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Cost-effectiveness of a community-based intervention for reducing the transmission of Schistosoma haematobium and HIV in Africa.
Proc Natl Acad Sci U S A. 2013 May 07; 110(19):7952-7.PN

Abstract

Epidemiological studies from sub-Saharan Africa show that genital infection with Schistosoma haematobium [corrected] may increase the risk for HIV infection in young women. Therefore, preventing schistosomiasis has the potential to reduce HIV transmission in sub-Saharan Africa. We developed a transmission model of female genital schistosomiasis and HIV infections that we fit to epidemiological data of HIV and female genital schistosomiasis prevalence and coinfection in rural Zimbabwe. We used the model to evaluate the cost-effectiveness of a multifaceted community-based intervention for preventing schistosomiasis and, consequently, HIV infections in rural Zimbabwe, from the perspective of a health payer. The community-based intervention combined provision of clean water, sanitation, and health education (WSH) with administration of praziquantel to school-aged children. Considering variation in efficacy between 10% and 70% of WSH for reducing S. haematobium [corrected] transmission, our model predicted that community-based intervention is likely to be cost-effective in Zimbabwe at an aggregated WSH cost corresponding to US $725-$1,000 per individual over a 20-y intervention period. These costs compare favorably with empirical measures of WSH provision in developing countries, indicating that integrated community-based intervention for reducing the transmission of S. haematobium [corrected] is an economically attractive strategy for reducing schistosomiasis and HIV transmission in sub-Saharan Africa that would have a powerful impact on averting infections and saving lives.

Authors+Show Affiliations

School of Public Health, and Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT 06520, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23589884

Citation

Ndeffo Mbah, Martial L., et al. "Cost-effectiveness of a Community-based Intervention for Reducing the Transmission of Schistosoma Haematobium and HIV in Africa." Proceedings of the National Academy of Sciences of the United States of America, vol. 110, no. 19, 2013, pp. 7952-7.
Ndeffo Mbah ML, Kjetland EF, Atkins KE, et al. Cost-effectiveness of a community-based intervention for reducing the transmission of Schistosoma haematobium and HIV in Africa. Proc Natl Acad Sci U S A. 2013;110(19):7952-7.
Ndeffo Mbah, M. L., Kjetland, E. F., Atkins, K. E., Poolman, E. M., Orenstein, E. W., Meyers, L. A., Townsend, J. P., & Galvani, A. P. (2013). Cost-effectiveness of a community-based intervention for reducing the transmission of Schistosoma haematobium and HIV in Africa. Proceedings of the National Academy of Sciences of the United States of America, 110(19), 7952-7. https://doi.org/10.1073/pnas.1221396110
Ndeffo Mbah ML, et al. Cost-effectiveness of a Community-based Intervention for Reducing the Transmission of Schistosoma Haematobium and HIV in Africa. Proc Natl Acad Sci U S A. 2013 May 7;110(19):7952-7. PubMed PMID: 23589884.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of a community-based intervention for reducing the transmission of Schistosoma haematobium and HIV in Africa. AU - Ndeffo Mbah,Martial L, AU - Kjetland,Eyrun F, AU - Atkins,Katherine E, AU - Poolman,Eric M, AU - Orenstein,Evan W, AU - Meyers,Lauren Ancel, AU - Townsend,Jeffrey P, AU - Galvani,Alison P, Y1 - 2013/04/15/ PY - 2013/4/17/entrez PY - 2013/4/17/pubmed PY - 2013/7/20/medline KW - cost-effectiveness analysis KW - mathematical modeling KW - schistosomiasis control SP - 7952 EP - 7 JF - Proceedings of the National Academy of Sciences of the United States of America JO - Proc Natl Acad Sci U S A VL - 110 IS - 19 N2 - Epidemiological studies from sub-Saharan Africa show that genital infection with Schistosoma haematobium [corrected] may increase the risk for HIV infection in young women. Therefore, preventing schistosomiasis has the potential to reduce HIV transmission in sub-Saharan Africa. We developed a transmission model of female genital schistosomiasis and HIV infections that we fit to epidemiological data of HIV and female genital schistosomiasis prevalence and coinfection in rural Zimbabwe. We used the model to evaluate the cost-effectiveness of a multifaceted community-based intervention for preventing schistosomiasis and, consequently, HIV infections in rural Zimbabwe, from the perspective of a health payer. The community-based intervention combined provision of clean water, sanitation, and health education (WSH) with administration of praziquantel to school-aged children. Considering variation in efficacy between 10% and 70% of WSH for reducing S. haematobium [corrected] transmission, our model predicted that community-based intervention is likely to be cost-effective in Zimbabwe at an aggregated WSH cost corresponding to US $725-$1,000 per individual over a 20-y intervention period. These costs compare favorably with empirical measures of WSH provision in developing countries, indicating that integrated community-based intervention for reducing the transmission of S. haematobium [corrected] is an economically attractive strategy for reducing schistosomiasis and HIV transmission in sub-Saharan Africa that would have a powerful impact on averting infections and saving lives. SN - 1091-6490 UR - https://www.unboundmedicine.com/medline/citation/23589884/Cost_effectiveness_of_a_community_based_intervention_for_reducing_the_transmission_of_Schistosoma_haematobium_and_HIV_in_Africa_ L2 - http://www.pnas.org/cgi/pmidlookup?view=long&pmid=23589884 DB - PRIME DP - Unbound Medicine ER -