Study On The Influencing Factors And Cost-effectiveness Of Rabies Vaccination In Guangdong Province

Objective: In recent years,the number of people exposed to rabies(or dog injuries)in Guangdong Province has shown an upward trend,but the overall vaccination rate of the exposed population has actually decreased,bringing huge pressure to rabies prevention and control.Therefore,exploring the influencing factors of rabies vaccination among the exposed population in Guangdong Province,analyzing the cost-effectiveness of different vaccination strategies,is of great significance for doing a good job in rabies prevention and control.Method:(1)Collect monitoring data on rabies and rabies exposure in Guangdong Province from 2010 to 2019,describe the epidemiological characteristics and prevention and treatment of rabies exposed populations in Guangdong Province.(2)Using Spearman linear correlation analysis and generalized additive model,explore the relationship between monthly rabies exposure and meteorological factors.(3)Based on the grey correlation analysis method,explore the influencing factors of vaccination for rabies exposed populations.(4)Considering the infectivity of dogs during the incubation period of rabies,the exposed population is divided into non disease risk and disease risk exposed populations.A rabies transmission dynamics model is established,which includes two types of exposed populations.The transmission mechanism of rabies is explained,and the population exposure and incidence of rabies in Guangdong Province under different dog and human vaccine coverage rates are fitted.The decision tree model is used to calculate the cost-effectiveness of different vaccination strategies.Main results:(1)From 2010 to2019,the main levels of exposure to rabies in Guangdong Province were level II and III,with the main injurious animals being domestic dogs and cats.The number of exposed individuals was concentrated from July to October.The exposure rate of rabies in Guangdong Province has increased year by year,but the incidence rate has decreased year by year,suggesting that the effect of rabies prevention and control in Guangdong Province is significant.(2)The meteorological factor that has the greatest impact on the number of rabies exposures in Guangdong Province is the monthly average temperature.The higher the temperature,the greater the risk of rabies exposure.(3)The wound site,injuring animals,exposure grade,and number of wounds of the exposed population are important influencing factors for their complete vaccination against rabies.(4)The higher the coverage rate of canine vaccines,the lower the virus carrying rate of dogs,and the better the cost-effectiveness of vaccinating dogs;The model shows that when the coverage rate of rabies vaccine in the dog population increases to over 60%,the number of rabies cases in the population of Guangdong Province will be controlled within 1 in 2019.Conclusions:From 2010 to 2019,the number of people exposed to rabies in Guangdong Province has been increasing year by year,and an increase in temperature will promote exposure opportunities for dog injuries;The overall vaccination rate of rabies vaccine shows a downward trend,and the factors affecting the overall vaccination are the wound site and the injured animals;The cost effectiveness of population vaccination strategies is lower,while the cost effectiveness of vaccinating dogs is higher.