Congenital Chagas Disease in the United States: The Effect of Commercially Priced Benznidazole on Costs and Benefits of Maternal Screening
| Autor: | Eileen Stillwaggon, Stephanie R. Bialek, Victoria Perez-Zetune, Susan P. Montgomery |
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| Rok vydání: | 2020 |
| Předmět: |
Chagas disease
Pediatrics medicine.medical_specialty Cost-Benefit Analysis 030231 tropical medicine 03 medical and health sciences 0302 clinical medicine Cost Savings Pregnancy Virology medicine Humans Mass Screening Chagas Disease Targeted screening health care economics and organizations Cost–benefit analysis business.industry Articles medicine.disease Trypanocidal Agents Infectious Disease Transmission Vertical United States Infectious Diseases Nitroimidazoles Benznidazole Pregnancy Complications Parasitic Cohort Gestation Female Parasitology Congenital transmission business medicine.drug |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene |
| ISSN: | 1476-1645 0002-9637 |
| DOI: | 10.4269/ajtmh.20-0005 |
| Popis: | Chagas disease, caused by Trypanosoma cruzi, is transmitted by insect vectors, and through transfusions, transplants, insect feces in food, and mother to child during gestation. An estimated 30% of infected persons will develop lifelong, potentially fatal cardiac or digestive complications. Treatment of infants with benznidazole is highly efficacious in eliminating infection. This work evaluates the costs of maternal screening and infant testing and treatment for Chagas disease in the United States, including the cost of commercially available benznidazole. We compare costs of testing and treatment for mothers and infants with the lifetime societal costs without testing and consequent morbidity and mortality due to lack of treatment or late treatment. We constructed a decision-analytic model, using one tree that shows the combined costs for every possible mother–child pairing. Savings per birth in a targeted screening program are $1,314, and with universal screening, $105 per birth. At current screening costs, universal screening results in $420 million in lifetime savings per birth-year cohort. We found that a congenital Chagas screening program in the United States is cost saving for all rates of congenital transmission greater than 0.001% and all levels of maternal prevalence greater than 0.06% compared with no screening program. |
| Databáze: | OpenAIRE |
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