Miniatura

Fitxers

alonso2017_2729.pdf (1.02 MB)

Tipus de document

Article

Versió

Versió publicada

Data de publicació

2017-08-19

Llicència de publicació

cc-by-nc (c) Alonso et al. , 2017
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/117625

Cost-effectiveness of diagnostic-therapeutic strategies for paediatric visceral leishmaniasis in Morocco

Títol de la revista

Autors

Director/Tutor

ISSN de la revista

Títol del volum

Recurs relacionat

http://dx.doi.org/10.1136/bmjgh-2017-000315

Resum

INTRODUCTION: Visceral leishmaniasis (VL) is a neglected parasitic disease with a high fatality rate if left untreated. Endemic in Morocco, as well as in other countries in the Mediterranean basin, VL mainly affects children living in rural areas. In Morocco, the direct observation of Leishmania parasites in bone marrow (BM) aspirates is used to diagnose VL and meglumine antimoniate (SB) is the first line of treatment. Less invasive, more efficacious and safer alternatives exist. In this study we estimate the cost-effectiveness of alternative diagnostic-therapeutic algorithms for paediatric VL in Morocco. METHODS: A decision tree was used to estimate the cost-effectiveness of using BM or rapid diagnostic tests (RDTs) as diagnostic tools and/or SB or two liposomal amphotericin B (L-AmB) regimens: 6-day and 2-day courses to treat VL. Incremental cost-effectiveness ratios, expressed as cost per death averted, were estimated by comparing costs and effectiveness of the alternative algorithms. A threshold analysis evaluated at which price L-AmB became cost-effective compared with current practices. RESULTS: Implementing RDT and/or L-AmB treatments would be cost-effective in Morocco according to the WHO thresholds. Introducing the 6-day course L-AmB, current second-line treatment, would be highly cost-effective if L-AmB price was below US$100/phial. The 2-day L-AmB treatment, current standard treatment of paediatric VL in France, is highly cost-effective, with L-AmB at its market price (US$165/phial). CONCLUSIONS: The results of this study should encourage the implementation of RDT and/or short-course L-AmB treatments for paediatric VL management in Morocco and other North African countries.

Matèries

Leishmaniosi, Marroc, Pediatria, Economia de la salut

Matèries (anglès)

Leishmaniasis, Morocco, Pediatrics, Medical economics

Citació

Col·leccions

Articles publicats en revistes (ISGlobal)

Citació

ALONSO, Sergi, TACHFOUTI, Nabil, NAJDI, Adil, SICURI, Elisa, PICADO DE PUIG, Albert. Cost-effectiveness of diagnostic-therapeutic strategies for
                paediatric visceral leishmaniasis in Morocco. _BMJ Global Health_. 2017. Vol. 2, núm. 3, pàgs. e000315. [consulta: 3 de febrer de 2026]. ISSN: 2059-7908. [Disponible a: https://hdl.handle.net/2445/117625]

Exportar metadades

JSON - METS

Compartir registre