African Programme for Onchocerciasis Control 1995-2015: Model-Estimated Health Impact and Cost
African Programme for Onchocerciasis Control 1995-2015: Model-Estimated Health Impact and Cost
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DOI：
10.1371/journal.pntd.0002032
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发表时间：
2013-01-01
影响因子：
3.8
通讯作者：
Amazigo, Uche V.
中科院分区：
文献类型：
--
作者：
Coffeng, Luc E.;Stolk, Wilma A.;Amazigo, Uche V.
背景：盘尾丝虫病在非洲造成相当大的疾病负担，主要是通过皮肤和眼睛疾病。自1995年以来，非洲盘尾丝虫病控制方案每年在16个国家协调使用伊维菌素进行大规模治疗。在这项研究中，我们估计的健康影响，APOC和相关费用从一个程序的角度到2010年，并提供预期的趋势，直到2015年。根据控制前的感染流行率和大规模治疗的人口覆盖率数据，我们使用微观模拟模型ONCHOSIM模拟了感染、失明、视力障碍和严重瘙痒的趋势，和因盘尾丝虫病损失的估计残疾调整生命年。我们评估了APOC、受益国政府和非政府发展组织的财务成本，不包括捐赠药物的成本。我们估计，在1995年至2010年期间，伊维菌素的大规模治疗避免了APOC地区因盘尾丝虫病造成的820万例DADs，名义成本约为2.57亿美元。我们预计，APOC将避免另一个920万DALOS在2011年和2015年之间，在2.21亿美元的名义成本。Conclusions：我们的模拟表明，APOC在1995年和2010年之间在非洲的人口健康产生了显着的影响。预计在该方案随后的五年中，到2015年，这一健康影响将翻一番。APOC是一个具有高度成本效益的公共卫生计划。鉴于一些APOC地区的盘尾丝虫病预计将被消除，我们预计在不久的将来伊维菌素大规模治疗将带来更多的健康益处和更有利的成本效益。
Background: Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015.Methods and Findings: With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million.Conclusions: Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future.