Document type
ArticleVersion
Published versionPublication date
Publication license
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/117625
Cost-effectiveness of diagnostic-therapeutic strategies for paediatric visceral leishmaniasis in Morocco
Journal Title
Director/Tutor
Journal ISSN
Volume Title
Related resource
Abstract
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.
Subject
Subject (English)
Citation
Collections
Citation
ALONSO, Sergi, et al. Cost-effectiveness of diagnostic-therapeutic strategies for
paediatric visceral leishmaniasis in Morocco. BMJ Global Health. 2017. Vol. 2, num. 3, pags. e000315. ISSN 2059-7908. [consulted: 15 of June of 2026]. Available at: https://hdl.handle.net/2445/117625