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

# metadata.dc.description.abstract[].value
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.

# metadata.dc.relation.isformatof[].value
Reproducció del document publicat a:
                http://dx.doi.org/10.1136/bmjgh-2017-000315

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Cost-effectiveness of diagnostic-therapeutic strategies for
                paediatric visceral leishmaniasis in Morocco