Cost-effectiveness of prevention strategies for American tegumentary leishmaniasis in Argentina

Orellano, Pablo Wenceslao; Vázquez, Néstor; Salomón, Oscar Daniel

doi:10.1590/0102-311x00172512

Cited by 17 publications

(21 citation statements)

References 42 publications

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“…(2013) in Argentina provided a cost-effective analysis of staining workers' clothes and mosquito nets with pyrethroids compared versus the strategy of training workers providing services for early diagnosis and/or treatment of CL and finally found out that the strategy of using pyrethroids was not cost-effective. [17] Asilian (2002) reported the effectiveness of staining Iranian soldiers' clothes with permethrin to prevent CL is close to zero. Aflatoonian et al .…”

Section: Discussionmentioning

confidence: 99%

“…According to Murray and Lopez study on global burden of disease, we applied a disability weight of 0.023 due to CL. [171920] Disability duration, i.e., the time a patient lives with the disability due to the disease, was estimated at 0.25 years or 3 months. [111617] To calculate DALYs, incidence rate in target population in a given year was multiplied by disability duration and disability weight.…”

Section: Methodsmentioning

confidence: 99%

“…[7161718] Although this strategy is being carried out annually in the infected areas of the Isfahan province, the cost-effectiveness of this strategy has not yet been analyzed.…”

Section: Introductionmentioning

confidence: 99%

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Economic evaluation of using pesticides to control cutaneous leishmaniasis in Isfahan

et al. 2018

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Objective:Pesticides have been used as the main part of the national cutaneous leishmaniasis control program for serveral years in Iran. However, the cost-effectiveness of this strategy has not been yet analyzed. The aim of this study is to to analyze the cost-effectiveness and cost-utility of using pesticides as the main strategy to prevent rural CL in Isfahan.Methods:This is an economic evaluation study performed from a health system perspective to estimate the cost-effectiveness and cost-utility of the control strategy with and without pesticides. The outcome measures are incidence rate of cutaneous leishmaniasis and the disability-adjusted life years (DALYs). The cost-effectiveness and cost-utility have been analyzed by calculating incremental cost-effectiveness ratio (ICER). Data of cost and incidence rate obtained from the health centers of Isfahan University of Medical Sciences and Vice-Chancellery for Health. The disability weight was obtained from the literature. A one-way sensitivity analysis was applied with a 20% increase and decrease in costs.Findings:The total cost of control program in 2013 and 2014 were US$578,453 (ppp) and US$14,978.2 (ppp), respectively. The incidence rate of cutaneous leishmaniasis was estimated at 1396 and 1277 (per 100,000 population in hyperendemic areas where pesticides have been used) in 2013 and 2014, respectively. DALY lost due to disease was estimated to be 8.024 and 7.342 in 2013 and 2014, correspondingly. Both the cost-effectiveness and the cost-utility analyses resulted in negative ICERs, lying in the rejection area of the ICER plane.Conclusion:The use of pesticides to prevent cutaneous leishmaniasis (rural sicker) in Isfahan province has not proved to offer a reduction in the incidence rate of cutaneous leishmaniasis as well as reduction in DALYs lost. However, due to data availability limitation, the time frame for this study was limited. A prospective design with longitudinal data is recommended to be used by future research. Other alternatives to raise population awareness about different aspects of disease should be also considered for evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Economic evaluation of using pesticides to control cutaneous leishmaniasis in Isfahan

et al. 2018

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“…The use of any kind of insecticide will reduce the

R_{0}

output value. The application of insecticide‐impregnated clothing and curtains are cost‐effective preventive strategies for reducing leishmaniasis transmission . However, some insecticides might be undesirable because of there side effects, and they should be used cautiously.…”

Section: Sensitivity Analysis Of R0mentioning

confidence: 99%

“…Educating people at places where leishmaniasis is present, and an opportune treatment are important measures for the management and control of cutaneous leishmaniasis. Improper treatment elevates the risk of the infected person developing mucocutaneous leishmaniasis …”

Section: Sensitivity Analysis Of R0mentioning

confidence: 99%

Cutaneous leishmaniasis in Peru using a vector‐host model: Backward bifurcation and sensitivity analysis

Barradas

Rivera

2018

Math Methods in App Sciences

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The final goal of control policies in neglected vector‐borne diseases in developing countries is to protect humans. These vector‐borne diseases include leishmaniasis, dengue, chagas, and malaria. The traditional control measures for vector‐borne diseases, as with any other illnesses, suggest to reduce the basic reproduction number R0 below the value 1. This strategy is not necessarily sufficient when a backward bifurcation occurs. Because of its worldwide relevance, we are interested in modeling cutaneous leishmaniasis with Peru as a specific example. We use a vector‐host model with an extrinsic incubation period, which gives evidence that a backward bifurcation can occur under certain conditions. We estimate some parameters for the cutaneous leishmaniasis model in Peru. The uncertainty of the parameters suggests that we cannot guarantee the avoidance of a backward bifurcation range. It is important to be attentive to the appearance of phenomena that could make eradication more difficult. Local and global sensitivity analyses agree that R0 is most sensitive to the number of bites by a female sandfly and its natural mortality rate. The former dependency suggests very practical control policies.

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Cutaneous Leishmaniasis: Recent Developments in Diagnosis and Management

2015

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This review focuses on recent developments in the diagnosis, treatment, management, and strategies for the prevention and control of cutaneous leishmaniasis (CL) caused by both Old and New World Leishmania species. CL is caused by the vector-borne protozoan parasite Leishmania and is transmitted via infected female sandflies. The disease is endemic in more than 98 countries and an estimated 350 million people are at risk. The overall prevalence is 12 million cases and the annual incidence is 2–2.5 million. The World Health Organization considers CL a severely neglected disease and a category 1 emerging and uncontrolled disease. The management of CL differs from region to region and is primarily based on local experience-based evidence. Most CL patients can be treated with topical treatments, but some Leishmania species can cause mucocutaneous involvement requiring a systemic therapeutic approach. Moreover, Leishmania species can vary in their sensitivity to available therapeutic options. This makes species determination critical for the choice of treatment and the clinical outcome of CL. Identification of the infecting parasite used to be laborious, but now the Leishmania species can be identified relatively easy with new DNA techniques that enable a more rational therapy choice. Current treatment guidelines for CL are based on poorly designed and reported trials. There is a lack of evidence for potentially beneficial treatments, a desperate need for large well-conducted studies, and standardization of future trials. Moreover, intensified research programs to improve vector control, diagnostics, and the therapeutic arsenal to contain further incidence and morbidity are needed.

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Cost-effectiveness of prevention strategies for American tegumentary leishmaniasis in Argentina

Cited by 17 publications

References 42 publications

Economic evaluation of using pesticides to control cutaneous leishmaniasis in Isfahan

Economic evaluation of using pesticides to control cutaneous leishmaniasis in Isfahan

Cutaneous leishmaniasis in Peru using a vector‐host model: Backward bifurcation and sensitivity analysis

Cutaneous Leishmaniasis: Recent Developments in Diagnosis and Management

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