scholarly journals Are current preventive chemotherapy strategies for controlling and eliminating neglected tropical diseases cost-effective?

2021 ◽  
Vol 6 (8) ◽  
pp. e005456
Author(s):  
Hugo C Turner ◽  
Wilma A Stolk ◽  
Anthony W Solomon ◽  
Jonathan D King ◽  
Antonio Montresor ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Low Income ◽  
Neglected Tropical Diseases ◽  
Cost Effective ◽  
Healthcare Spending ◽  
Tropical Diseases ◽  
Preventive Chemotherapy ◽  
Middle Income ◽  
Disability Adjusted Life ◽  
The Cost

Neglected tropical diseases (NTDs) remain a significant cause of morbidity and mortality in many low-income and middle-income countries. Several NTDs, namely lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH) and trachoma, are predominantly controlled by preventive chemotherapy (or mass drug administration), following recommendations set by the WHO. Over one billion people are now treated for NTDs with this strategy per year. However, further investment and increased domestic healthcare spending are urgently needed to continue these programmes. Consequently, it is vital that the cost-effectiveness of preventive chemotherapy is understood. We analyse the current estimates on the cost per disability-adjusted life year (DALY) of the preventive chemotherapy strategies predominantly used for these diseases and identify key evidence gaps that require further research. Overall, the reported estimates show that preventive chemotherapy is generally cost-effective, supporting WHO recommendations. More specifically, the cost per DALY averted estimates relating to community-wide preventive chemotherapy for lymphatic filariasis and onchocerciasis were particularly favourable when compared with other public health interventions. Cost per DALY averted estimates of school-based preventive chemotherapy for schistosomiasis and STH were also generally favourable but more variable. Notably, the broader socioeconomic benefits are likely not being fully captured by the DALYs averted metric. No estimates of cost per DALY averted relating to community-wide mass antibiotic treatment for trachoma were found, highlighting the need for further research. These findings are important for informing global health policy and support the need for continuing NTD control and elimination efforts.

The Epitome of Novel Techniques and Targeting Approaches in Drug Delivery for Treating Lymphatic Filariasis

2020 ◽  
Vol 21 (12) ◽  
pp. 1250-1263
Author(s):  
Saurabh Shrivastava ◽  
Anshita Gupta ◽  
Chanchal Deep Kaur
Keyword(s):  
Lymphatic Filariasis ◽  
Neglected Tropical Diseases ◽  
Therapeutic Interventions ◽  
Tropical Diseases ◽  
Human Beings ◽  
Therapeutic Approaches ◽  
Preventive Chemotherapy ◽  
Bioactive Substances ◽  
Lymphatic Diseases ◽  
Life Threatening

Background: Lymphatic filariasis is a pervasive and life-threatening disease for human beings. Currently, 893 million people in 49 countries worldwide affected by lymphatic filariasis as per WHO statistics. The concealed aspects of lymphatic diseases such as delayed disease detection, inappropriate disease imaging, the geographical outbreak of infection, and lack of preventive chemotherapy have brought this epidemic to the edge of Neglected Tropical Diseases. Many medications and natural bioactive substances have seen to promote filaricidal activity against the target parasitic species. However, the majority of failures have occurred in pharmaceutical and pharmacokinetic issues. Objective: The purpose of the study is to focus on the challenges and therapeutic issues in the treatment of filariasis. The review brings novel techniques and therapeutic approaches for combating lymphatic filariasis. It also offers significant developments and opportunities for such therapeutic interventions. Conclusion: Through this review, an attempt has made to critically evaluate the avenues of innovative pharmaceuticals and molecular targeting approaches to bring an integrated solution to combat lymphatic filariasis.

scholarly journals African regional progress and status of the programme to eliminate lymphatic filariasis: 2000–2020

2020 ◽  
Vol 13 (Supplement_1) ◽  
pp. S22-S27
Author(s):  
Kebede Deribe ◽  
Didier K Bakajika ◽  
Honorat Marie-Gustave Zoure ◽  
John O Gyapong ◽  
David H Molyneux ◽  
...  
Keyword(s):  
Vector Control ◽  
Lymphatic Filariasis ◽  
Neglected Tropical Diseases ◽  
Public Health Problem ◽  
World Health ◽  
Malaria Vector Control ◽  
Tropical Diseases ◽  
Significant Progress ◽  
African Region ◽  
Preventive Chemotherapy

Abstract To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Africa through the WHO neglected tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme in the region while we identify the key remaining challenges in achieving an Africa free of LF.

