Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR

Background Control and elimination of zoonotic diseases requires robust information about their effect on both human and livestock health in order to enable policy formulation and the allocation of resources. This study aimed to evaluate the cost-effectiveness of controlling Taenia solium taeniasis...

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Main Authors: Okello, Walter O., Okello, Anna L., Inthavong, Phouth, Tiemann, Tassilo T., Phengsivalouk, Ammaly, Devleesschauwer, Brecht, Shaw, Alexandra, Allen, John
Format: Journal Article
Language:Inglés
Published: Public Library of Science 2018
Subjects:
Online Access:https://hdl.handle.net/10568/97893
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author Okello, Walter O.
Okello, Anna L.
Inthavong, Phouth
Tiemann, Tassilo T.
Phengsivalouk, Ammaly
Devleesschauwer, Brecht
Shaw, Alexandra
Allen, John
author_browse Allen, John
Devleesschauwer, Brecht
Inthavong, Phouth
Okello, Anna L.
Okello, Walter O.
Phengsivalouk, Ammaly
Shaw, Alexandra
Tiemann, Tassilo T.
author_facet Okello, Walter O.
Okello, Anna L.
Inthavong, Phouth
Tiemann, Tassilo T.
Phengsivalouk, Ammaly
Devleesschauwer, Brecht
Shaw, Alexandra
Allen, John
author_sort Okello, Walter O.
collection Repository of Agricultural Research Outputs (CGSpace)
description Background Control and elimination of zoonotic diseases requires robust information about their effect on both human and livestock health in order to enable policy formulation and the allocation of resources. This study aimed to evaluate the cost-effectiveness of controlling Taenia solium taeniasis/cysticercosis in both humans and pigs, and soil-transmitted helminths (STH) in humans by integrating their control to on-going human and animal health control programmes in northern Lao People’s Democratic Republic. Method A cross-sectional study was carried out in 49 households, focusing on the prevalence of T. solium taenias/cysticercosis and soil transmitted helminths before and after a twelve month intervention. The village data was collected using a semi-structured questionnaire through a door-to-door survey. The village data was then projected to the wider northern Lao PDR population using stochastic modelling and cost-effectiveness ratio (after aggregating the net cost to capture both human and animal health parameters) and GDP per capita as a threshold, to determine the cost-effectiveness of the integrated control of T. solium taeniasis/ cysticercosis and STH, assuming linear scaling out of the intervention. The zoonotic DALY (zDALY) approach was also used as an alternative method of estimating the cost-effectiveness ratio of controlling T. solium taeniasis/cysticercosis in humans and pigs. Findings Using cost-effectiveness analysis after aggregating the net cost and control of T. solium taeniasis/cysticercosis alone as the base case, the study found that simultaneous control of T. solium taeniasis/cysticercosis in humans and pigs, STH in humans and Classical Swine Fever (CSF) in pigs was USD 14 per DALY averted and USD 234 per zDALY averted using zDALY method hence considered highly cost-effective whereas controlling T. solium taeniasis/cysticercosis without incorporating STH and CSF was the least cost-effective (USD 3,672 per DALY averted). Additionally, the cost-effectiveness of controlling T. solium taeniasis/cysticercosis in people and pigs using zDALY as an alternative method was USD 3,662 per zDALY averted which was quite close to our findings using the aggregate net cost method. Conclusion The study showed that control of T. solium taeniasis/cysticercosis alone in humans and pigs is not cost-effective in northern Lao PDR whereas control of STH is. Consequently, integrating T. solium taeniasis/cysticercosis control with other cost-effective programmes such as STH and CSF markedly improved the cost-effectiveness of the intervention. This is especially important in low resource countries where control of zoonotic neglected tropical diseases could be integrated with the human and animal health sectors to optimize use of the limited resources.
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spelling CGSpace978932025-11-12T05:59:31Z Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR Okello, Walter O. Okello, Anna L. Inthavong, Phouth Tiemann, Tassilo T. Phengsivalouk, Ammaly Devleesschauwer, Brecht Shaw, Alexandra Allen, John disease control control de enfermedades taenia solium livestock ganado Background Control and elimination of zoonotic diseases requires robust information about their effect on both human and livestock health in order to enable policy formulation and the allocation of resources. This study aimed to evaluate the cost-effectiveness of controlling Taenia solium taeniasis/cysticercosis in both humans and pigs, and soil-transmitted helminths (STH) in humans by integrating their control to on-going human and animal health control programmes in northern Lao People’s Democratic Republic. Method A cross-sectional study was carried out in 49 households, focusing on the prevalence of T. solium taenias/cysticercosis and soil transmitted helminths before and after a twelve month intervention. The village data was collected using a semi-structured questionnaire through a door-to-door survey. The village data was then projected to the wider northern Lao PDR population using stochastic modelling and cost-effectiveness ratio (after aggregating the net cost to capture both human and animal health parameters) and GDP per capita as a threshold, to determine the cost-effectiveness of the integrated control of T. solium taeniasis/ cysticercosis and STH, assuming linear scaling out of the intervention. The zoonotic DALY (zDALY) approach was also used as an alternative method of estimating the cost-effectiveness ratio of controlling T. solium taeniasis/cysticercosis in humans and pigs. Findings Using cost-effectiveness analysis after aggregating the net cost and control of T. solium taeniasis/cysticercosis alone as the base case, the study found that simultaneous control of T. solium taeniasis/cysticercosis in humans and pigs, STH in humans and Classical Swine Fever (CSF) in pigs was USD 14 per DALY averted and USD 234 per zDALY averted using zDALY method hence considered highly cost-effective whereas controlling T. solium taeniasis/cysticercosis without incorporating STH and CSF was the least cost-effective (USD 3,672 per DALY averted). Additionally, the cost-effectiveness of controlling T. solium taeniasis/cysticercosis in people and pigs using zDALY as an alternative method was USD 3,662 per zDALY averted which was quite close to our findings using the aggregate net cost method. Conclusion The study showed that control of T. solium taeniasis/cysticercosis alone in humans and pigs is not cost-effective in northern Lao PDR whereas control of STH is. Consequently, integrating T. solium taeniasis/cysticercosis control with other cost-effective programmes such as STH and CSF markedly improved the cost-effectiveness of the intervention. This is especially important in low resource countries where control of zoonotic neglected tropical diseases could be integrated with the human and animal health sectors to optimize use of the limited resources. 2018-09 2018-11-08T16:21:23Z 2018-11-08T16:21:23Z Journal Article https://hdl.handle.net/10568/97893 en Open Access application/pdf Public Library of Science Okello, Walter O.; Okello, Anna L.; Inthavong, Phouth; Tiemann, Tassilo; Phengsivalouk, Ammaly; Devleesschauwer, Brecht; Shaw, Alexandra; Allen, John. (2018). Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR. PLOS Neglected Tropical Diseases, 12(9), e0006782.
spellingShingle disease control
control de enfermedades
taenia solium
livestock
ganado
Okello, Walter O.
Okello, Anna L.
Inthavong, Phouth
Tiemann, Tassilo T.
Phengsivalouk, Ammaly
Devleesschauwer, Brecht
Shaw, Alexandra
Allen, John
Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR
title Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR
title_full Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR
title_fullStr Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR
title_full_unstemmed Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR
title_short Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR
title_sort improved methods to capture the total societal benefits of zoonotic disease control demonstrating the cost effectiveness of an integrated control programme for taenia solium soil transmitted helminths and classical swine fever in northern lao pdr
topic disease control
control de enfermedades
taenia solium
livestock
ganado
url https://hdl.handle.net/10568/97893
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