Health and economic burden of rabies in northwest Ethiopia

Background: Rabies remains a significant threat to both public health and economic stability across many developing countries. The challenge of effectively managing and preventing rabies is compounded by insufficient quantitative data regarding its financial and health consequences. Despite Ethiopia being one of the most-affected countries in the world, data on the public health and economic burden of rabies are limited.

Objective: This research aimed to quantify both the health and economic burden of rabies in northwest Ethiopia.

Method: Follow-up and recording of potential rabies cases were conducted for 18 months in seven districts of northwest Ethiopia. Data were collected from potential rabies cases using a pre-planned checklist. The health and economic burden were quantified using deterministic models. The study primarily adopted a household/patient perspective, focusing on the direct financial burdens faced by individuals and families.

Results: In the follow-up period, approximately 353 individuals were recorded as rabies victims. Among them, 126 households with suspected rabies cases were treated with traditional medicine, while 60 individuals from 59 households received post-exposure prophylaxis. The annual premature death rate due to rabies was estimated to be 3.14 per 100,000 population. The annual years of life lost due to premature death was estimated to be 90.69 per 100,000 population. Years lived with disability due to rabies illness, disability due to post-exposure vaccine, and traditional treatment were estimated to be 0.68 per 100,000 population. The annual health burden of rabies was estimated to be 91.34 disability-adjusted life years per 100,000 people. The total cost for rabies control measures in humans was estimated to be United States (US) $11,474.66. On average, each household spent US $40.55 on post-exposure prophylaxis, with an annual cost of US $27.03 per household. Regarding livestock, the losses due to rabies were estimated to be US $29,599.85 annually, which translates to an approximate loss of US $274.07 per household per year.

Conclusion: The findings emphasise the need for targeted interventions to mitigate rabies’ disproportionate impact on vulnerable communities, aligning with global efforts to eliminate the disease by 2030. A One Health approach that integrates rabies control in human and animal health is suggested.