RESUMEN
The World Bank Loan Project for schistosomiasis in China commenced field activities in 1992. In this paper, we describe disease control strategies for levels of different endemicity, and estimate unit costs and total expenditure of screening, treatment (cattle and humans) and snail control for 8 provinces where Schistosoma japonicum infection is endemic. Overall, we estimate that more than 21 million US dollars were spent on field activities during the first three years of the project. Mollusciciding (43% of the total expenditure) and screening (28% of the total) are estimated to have the most expensive field activities. However, despite the expense of screening, a simple model predicts that selective chemotherapy could have been cheaper than mass chemotherapy in areas where infection prevalence was higher than 15%, which was the threshold for mass chemotherapy intervention. It is concluded that considerable cost savings could be made in the future by narrowing the scope of snail control activities, redefining the threshold infection prevalence for mass chemotherapy, defining smaller administrative units, and developing rapid assessment tools.
Asunto(s)
Animales , Bovinos , Enfermedades de los Bovinos/economía , China/epidemiología , Reservorios de Enfermedades , Vectores de Enfermedades , Quimioterapia/economía , Enfermedades Endémicas , Gastos en Salud , Helmintiasis Animal/economía , Humanos , Tamizaje Masivo/economía , Modelos Econométricos , Control de Plagas/economía , Servicios Preventivos de Salud/economía , Esquistosomiasis/economía , Caracoles , Naciones UnidasRESUMEN
There is a growing interest in health economics in developing countries. In this paper, some of the economic literature concerning schistosomiasis is reviewed and a set of economic questions is derived which could form the basis of a broad research agenda for tropical diseases. The major criterion used to identify research issues is that they should be of practical value to control programs.