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

作　　者：Dora Buonfrate Lorenzo Zammarchi Zeno Bisoffi Antonio Montresor Sara Boccalin 

机构地区：[1]Department of Infectious Tropical Diseases and Microbiology,IRCCS Sacro Cuore Don Calabria Hospital,Negrar,Verona,Italy [2]Department of Experimental and Clinical Medicine,University of Florence,Florence,Italy [3]Referral Center for Tropical Diseases of Tuscany,Infectious and Tropical Diseases Unit,Careggi University Hospital,Florence,Italy. [4]Department of Diagnostics and Public Health,University ofVerona,Verona,Italy [5]Department of Control of Neglected Tropical Diseases,World Health Organization,Geneva,Switzerland [6]Department of Health Sciences,University of Florence,Florenee,Italy.

出　　处：《Infectious Diseases of Poverty》2021年第3期72-81,共10页贫困所致传染病（英文）

基　　金：funded by the Italian Ministry of Health"Fondi Ricerca Corrente-L2P2"to IRCCS Sacro Cuore Don Calabria Hospital,Negrar,Verona,Italy and by funds of"Ministry of Education,University and Research(Italy)Excellence Departments 2018-2022"Project for the Department of Experimental and Clinical Medicine,University of Florenee,Florenee,Italy.

摘　　要：Background:Implementation of control programmes for Strongyloides stercoralis infection is among the targets of the World Health Organization Roadmap to 2030.Aim ofthis 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 seenario,15%prevalence of strongyloidiasis was considered;the 3 strategies were then evaluated at different thresholds of prevalenee,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 seenario,cases of infections would reduce dramatically in the first year of implementation of PC with both strategy B and C:from 172500 cases to 77040 following strategy B and 146700 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 prevalenee.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.T

关 键 词：Strongyloides stercoralis STRONGYLOIDIASIS Control programme Preventive chemotherapy IVERMECTIN Economic Adverted death Adverted infection 

分 类 号：R532.1[医药卫生—内科学]