Modelling geographic variation in the cost-effectiveness of control policies for infectious vector diseases: The example of Chagas disease

Castillo-Riquelme, Marianela; Chalabi, Zaid; Lord, Joanne; Guhl, Felipe; Campbell-Lendrum, Diarmid; Davies, Clive R.; Fox-Rushby, Julia

doi:10.1016/j.jhealeco.2007.04.005

Cited by 18 publications

(11 citation statements)

References 35 publications

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“…These rough estimations nonetheless seem to suggest that preventing Chagas disease in Colombia may be cost-effective in comparison to treating disease, with the potential of accruing not only economic savings, as well as more importantly, avoiding disability and suffering. A more comprehensive analysis on the cost-effectiveness of control activities over time is addressed in a separate paper [32], where the incremental net benefit of control activities in specific geographic locations of Colombia is determined.…”

Section: Discussionmentioning

confidence: 99%

The Costs of Preventing and Treating Chagas Disease in Colombia

et al. 2008

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BackgroundThe objective of this study is to report the costs of Chagas disease in Colombia, in terms of vector disease control programmes and the costs of providing care to chronic Chagas disease patients with cardiomyopathy.MethodsData were collected from Colombia in 2004. A retrospective review of costs for vector control programmes carried out in rural areas included 3,084 houses surveyed for infestation with triatomine bugs and 3,305 houses sprayed with insecticide. A total of 63 patient records from 3 different hospitals were selected for a retrospective review of resource use. Consensus methodology with local experts was used to estimate care seeking behaviour and to complement observed data on utilisation.FindingsThe mean cost per house per entomological survey was $4.4 (in US$ of 2004), whereas the mean cost of spraying a house with insecticide was $27. The main cost driver of spraying was the price of the insecticide, which varied greatly. Treatment of a chronic Chagas disease patient costs between $46.4 and $7,981 per year in Colombia, depending on severity and the level of care used. Combining cost and utilisation estimates the expected cost of treatment per patient-year is $1,028, whereas lifetime costs averaged $11,619 per patient. Chronic Chagas disease patients have limited access to healthcare, with an estimated 22% of patients never seeking care.ConclusionChagas disease is a preventable condition that affects mostly poor populations living in rural areas. The mean costs of surveying houses for infestation and spraying infested houses were low in comparison to other studies and in line with treatment costs. Care seeking behaviour and the type of insurance affiliation seem to play a role in the facilities and type of care that patients use, thus raising concerns about equitable access to care. Preventing Chagas disease in Colombia would be cost-effective and could contribute to prevent inequalities in health and healthcare.

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Section: Discussionmentioning

confidence: 99%

The Costs of Preventing and Treating Chagas Disease in Colombia

et al. 2008

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“…A number of studies around the world have demonstrated that environmental, demographic and statistical data about the ecology of VL can provide the basis for the development of spatial, predictive risk models (Peterson and Shaw, 2003;Castillo-Riquelme et al, 2008;Salahi-Moghaddam et al, 2010). Geographical information systems (GIS) can be applied for risk mapping and identifying endemic areas for diseases (Elnaiem et al, 2003;Rinaldi et al, 2006;Pezeshki et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Environmental modelling of visceral leishmaniasis by susceptibility-mapping using neural networks: a case study in north-western Iran

et al. 2014

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Abstract. Visceral leishmaniasis (VL) is a potentially fatal vector-borne zoonotic disease, which has become an increasing public health problem in the north-western part of Iran. This work presents an environmental health modelling approach to map the potential of VL outbreaks in this part of the country. Radial basis functional link networks is used as a data-driven method for predictive mapping of VL in the study area. The high susceptibility areas for VL outbreaks account for 36.3% of the study area and occur mainly in the north (which may affect the neighbouring countries) and South (which is a warning for other provinces in Iran). These parts of the study area have many nomadic, riverside villages. The overall accuracy of the resultant map was 92% in endemic villages. Such susceptibility maps can be used as reconnaissance guides for planning of effective control strategies and identification of possible new VL endemic areas.

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“…Lifetime reported Chagas‐related clinical symptoms occur in a range from 20% to 30% of infected individuals [13] . In previous models a lag of 15 to 20 years in indeterminate phase of Chagas is followed by a variable percentage of the cohort progressing to clinically evident Chagas [14],[15] . Assuming a faster disease progression in the transfused population, we modeled a 10‐year negligible annual transition rate followed by transition increase of 1.087 to clinical symptoms each year thereafter [16] …”

Section: Technical Appendixmentioning

confidence: 99%