02531nas a2200421   4500000000100000008004100001653001600042653001300058653001100071653001600082653000900098653001100107653001100118653001100129653000900140653002000149653002100169653001000190653002100200653001200221653002200233653000900255653001000264653001500274100001200289700001700301700001500318700001200333700001200345700001300357700001400370245007400384856007800458300001000536490000600546520154300552022001402095       2013                            d10aYoung Adult10aTanzania10aRabies10aMiddle Aged10aMale10aInfant10aHumans10aFemale10aDogs10aCost of Illness10aChild, Preschool10aChild10aBites and Stings10aAnimals10aAged, 80 and over10aAged10aAdult10aAdolescent1 aSambo M1 aCleaveland S1 aFerguson H1 aLembo T1 aSimon C1 aUrassa H1 aHampson K00aThe burden of rabies in Tanzania and its impact on local communities.  uhttp://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0002510  ae25100 v73 a<p><strong>BACKGROUND: </strong>Rabies remains a major public health threat in many parts of the world and is responsible for an estimated 55,000 human deaths annually. The burden of rabies is estimated to be around US$20 million in Africa, with the highest financial expenditure being the cost of post-exposure prophylaxis (PEP). However, these calculations may be substantial underestimates because the costs to households of coping with endemic rabies have not been investigated. We therefore aimed to estimate the household costs, health-seeking behaviour, coping strategies, and outcomes of exposure to rabies in rural and urban communities in Tanzania.</p>

<p><strong>METHODS AND FINDINGS: </strong>Extensive investigative interviews were used to estimate the incidence of human deaths and bite exposures. Questionnaires with bite victims and their families were used to investigate health-seeking behaviour and costs (medical and non-medical costs) associated with exposure to rabies. We calculated that an average patient in rural Tanzania, where most people live on less than US$1 per day, would need to spend over US$100 to complete WHO recommended PEP schedules. High costs and frequent shortages of PEP led to poor compliance with PEP regimens, delays in presentation to health facilities, and increased risk of death.</p>

<p><strong>CONCLUSION: </strong>The true costs of obtaining PEP were twice as high as those previously reported from Africa and should be considered in re-evaluations of the burden of rabies.</p>
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