dc.contributor.author |
Kim, Young E. |
dc.contributor.author |
Sicuri, Elisa |
dc.contributor.author |
Tediosi, Fabrizio |
dc.date |
2016-02-03T09:19:30Z |
dc.date |
2016-02-03T09:19:30Z |
dc.date |
2015-09-11 |
dc.date |
2016-02-02T15:33:39Z |
dc.identifier.citation |
1935-2727 |
dc.identifier.uri |
http://hdl.handle.net/2445/69171 |
dc.format |
17 p. |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
Public Library of Science (PLoS) |
dc.relation |
Reproducció del document publicat a:
http://dx.doi.org/10.1371/journal.pntd.0004056 |
dc.relation |
PLoS Neglected Tropical Diseases, 2015, vol. 9, num. 9, p. e0004056 |
dc.relation |
http://dx.doi.org/10.1371/journal.pntd.0004056 |
dc.rights |
cc by (c) Kim et al., 2015 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.rights |
http://creativecommons.org/licenses/by/3.0/es/ |
dc.subject |
Malalties parasitàries |
dc.subject |
Epidemiologia |
dc.subject |
Àfrica subsahariana |
dc.subject |
Anàlisi econòmica |
dc.subject |
Oncocercosi |
dc.subject |
Parasitic diseases |
dc.subject |
Epidemiology |
dc.subject |
Sub-Saharan Africa |
dc.subject |
Economic analysis |
dc.subject |
Onchocerciasis |
dc.title |
Financial and Economic Costs of the Elimination and Eradication
of Onchocerciasis (River Blindness) in Africa |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/publishedVersion |
dc.description.abstract |
BACKGROUND: Onchocerciasis (river blindness) is a parasitic
disease transmitted by blackflies. Symptoms include severe
itching, skin lesions, and vision impairment including
blindness. More than 99% of all cases are concentrated in
sub-Saharan Africa. Fortunately, vector control and
community-directed treatment with ivermectin have significantly
decreased morbidity, and the treatment goal is shifting from
control to elimination in Africa. METHODS: We estimated
financial resources and societal opportunity costs associated
with scaling up community-directed treatment with ivermectin and
implementing surveillance and response systems in endemic
African regions for alternative treatment goals-control,
elimination, and eradication. We used a micro-costing approach
that allows adjustment for time-variant resource utilization and
for the heterogeneity in the demographic, epidemiological, and
political situation. RESULTS: The elimination and eradication
scenarios, which include scaling up treatments to hypo-endemic
and operationally challenging areas at the latest by 2021 and
implementing intensive surveillance, would allow savings of $1.5
billion and $1.6 billion over 2013-2045 as compared to the
control scenario. Although the elimination and eradication
scenarios would require higher surveillance costs ($215 million
and $242 million) than the control scenario ($47 million),
intensive surveillance would enable treatments to be safely
stopped earlier, thereby saving unnecessary costs for prolonged
treatments as in the control scenario lacking such surveillance
and response systems. CONCLUSIONS: The elimination and
eradication of onchocerciasis are predicted to allow substantial
cost-savings in the long run. To realize cost-savings,
policymakers should keep empowering community volunteers, and
pharmaceutical companies would need to continue drug donation.
To sustain high surveillance costs required for elimination and
eradication, endemic countries would need to enhance their
domestic funding capacity. Societal and political will would be
critical to sustaining all of these efforts in the long term. |