe
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jesse Blanton
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sali Ngam Ngam
- Laboratoire National Vétérinaire (LANAVET), Garoua, Cameroon
| | - Sergio Recuenco
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- National Centre for Public Health, Instituto Nacional de Salud, Lima, Peru
| | - Ryan Wallace
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Kazadi EK, Tshilenge GM, Mbao V, Njoumemi Z, Masumu J. Determinants of dog owner-charged rabies vaccination in Kinshasa, Democratic Republic of Congo. PLoS One 2017; 12:e0186677. [PMID: 29059205 PMCID: PMC5653331 DOI: 10.1371/journal.pone.0186677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 10/05/2017] [Indexed: 11/20/2022] Open
Abstract
Rabies is a preventable fatal disease that causes about 61,000 human deaths annually around the world, mostly in developing countries. In Africa, several studies have shown that vaccination of pets is effective in controlling the disease. An annual vaccination coverage of 70% is recommended by the World Health Organization as a control threshold. The effective control of rabies requires vaccination coverage of owned dogs. Identification of the factors determining dog owners’ choice to vaccinate is necessary for evidence-based policy-making. However, for the Democratic Republic of Congo (DRC), the limited data on rabies vaccination coverage makes it difficult for its control and formulation of appropriate policies. A cross-sectional study was conducted in Kinshasa (Lemba commune) with dog-owning households and owned dogs as study populations. The association between dog vaccination and independent factors (household socio-demographics characteristics, dog characteristics, knowledge of rabies and location of veterinary offices/clinics) was performed with Epi-info 7. The Odds Ratio (OR) and p-value < 0.05 were used to determine levels of significance. A total of 166 households owning dogs and 218 owned dogs were investigated. 47% of the dogs had been vaccinated within one year preceding the survey which is higher than the critical coverage (25 to 40%) necessary to interrupt rabies transmission but below the 70% threshold recommended by WHO for control. The determinants of vaccination included socio-economic level of the household (OR = 2.9, p<0.05), formal education level of the dog owner (OR = 4, p<0.05), type of residence (OR = 4.6, p<0.05), knowledge of rabies disease (OR = 8.0, p<0.05), knowledge of location of veterinary offices/clinics (OR = 3.4, p<0.05), dog gender (OR = 1.6, p<0.05) and dog breed (OR = 2.1, p<0.05). This study shows that the vaccination coverage in this area can easily reach the WHO threshold if supplemented by mass vaccination campaigns.
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Affiliation(s)
- Eric Kawaya Kazadi
- Veterinary Faculty, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- * E-mail:
| | - Georges Mbuyi Tshilenge
- Veterinary Faculty, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- Veterinary Laboratory of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Victor Mbao
- International Development Research Centre, Nairobi, Kenya
| | - Zakariaou Njoumemi
- Faculty of Medecine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
| | - Justin Masumu
- Veterinary Laboratory of Kinshasa, Kinshasa, Democratic Republic of Congo
- Veterinary Faculty, National Pedagogical University, Kinshasa, Democratic Republic of Congo
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of Congo
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Harapan H, Anwar S, Bustamam A, Radiansyah A, Angraini P, Fasli R, Salwiyadi S, Bastian RA, Oktiviyari A, Akmal I, Iqbalamin M, Adil J, Henrizal F, Darmayanti D, Mahmuda M, Mudatsir M, Imrie A, Sasmono RT, Kuch U, Shkedy Z, Pramana S. Willingness to pay for a dengue vaccine and its associated determinants in Indonesia: A community-based, cross-sectional survey in Aceh. Acta Trop 2017; 166:249-256. [PMID: 27908746 DOI: 10.1016/j.actatropica.2016.11.035] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/25/2016] [Accepted: 11/27/2016] [Indexed: 10/20/2022]
Abstract
Vaccination strategies are being considered as a part of dengue prevention programs in endemic countries. To accelerate the introduction of dengue vaccine into the public sector program and private markets, understanding the private economic benefits of a dengue vaccine is therefore essential. The aim of this study was to assess the willingness to pay (WTP) for a dengue vaccine among community members in Indonesia and its associated explanatory variables. A community-based, cross-sectional survey was conducted in nine regencies of Aceh province, Indonesia, from November 2014 to March 2015. A pre-tested validated questionnaire was used to facilitate the interviews. To assess the explanatory variables influencing participants' WTP for a dengue vaccine, a linear regression analysis was employed. We interviewed 677 healthy community members; 476 participants (87.5% of the total) were included in the final analysis. An average individual was willing to pay around US-$ 4 (mean: US-$ 4.04; median: US-$ 3.97) for a dengue vaccine. Our final multivariate model revealed that working as a civil servant, living in the city, and having good knowledge on dengue viruses, a good attitude towards dengue, and good preventive practice against dengue virus infection were associated with a higher WTP (P<0.05). Our model suggests that marketing efforts should be directed to community members who are working in the suburbs especially as farmers. In addition, the results of our study underscore the need for low-cost quality vaccines, public sector subsidies for vaccinations, and intensifying efforts to further educate and encourage households regarding other dengue preventive measures, using trusted individuals as facilitators.
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Harapan H, Fajar JK, Sasmono RT, Kuch U. Dengue vaccine acceptance and willingness to pay. Hum Vaccin Immunother 2016; 13:786-790. [PMID: 27905832 DOI: 10.1080/21645515.2016.1259045] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The introduction of new vaccines is accompanied by a variety of challenges. Among these, very important ones concern the questions whether the public is willing to accept and willing to purchase the vaccine. Here we discuss factors associated with these questions in the context of vaccines that are becoming available against dengue virus infection. We reviewed published studies available from PubMed and Embase, conducting a meta-analysis when possible and narrative review when the data did not qualify for meta-analysis. We found that attitude toward vaccination and socioeconomic level had significant associations with dengue vaccine acceptance. In addition, socioeconomic level, knowledge, attitude and practice regarding dengue fever, having personally experienced dengue fever and vaccine price were associated with willingness to pay for dengue vaccine. To improve acceptance and willingness to pay for dengue vaccine, well-designed introduction programs that address the associated factors in a context-specific manner are essential.
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Affiliation(s)
- Harapan Harapan
- a Medical Research Unit , School of Medicine, Syiah Kuala University , Banda Aceh , Indonesia.,b Tropical Disease Centre, School of Medicine, Syiah Kuala University , Banda Aceh , Indonesia.,c Department of Microbiology , School of Medicine, Syiah Kuala University , Banda Aceh , Indonesia
| | - Jonny K Fajar
- a Medical Research Unit , School of Medicine, Syiah Kuala University , Banda Aceh , Indonesia
| | - R Tedjo Sasmono
- d Eijkman Institute for Molecular Biology , Jakarta , Indonesia
| | - Ulrich Kuch
- e Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University , Frankfurt am Main , Germany
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