Optimal Drug Control under Risk of Drug Resistance – The Case of African Animal Trypanosomosis
Optimal Drug Control under Risk of Drug Resistance – The Case of African Animal Trypanosomosis
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耐药性风险下的最佳药物控制——非洲动物锥虫病案例
DOI：
10.1111/1477-9552.12142
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发表时间：
2016
影响因子：
3.4
通讯作者：
M. Said
中科院分区：
文献类型：
--
作者：
Liebenehm;B. Bett;C. Verdugo;M. Said
我们研究了在西非广泛使用的两种治疗非洲动物锥虫病的策略：预防药物控制前锥虫感染和治疗药物控制后锥虫感染。我们调查了这些替代战略的哪种组合对养牛农民来说是经济上最优的。我们应用动态优化框架来考虑抗药性发展的负外部性和人类行为。我们开发了一个生物经济模型来模拟动态情景中处理策略的经济后果，该模型考虑了病媒、宿主和畜牧业农民之间的相互作用。该模型允许通过滥用杀锥虫剂来进化具有抗药性的锥虫，并根据马里和布基纳法索202名养牛户的样本引起的风险和时间偏好来模拟观察到的养牛户的行为。结果表明，对于风险厌恶和耐心的农民来说，私人治疗策略的最佳组合包括对易感牛进行预防性治疗，并辅之以对受感染牛进行少量根治性治疗。与现场观察的治疗策略相比，这种治疗策略的最佳组合将为研究地区的牲畜养殖户节省约5%的年收入，并将降低锥虫病的患病率。此外，我们还证明，农民风险厌恶程度的降低与较高的治疗率有关，从而可以避免额外的损失。相比之下，农民耐心的下降与较低的治疗率有关，从而阻碍了额外的好处。我们的结果表明，在疾病控制干预措施的制定过程中，需要考虑个体风险和时间偏好。
We examine two widely used treatment strategies for African animal trypanosomosis in West Africa: preventive drug control ex‐ante trypanosomosis infection and curative drug control ex‐post trypanosomosis infection. We investigate which combination of these alternative strategies is economically optimal for cattle farmers. We apply a dynamic optimisation framework to consider both the negative externality of drug resistance development and human behaviour. We develop a bio‐economic model to simulate the economic consequences of treatment strategies in a dynamic scenario that takes into account the interactions among the vector, host and livestock farmers. This model allows for the evolution of drug‐resistant trypanosomes through trypanocide misuse and simulates the observed behaviours of cattle farmers based on the elicited risk and time preferences of a sample of 202 cattle farmers in Mali and Burkina Faso. The results show that the private optimal mix of treatment strategies for a risk averse and patient farmer involves preventive treatment for susceptible cattle, supported by a small number of curative treatments for infected cattle. Compared with the treatment strategies observed in the field, this optimal mix of treatment strategies would save approximately 5% of the annual income of a livestock farmer in the study area and would reduce the prevalence of trypanosomosis. In addition, we demonstrate that a reduction in a farmer's risk aversion is associated with higher treatment rates that can avoid additional losses. By contrast, a decrease in a farmer's patience is related to lower treatment rates that thwart additional benefits. Our results suggest that individual risk and time preferences need to be considered in the development process of disease control interventions.
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DOI：
--
发表时间：
2007
期刊：
影响因子：
--
作者：
H. Affognon
通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
Shaw, A. P. M.;Cecchi, G.;Robinson, T. P.
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