Schistosomiasis screening in non-endemic countries from a cost perspective: Knowledge gaps and research priorities. The case of African long-term residents in a Metropolitan Area, Spain.

Autor: Roure S; International Health Program (PROSICS), Direcció Territorial de Malalties Infeccioses Metropolitana Nord, Institut Català de la Salut, Badalona, Spain.; Fight and Infectious Diseases Foundation, Badalona, Spain.; Infectious Diseases Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain., López F; Centre de Recerca en Economia de la Salut (CRES), Universitat Pompeu Fabra, Barcelona, Spain.; Grup de Recerca en Innovació, Economia de la Salut i Transformació Digital (Institut de Recerca Germans Trias i Pujol-IGTP), Badalona, Spain.; Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Badalona, Spain., Oliva I; Grup de Recerca en Innovació, Economia de la Salut i Transformació Digital (Institut de Recerca Germans Trias i Pujol-IGTP), Badalona, Spain., Pérez-Quílez O; International Health Program (PROSICS), Direcció Territorial de Malalties Infeccioses Metropolitana Nord, Institut Català de la Salut, Badalona, Spain., March O; Grup de Recerca en Innovació, Economia de la Salut i Transformació Digital (Institut de Recerca Germans Trias i Pujol-IGTP), Badalona, Spain., Chamorro A; Fight and Infectious Diseases Foundation, Badalona, Spain., Abad E; Fight and Infectious Diseases Foundation, Badalona, Spain., Muñoz IL; International Health Program (PROSICS), Direcció Territorial de Malalties Infeccioses Metropolitana Nord, Institut Català de la Salut, Badalona, Spain., Castillo A; International Health Program (PROSICS), Direcció Territorial de Malalties Infeccioses Metropolitana Nord, Institut Català de la Salut, Badalona, Spain., Soldevila L; International Health Program (PROSICS), Direcció Territorial de Malalties Infeccioses Metropolitana Nord, Institut Català de la Salut, Badalona, Spain.; Infectious Diseases Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain., Valerio L; International Health Program (PROSICS), Direcció Territorial de Malalties Infeccioses Metropolitana Nord, Institut Català de la Salut, Badalona, Spain., Lozano M; Neurology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain., Masnou H; Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain., Oliveira M; Urology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain., Cañas L; Nephrology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain., Gibrat M; Primary Health Care Unit Canovelles, North Metropolitan Health Region from Barcelona, Institut Català de la Salut, Granollers, Spain., Chuecos M; Primary Health Care Unit Mataró-3 (Rocafonda-Palau), North Metropolitan Health Region from Barcelona, Institut Català de la Salut, Badalona, Spain., Montero JJ; Primary Health Care Unit Mataró-3 (Rocafonda-Palau), North Metropolitan Health Region from Barcelona, Institut Català de la Salut, Badalona, Spain., Colmenares K; Unitat de Suport Assistencial i Avaluació (USUAiA), Direcció d'Atenció Primària Metropolitana Nord, Institut Català de la Salut, Sabadell, Spain., Falguera G; North Metropolitan Primary Care Directorate, Instiut Català de la Salut, Sabadell, Spain., Bonet JM; North Metropolitan Primary Care Directorate, Instiut Català de la Salut, Sabadell, Spain., Isnard M; North Metropolitan Primary Care Directorate, Instiut Català de la Salut, Sabadell, Spain., Prat N; North Metropolitan Primary Care Directorate, Instiut Català de la Salut, Sabadell, Spain., Estrada O; Grup de Recerca en Innovació, Economia de la Salut i Transformació Digital (Institut de Recerca Germans Trias i Pujol-IGTP), Badalona, Spain.; Directorate for Innovation and Interdisciplinary Cooperation, North Metropolitan Territorial Health Region, Institut Català de la Salut, Badalona, Spain., Clotet B; Fight and Infectious Diseases Foundation, Badalona, Spain.; IrsiCaixa-Institut de Recerca de La SIDA, Hospital Universitari Germans Trias I Pujol, Badalona, Spain.; Direcció Territorial Malalties Infeccioses, North Metropolitan Territorial Health Region, Institut Català de la Salut, Badalona, Spain., Vallès X; International Health Program (PROSICS), Direcció Territorial de Malalties Infeccioses Metropolitana Nord, Institut Català de la Salut, Badalona, Spain.; Fight and Infectious Diseases Foundation, Badalona, Spain.; Institut de Recerca Germans Trias i Pujol, Badalona, Spain.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2023 Apr 04; Vol. 17 (4), pp. e0011221. Date of Electronic Publication: 2023 Apr 04 (Print Publication: 2023).
DOI: 10.1371/journal.pntd.0011221
Abstrakt: Background: Imported schistosomiasis is an emerging issue in European countries as a result of growing global migration from schistosomiasis-endemic countries, mainly in sub-Saharan Africa. Undetected infection may lead to serious long-term complications with an associated high cost for public healthcare systems especially among long-term migrants.
Objective: To evaluate from a health economics perspective the introduction of schistosomiasis screening programs in non-endemic countries with high prevalence of long-term migrants.
Methodology: We calculated the costs associated with three approaches-presumptive treatment, test-and-treat and watchful waiting-under different scenarios of prevalence, treatment efficacy and the cost of care resulting from long-term morbidity. Costs were estimated for our study area, in which there are reported to reside 74,000 individuals who have been exposed to the infection. Additionally, we methodically reviewed the potential factors that could affect the cost/benefit ratio of a schistosomiasis screening program and need therefore to be ascertained.
Results: Assuming a 24% prevalence of schistosomiasis in the exposed population and 100% treatment efficacy, the estimated associated cost per infected person of a watchful waiting strategy would be €2,424, that of a presumptive treatment strategy would be €970 and that of a test-and-treat strategy would be €360. The difference in averted costs between test-and-treat and watchful waiting strategies ranges from nearly €60 million in scenarios of high prevalence and treatment efficacy, to a neutral costs ratio when these parameters are halved. However, there are important gaps in our understanding of issues such as the efficacy of treatment in infected long-term residents, the natural history of schistosomiasis in long-term migrants and the feasibility of screening programs.
Conclusion: Our results support the roll-out of a schistosomiasis screening program based on a test-and-treat strategy from a health economics perspective under the most likely projected scenarios, but important knowledge gaps should be addressed for a more accurate estimations among long-term migrants.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Roure et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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