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Cost-effectiveness modelling to optimise active screening strategy for gambiense human African trypanosomiasis in endemic areas of the Democratic Republic of Congo

Davis, C. N. and Rock, K. S. and Antillón, M. and Miaka, E. M. and Keeling, M. J.. (2021) Cost-effectiveness modelling to optimise active screening strategy for gambiense human African trypanosomiasis in endemic areas of the Democratic Republic of Congo. BMC Med, 19. p. 86.

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Abstract

BACKGROUND: Gambiense human African trypanosomiasis (gHAT) has been brought under control recently with village-based active screening playing a major role in case reduction. In the approach to elimination, we investigate how to optimise active screening in villages in the Democratic Republic of Congo, such that the expenses of screening programmes can be efficiently allocated whilst continuing to avert morbidity and mortality. METHODS: We implement a cost-effectiveness analysis using a stochastic gHAT infection model for a range of active screening strategies and, in conjunction with a cost model, we calculate the net monetary benefit (NMB) of each strategy. We focus on the high-endemicity health zone of Kwamouth in the Democratic Republic of Congo. RESULTS: High-coverage active screening strategies, occurring approximately annually, attain the highest NMB. For realistic screening at 55% coverage, annual screening is cost-effective at very low willingness-to-pay thresholds (20.4 per disability adjusted life year (DALY) averted), only marginally higher than biennial screening (14.6 per DALY averted). We find that, for strategies stopping after 1, 2 or 3 years of zero case reporting, the expected cost-benefits are very similar. CONCLUSIONS: We highlight the current recommended strategy-annual screening with three years of zero case reporting before stopping active screening-is likely cost-effective, in addition to providing valuable information on whether transmission has been interrupted.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Household Economics and Health Systems Research > Health Systems and Policy (Tediosi)
UniBasel Contributors:Antillon, Marina
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1741-7015 (Electronic)1741-7015 (Linking)
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:20 Dec 2022 09:40
Deposited On:20 Dec 2022 09:40

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