The costs and coverage of a strategy to control schistosomiasis morbidity in nonenrolled school-age children in Egypt
The costs and coverage of a strategy to control schistosomiasis morbidity in nonenrolled school-age children in Egypt
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DOI：
10.1016/s0035-9203(00)90137-8
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发表时间：
2000-07-01
影响因子：
2.2
通讯作者：
Evans, DB
中科院分区：
文献类型：
--
作者：
Talaat, M;Evans, DB
血吸虫病仍然是埃及农村某些地方病流行地区的一个主要公共卫生问题，特别是在学龄儿童中。埃及卫生和人口部通过的以学校为基础的血吸虫病控制保健方案的重点是治疗入学的学童。未入学或不经常上学（校外）的儿童无法获得这一服务，尽管有证据表明，这些儿童的感染率和严重程度高于经常上学的儿童。本研究的目的是测试一种干预措施，以扩大现有的常规应用的学校为基础的治疗校外儿童。本文报告的成本和覆盖率的干预下获得的2种替代交付策略：选择性与大规模化疗的失学儿童。干预措施覆盖了88.5%的失学儿童，每名受感染儿童的成本相对较低，为2.29列伊。(US 0.67美元）和2.02 L. E. (US$0.59）分别用于选择性和大规模化疗。计算还表明，如果政府要实施这样的计划，在观察到的流行水平上，提供大规模化疗比选择性化疗更有效。敏感性分析显示，在失学儿童感染率较高的地区，选择性化疗将更具成本效益。
Schistosomiasis still constitutes a major public health problem in some endemic parts of rural Egypt, particularly in school-aged children. The school-based health programme for schistosomiasis control adopted by the Egyptian Ministry of Health and Population (MOHP) focuses on treating enrolled schoolchildren. Children who are not enrolled or who do not attend regularly (out-of-school) do not have access to this service, in spite of evidence that the prevalence and intensity of infection are higher in these children than among children who attend school regularly. The aim of the present study was to test an intervention to extend the existing routinely applied school-based treatment to the out-of-school children. This paper reports on the costs and the coverage obtained by the intervention under 2 alternative delivery strategies: selective versus mass chemotherapy for out-of-school children. The intervention reached 88.5% of the out-of-school children at a relatively low cost per infected child of 2.29 L.E. (US$0.67) and 2.02 L.E. (US$0.59) for selective and mass chemotherapy, respectively. The calculations also suggest that, if the government were to implement such a programme, it would be more efficient to offer mass than selective chemotherapy at observed levels of prevalence. Sensitivity analysis showed that selective chemotherapy would be more cost-effective in areas where the prevalence of infection in out-of-school children was