scholarly journals Impact and cost-effectiveness of potential interventions against infant respiratory syncytial virus (RSV) in 131 low-income and middle-income countries using a static cohort model

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046563
Author(s):  
Ranju Baral ◽  
Deborah Higgins ◽  
Katie Regan ◽  
Clint Pecenka
Keyword(s):  
Respiratory Syncytial Virus ◽  
Cost Effectiveness ◽  
Low Income ◽  
Cost Effective ◽  
Cohort Model ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disability Adjusted Life ◽  
Syncytial Virus ◽  
Duration Of Protection

ObjectivesInterventions to prevent childhood respiratory syncytial virus (RSV) disease are limited and costly. New interventions are in advanced stages of development and could be available soon. This study aims to evaluate the potential impact and cost-effectiveness of two interventions to prevent childhood RSV—a maternal vaccine and a monoclonal antibody (mAb).DesignUsing a static population-based cohort model, we evaluate impact and cost-effectiveness of RSV interventions, from a health systems perspective. The assumed baseline efficacy and duration of protection were higher for the mAb (60%–70% efficacy, protection 6 months) compared with the maternal vaccine (40%–60% efficacy, protection 3 months). Both interventions were evaluated at US$3 and US$5 per dose for Gavi and non-Gavi countries, respectively. A range of input values were considered to explore uncertainty.Settings131 low-income and middle-income countries.ParticipantsPregnant women and live birth cohorts.InterventionsMaternal vaccine given to pregnant women and mAb given to young infants.Primary and secondary outcome measuresDisability-adjusted life years averted, severe case averted, deaths averted, incremental cost effectiveness ratios.ResultsUnder baseline assumptions, maternal vaccine and mAbs were projected to avert 25% and 55% of RSV-related deaths among infants younger than 6 months of age, respectively. The average incremental cost-effectiveness ratio per disability-adjusted life year averted was US$1342 (range US$800–US$1866) for maternal RSV vaccine and US$431 (range US$167–US$692) for mAbs. At a 50% gross domestic product per capita threshold, maternal vaccine and mAbs were cost-effective in 60 and 118 countries, respectively.ConclusionsBoth interventions are projected to be impactful and cost-effective in many countries, a finding that would be enhanced if country-specific Gavi cofinancing to eligible countries were included. mAbs, with assumed higher efficacy and duration of protection, are expected to be more cost-effective than RSV maternal vaccines at similar prices. Final product characteristics will influence this finding.

scholarly journals Cost-Effectiveness Analysis of BCG Vaccination against Tuberculosis in Indonesia: A Model-Based Study

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 707
Author(s):  
Afifah Machlaurin ◽  
Franklin Christiaan Karel Dolk ◽  
Didik Setiawan ◽  
Tjipke Sytse van der Werf ◽  
Maarten J. Postma
Keyword(s):  
Cost Effectiveness ◽  
Univariate Analysis ◽  
Cost Effective ◽  
Epidemiological Data ◽  
Control Programme ◽  
Detection Rates ◽  
Middle Income ◽  
Bcg Vaccination ◽  
Life Years ◽  
The Cost

Bacillus Calmette–Guerin (BCG), the only available vaccine for tuberculosis (TB), has been applied for decades. The Indonesian government recently introduced a national TB disease control programme that includes several action plans, notably enhanced vaccination coverage, which can be strengthened through underpinning its favourable cost-effectiveness. We designed a Markov model to assess the cost-effectiveness of Indonesia’s current BCG vaccination programme. Incremental cost-effectiveness ratios (ICERs) were evaluated from the perspectives of both society and healthcare. The robustness of the analysis was confirmed through univariate and probabilistic sensitivity analysis (PSA). Using epidemiological data compiled for Indonesia, BCG vaccination at a price US$14 was estimated to be a cost-effective strategy in controlling TB disease. From societal and healthcare perspectives, ICERs were US$104 and US$112 per quality-adjusted life years (QALYs), respectively. The results were robust for variations of most variables in the univariate analysis. Notably, the vaccine’s effectiveness regarding disease protection, vaccination costs, and case detection rates were key drivers for cost-effectiveness. The PSA results indicated that vaccination was cost-effective even at US$175 threshold in 95% of cases, approximating the monthly GDP per capita. Our findings suggest that this strategy was highly cost-effective and merits prioritization and extension within the national TB programme. Our results may be relevant for other high endemic low- and middle-income countries.

scholarly journals Analisis Spasial Kejadian Filariasi di Kabupaten Demak Jawa Tengah

