Control programs for strongyloidiasis in areas of high endemicity: an economic analysis of different approaches.

IF 4.8 1区 医学 Q1 INFECTIOUS DISEASES
Dora Buonfrate, Lorenzo Zammarchi, Zeno Bisoffi, Antonio Montresor, Sara Boccalini
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引用次数: 0

Abstract

Background: Implementation of control programmes for Strongyloides stercoralis infection is among the targets of the World Health Organization Roadmap to 2030. Aim of this work was to evaluate the possible impact in terms of economic resources and health status of two different strategies of preventive chemotherapy (PC) compared to the current situation (strategy A, no PC): administration of ivermectin to school-age children (SAC) and adults (strategy B) versus ivermectin to SAC only (strategy C).

Methods: The study was conducted at the IRCCS Sacro Cuore Don Calabria hospital, Negrar di Valpolicella, Verona, Italy, at the University of Florence, Italy, and at the WHO, Geneva, Switzerland, from May 2020 to April 2021. Data for the model were extracted from literature. A mathematical model was developed in Microsoft Excel to assess the impact of strategies B and C in a standard population of 1 million subjects living in a strongyloidiasis endemic area. In a case base scenario, 15% prevalence of strongyloidiasis was considered; the 3 strategies were then evaluated at different thresholds of prevalence, ranging from 5 to 20%. The results were reported as number of infected subjects, deaths, costs, and Incremental-Effectiveness Ratio (ICER). A 1-year and a 10-year horizons were considered.

Results: In the case base scenario, cases of infections would reduce dramatically in the first year of implementation of PC with both strategy B and C: from 172 500 cases to 77 040 following strategy B and 146 700 following strategy C. The additional cost per recovered person was United States Dollar (USD) 2.83 and USD 1.13 in strategy B and C, respectively, compared to no treatment in the first year. For both strategies, there was a downtrend in costs per recovered person with increasing prevalence. The number of adverted deaths was larger for strategy B than C, but cost to advert one death was lower for strategy C than B.

Conclusions: This analysis permits to estimate the impact of two PC strategies for the control of strongyloidiasis in terms of costs and adverted infections/deaths. This could represent a basis on which each endemic country can evaluate which strategy can be implemented, based on available funds and national health priorities.

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强直性脊柱炎高流行地区的控制计划:对不同方法的经济分析。
背景:实施盘尾丝虫感染控制计划是世界卫生组织 2030 年路线图的目标之一。这项工作旨在评估两种不同的预防性化疗(PC)策略与当前情况(策略 A,无 PC)相比在经济资源和健康状况方面可能产生的影响:对学龄儿童(SAC)和成人施用伊维菌素(策略 B)与仅对学龄儿童(SAC)施用伊维菌素(策略 C):研究于 2020 年 5 月至 2021 年 4 月在意大利维罗纳 Negrar di Valpolicella 的 IRCCS Sacro Cuore Don Calabria 医院、意大利佛罗伦萨大学和瑞士日内瓦的世界卫生组织进行。模型数据来自文献。用 Microsoft Excel 建立了一个数学模型,以评估策略 B 和 C 对生活在强直性伊蚊病流行地区的 100 万标准人口的影响。在案例基础情景中,考虑了 15%的强直性阿米巴病流行率;然后在 5%至 20%的不同流行阈值下对 3 种策略进行了评估。评估结果以感染人数、死亡人数、成本和增效比(ICER)的形式报告。结果:与第一年不进行治疗相比,策略 B 和策略 C 中每个康复者的额外成本分别为 2.83 美元和 1.13 美元。对于这两种策略,随着流行率的增加,每名康复者的成本呈下降趋势。策略 B 的广告死亡人数多于策略 C,但策略 C 的广告死亡成本低于策略 B:这项分析可以从成本和广告感染/死亡人数的角度估算两种 PC 策略对控制强直性阿米巴病的影响。这可以为每个流行国家根据可用资金和国家卫生优先事项评估可实施的战略提供依据。
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来源期刊
Infectious Diseases of Poverty
Infectious Diseases of Poverty Medicine-Public Health, Environmental and Occupational Health
CiteScore
16.70
自引率
1.20%
发文量
368
审稿时长
13 weeks
期刊介绍: Infectious Diseases of Poverty is a peer-reviewed, open access journal that focuses on essential public health questions related to infectious diseases of poverty. It covers a wide range of topics and methods, including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies, and their application. The journal also explores the impact of transdisciplinary or multisectoral approaches on health systems, ecohealth, environmental management, and innovative technologies. It aims to provide a platform for the exchange of research and ideas that can contribute to the improvement of public health in resource-limited settings. In summary, Infectious Diseases of Poverty aims to address the urgent challenges posed by infectious diseases in impoverished populations. By publishing high-quality research in various areas, the journal seeks to advance our understanding of these diseases and contribute to the development of effective strategies for prevention, diagnosis, and treatment.
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