Cost-effectiveness of sleeping sickness elimination campaigns in five settings of the Democratic Republic of Congo

Marina Antillon (), Ching-I Huang, Ronald E. Crump, Paul E. Brown, Rian Snijders, Erick Mwamba Miaka, Matt J. Keeling, Kat S. Rock () and Fabrizio Tediosi
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Marina Antillon: Swiss Tropical and Public Health Institute
Ching-I Huang: University of Warwick
Ronald E. Crump: University of Warwick
Paul E. Brown: University of Warwick
Rian Snijders: Swiss Tropical and Public Health Institute
Erick Mwamba Miaka: Programme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA)
Matt J. Keeling: University of Warwick
Kat S. Rock: University of Warwick
Fabrizio Tediosi: Swiss Tropical and Public Health Institute

Nature Communications, 2022, vol. 13, issue 1, 1-13

Abstract: Abstract Gambiense human African trypanosomiasis (gHAT) is marked for elimination of transmission by 2030, but the disease persists in several low-income countries. We couple transmission and health outcomes models to examine the cost-effectiveness of four gHAT elimination strategies in five settings – spanning low- to high-risk – of the Democratic Republic of Congo. Alongside passive screening in fixed health facilities, the strategies include active screening at average or intensified coverage levels, alone or with vector control with a scale-back algorithm when no cases are reported for three consecutive years. In high or moderate-risk settings, costs of gHAT strategies are primarily driven by active screening and, if used, vector control. Due to the cessation of active screening and vector control, most investments (75-80%) are made by 2030 and vector control might be cost-saving while ensuring elimination of transmission. In low-risk settings, costs are driven by passive screening, and minimum-cost strategies consisting of active screening and passive screening lead to elimination of transmission by 2030 with high probability.

Date: 2022
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DOI: 10.1038/s41467-022-28598-w

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