2018 ◽  
Vol 17 (1) ◽  
pp. 46
Author(s):  
Nurjazuli Nurjazuli ◽  
Hanan Lanang Dangiran ◽  
Asty Awiyatul Bari'ah
Keyword(s):  
Spatial Analysis ◽  
Lymphatic Filariasis ◽  
Water Flow ◽  
Culex Quinquefasciatus ◽  
Index Case ◽  
Neglected Tropical Diseases ◽  
Observational Research ◽  
Positioning System ◽  
Tropical Diseases ◽  
Cross Sectional

Latar Belakang: Filariasis merupakan salah satu penyakit tular vektor yang kurang mendapatkan perhatian, termasuk kelompok Neglected Tropical Diseases (NTDs). Kabupaten Demak merupakan salah satu wilayah di Propinsi Jawa Tengah  yang merupakan daerah endemis filarisis (mf rate>1%). Kejadian filarisis di daerah ini diduga berkaitan dengan kondisi lingkungan fisik dan biologis (nyamuk) yang mempunyai peran penting dalam penyebaran penyakit filarisis. Penelitian ini bertujuan untuk menemukan adanya penderita baru,  mengidentifikasi kondisi lingkungan fisik dan biologi yang berkaitan dengan sebaran filarisis di Kabupaten Demak.Matede: Penelitian ini merupakan penelitian observasional dengan rancangan cross-sectional. Sebanyak 30 kasus filariasis dijadikan indek kasus yang selanjutnya dipilih secara purposif sebanyak 140 yang tinggal di sekitar 30 kasus tersebut untuk dilakukan pengamblan darah jari. Observasi lingkungan dilakukan untuk mengidentifikasi kondisi lingkungan (breeding places dan resting places) dari yang diduga sebagai nyamuk vektor filariasis. Penangkapan nyamuk dilakukan di sekitar rumah penderita filariasis. Pengukuran koordinat kasus filariais dilakukan dengan pesawat Geographic Positioning System (GPS). Pemeriksaan darah jadi jari dilakukan di Laboratorium Kesehatan Daerah (LABKESDA) Propinsi Jawa Tengah. Sedang bedah nyamuk dilakukan di Balai Penelitian Vektor Penyakit Banjarnegara. Analisis data dlakukan secara deskriptif, analisis spasial dilakukan dengan software ArcGis 9.3.Hasil: Penelitian ini tidak menemukan penderita baru filarisis (mf rate=0%). Sebanyak 129 ekor nyamuk telah dilakukan pembedahan dengan hasil semuanya negatip cacing filaria. Hasil identifikasi nyamuk menemukan spesies nyamuk Culex quinquefasciatus merupakan nyamuk yang dominan (72,86%) di lokasi penelitian.Terdapat breeding places (40%) berupa genangan air terbuka (SPAL) dan resting places (83,3%) berupa semak-semak di sekitar rumah penderita. Analisis spasial menunjukkan bahwa kasus filariasi hampir menyebar di seluruh wilayah Kaputaen Demak. Daerah cekungan aliran air nampaknya merupakan kondisi dimana kasus filariasis banyak terjadi. Simpulan: Kasus filariasis hampir menyebar di seluruh wilayah Kabupaten Demak dengan konsentrasi lebih banyak pada daerah cekungan aliran air Semarang-Demak. ABSTRACTTitle: Spatial Analysis of Lymphatic Filariasis in Demak Dictric, Central JavaBackground: Lymphatic filariasis (LF) is one of vector related diseaseswhich less attention from goverment, It was classified as Neglected Tropical Diseases (NTDs). Demak District is one of area in Central Jawa which was endemic of LF (mf rate>1%). It may be related to the physical and biologycal environment condition which have important role in the spreading of LF. This research aimed to identify new cases, find mosquitoe vector , and asses the condition of physical and biologycal environment related to the distribuion of LF cases in Demak District. Methods: It was an observational research using cross-sectional design. As more as 30 LF cases defined as index case and then 140 persons living around index case were selected for blood testing of microfilaria. Observation was conducted to assess the presence of breeding and resting places for mosquitoes development. Mosquito collection was conducted around the houses the LF cases early in the morning. Site of LF cases were measured using Geographic Positioning System (GPS) Apparatus. Blood test for identifying microfilaria was performed at Province Health Labotatory of Centra Java. Mosquotoes dissection was performed at Research Institule of  Disease Vector Banjarnegara. Data would be analyzed descriptively and spatial analysis was performed using ArcGis 9.3.Results: This research did’t find new cases of filariasis (mf rate=0%). As more as 129 mosquitoes had been dissected and all of them indicated negative of filarial worm. This research showed that Culex quinquefasciatus as dominant mosquitoe species with the proportion of 72,86%. Water puddle (40%) and small three (83,3%) were found as a good habitats located around the house of filariasis cases. Spatial analysis indicated that filariasis cases spread in all over area of Demak Distirct, and It concentated in the area of undergroud water flow of Semarang-DemakConclusion: Lymphatif Filariasis cases were nearly distributed all over area of Demak Distict and It was concentrated in area with underground water flow Semarang-Demak.

