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Cost-effectiveness of algorithms for confirmation test of human African trypanosomiasis


Document type: article
Download file(s): 118187 (625 KB)
Abstract: The control of Trypanosoma brucei gambiense human African trypanosomiasis (HAT) is compromised by low sensitivity of the routinely used parasitologic confirmation tests. More sensitive alternatives, such as mini-anion exchange centrifugation technique (mAECT) or capillary tube centrifugation (CTC), are more expensive. We used formal decision analysis to assess the cost-effectiveness of alternative HAT confirmation algorithms in terms of cost per life saved. The effectiveness of the standard method, a combination of lymph node puncture (LNP), fresh blood examination (FBE), and thick blood film (TBF), was 36.8%; the LNP-FBE-CTC-mAECT sequence reached almost 80%. The cost per person examined ranged from €1.56 for LNPFBE-TBF to €2.99 for LNP-TBF-CTC-mAECT-CATT (cardagglutination test for trypanosomiasis) titration. LNP-TBFCTC-mAECT was the most cost effective in terms of cost per life saved. HAT confirmation algorithms that incorporate concentration techniques are more effective and efficient than the algorithms that are currently and routinely used by several T.b. gambiense control programs.
Authors: Lutumba, P. , Meheus, F. , Robays, J. , Miaka, C. , Kande, V. , Büscher, P. , Dujardin, B. , Boelaert, M.
Category: Research
End Page: 1490
Serial number: 10
Volume: 13
Journal: Emerging Infectious Diseases
Keywords: disease prevention and control , health
Language: eng
Organization: KIT - Royal Tropical Institute
Year: 2007
Region: Eastern Africa , Southern Africa , Western Africa , Africa
Right: Copyright status unknown
Subject: Health and Nutrition
Start Page: 1484
Title: Cost-effectiveness of algorithms for confirmation test of human African trypanosomiasis