The Costs of Preventing and Treating Chagas Disease in Colombia

Abstract

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.

Comparative Field Trial of Alternative Vector Control Strategies for Non-Domiciliated Triatoma dimidiata

“…Insecticide spraying had a cost within the lower range of that reported in other studies ($7-48/house). 26,[36][37][38][39][40] However, it should be noted that we did not include transportation costs in our estimate. Impregnated curtains and insect screens had a higher cost, as do most housing improvement strategies, 26,35 but their sustainability would likely make them more cost-effective in the long term.…”

Advances and challenges towards a vaccine against Chagas disease

“…6 Thus treatment can cost up to over 1,000 USD per year and per patient. 7 Prevention currently only relies on vector control, which has considerably reduced disease incidence and prevalence in most Latin America. 8 Nonetheless, a number of triatomine species have proven difficult to control and the most likely scenario is that low level vectorial transmission to humans will be mantained in may regions and countries in spite of vector control interventions.…”

Modeling the economic value of a Chagas’ disease therapeutic vaccine

“…Vaccine profiles are further outlined in Table 2. The desired target vaccine cost of $46 represents the minimum cost of treating chronic Chagas' disease in Colombia; 32 the cost of $200 assumed for the minimally acceptable vaccine target is equal to one fifth of the maximum yearly cost of treatment reported from the same study.…”