scholarly journals Development and validation of a framework to improve neglected tropical diseases surveillance and response at the sub-national level in Kenya

2021 ◽  
Author(s):  
Arthur Kipkemoi Saitabau Ng'etich ◽  
Kuku Voyi ◽  
Clifford Maina Mutero
Keyword(s):  
Disease Transmission ◽  
Neglected Tropical Diseases ◽  
Methodological Approach ◽  
National Level ◽  
Primary Data ◽  
Second Phase ◽  
Tropical Diseases ◽  
Preventive Chemotherapy ◽  
Response System ◽  
Surveillance And Response

Background Assessment of surveillance and response system functions focusing on notifiable diseases has widely been documented in literature. However, there is limited focus on diseases targeted for elimination or eradication, particularly preventive chemotherapy neglected tropical diseases (PC-NTDs). There are limited strategies to guide strengthening of surveillance and response system functions concerning PC-NTDs. The aim of this study was to develop and validate a framework to improve surveillance and response to PC-NTDs at the sub-national level in Kenya. Methods Framework development adopted a multi-phased approach. The first phase involved a systematic literature review of surveillance assessment studies conducted in Africa to derive generalised recommendations. The second phase utilised primary data surveys to identify disease-specific recommendations to improve PC-NTDs surveillance in Kenya. The third phase utilised a Delphi survey to assess stakeholders consensus on feasible recommendations. The fourth phase drew critical lessons from existing conceptual frameworks. The final validated framework was based on resolutions and inputs from concerned stakeholders. Results Framework components constituted inputs with the first domain combining surveillance tools, equipment and infrastructure while the second domain combined financial, technical and logistical support. Processes were categorised into four sub-domains with activities for strengthening existing surveillance tools, surveillance core, support and attribute functions. The intended results phase comprised of ten distinct outputs with the anticipated outcomes categorised into three sub domains. Lastly, the overall impact alluded to reduced disease burden, halted disease transmission and reduced costs for implementing treatment interventions to achieve PC-NTDs control and elimination. Conclusion In view of the mixed methodological approach used to develop the framework coupled with further inputs and consensus among concerned stakeholders, the validated framework appears to be relevant in guiding decisions by policy makers to strengthen the existing surveillance and response system functions towards achieving PC-NTDs elimination.

scholarly journals INCREASE IN THE ROLE OF PHARMACIST AS A PROFESSIONAL UNDER THE CONDITIONS OF THE BOLOGNA SYSTEM IN UKRAINE

2014 ◽  
Vol 2 ◽  
pp. 319-322
Author(s):  
Vitaliy Moskalenko ◽  
Iryna Nizhenkovskaya ◽  
Elena Welchinska
Keyword(s):  
Cost Effective ◽  
Healthcare Spending ◽  
Healthcare Management ◽  
Public Health Care ◽  
Public Healthcare ◽  
State Agencies ◽  
High Quality Education ◽  
Technological Advances ◽  
The Cost

Countries worldwide are facing similar healthcare problems.  Medicine develops new methods for treatment, and pharmaceutical companies invent more efficient products.  These technological advances are, however, expensive, and put a double-strain on public healthcare spending: the cost of sophisticated treatment keeps growing, and improved healthcare allows patients to live longer, thus requiring more treatment.  Budgetary constraints, however, require government to restrict expenditure.  These challenges have to be answered in the context of existing public healthcare systems, which, are well established and complex.  Healthcare reforms will necessarily reflect these characteristics, as well as the relative political weight of the partners.  Such reforms will most likely affect all partners involved in the provision and healthcare management, including social security institutions (state agencies, sickness funds, etc.), doctors, and other health professionals—pharmacists.  Currently one of most important strategic tasks of modernization of the system of higher education in Ukraine is the high quality education provided to pharmacists in order to satisfy the worldwide needs.Whatever specific reform will be adopted, the main goals are to make the system more efficient and, thus, more cost effective; and, because the first aspect will not sufficiently decrease the expenditure, it is necessary to limit the scope of public health care while maintaining a balance of benefits.  

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