Volume 72, Issue 9 (December 2014)                   Tehran Univ Med J 2014, 72(9): 630-637 | Back to browse issues page

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Esmaeilzadeh F, Hatam N, Esmaeilzadeh Z, Rajabi A, Anami M, Vahedi S et al . Effectiveness of post-exposure rabies prophylaxis. Tehran Univ Med J 2014; 72 (9) :630-637
URL: http://tumj.tums.ac.ir/article-1-6388-en.html
1- Department of Health Economics, Tehran University of Medical Sci-ences, Tehran, Iran.
2- Department of Health Service Administration, School of Man-agement and Information Scienc-es, Shiraz University of Medical Sciences, Shiraz, Iran.
3- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran.
4- Department of Epidemiology, Iran University of Medical Sciences, Tehran, Iran. , rajabiepid@gmail.com
5- Department of Health Economics, Shiraz University of Medical Sci-ences, Shiraz, Iran.
6- Department of Epidemiology, Tehran University of Medical Sciences, Tehran, Iran.
Abstract:   (6297 Views)
Background: The rabies is a deadly disease and if its symptoms break out in a person, he will certainly die. However, the deaths caused rabies can be prevented by post-exposure prophylaxis (PEP). Methods: In this study, subjects were recruited through census and with respect to in-formation which gathered from Fars Province health centers, Pasteur institution and previous studies In Iran. The mortalities for age groups and by sex type have been cal-culated. The decision tree model using probabilities, which the effectiveness of PEP treatment after getting bitten by an animal suspected, persons to receive specified. Dis-ability adjusted life year score (DALY) was applied to estimate the DALYs saved from PEP. In this study it was assumed that if a person suffering with rabies, a few days af-ter the onset of symptoms, death is compulsory. Therefore YLD rabies was considered zero. Finally, to increasing the accuracy and because inherent uncertainty of the data, and the increase the power of analysis, one-way sensitivity analysis was used. Results: From March 2011 to March 2012, in Fars Province, total cases of animal bites were reported and received PEP treatment. The cases were 5394 (75.85%) male and 1717 (24.15%) female. PEP generally prevented from 177.076 deaths which 134.096 (75.72%) were men and 42.98 (24.27%) of them were women. The age distribution of suspected animal bites in youth more than adults, and in men higher than women. Also due to prevented mortality caused by PEP, it is prevented from 4455.71 DALYs. Based on the sensitivity analysis DALY prevented, except for dogs and cats, there was no change in the other animals. Conclusion: The implementation of PEP for animal bitten people remarkably reduced the burden of disease in community. Calculations with primitive cost estimations im-plicitly revealed that this intervention is a most cost-effectiveness program.
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