Cost-effectiveness of combining drug and environmental treatments for environmentally transmitted diseases
Cost-effectiveness of combining drug and environmental treatments for environmentally transmitted diseases
复制标题
DOI：
10.1098/rspb.2020.0966
复制
发表时间：
2020-08-26
影响因子：
4.7
通讯作者：
Sanchirico, James N.
中科院分区：
文献类型：
--
作者：
Castonguay, Francois M.;Sokolow, Susanne H.;Sanchirico, James N.
在过去十年中，通过大规模药物管理（MDA）控制被忽视的热带病（NTD）的情况大大增加，但专门针对人类治疗的策略效果有限。本文以日本血吸虫病为例，探讨了药物治疗和环境治疗在防治NTDs中的权衡。我们使用最优控制技术，规划者的目标是在一段时间内以尽可能低的总成本治疗疾病，总成本包括治疗，运输和损害（减少人类健康）。我们表明，环境治疗和药物治疗相结合可以减少对MDA的依赖，并且当规划者从更长远的角度看待减少NTD的斗争时，这种减少会增加。我们的研究结果表明，NTDs与环境水库需要从单纯依赖MDA的综合治疗涉及投资在药物和环境控制。
Control of neglected tropical diseases (NTDs) via mass drug administration (MDA) has increased considerably over the past decade, but strategies focused exclusively on human treatment show limited efficacy. This paper investigated trade-offs between drug and environmental treatments in the fight against NTDs by using schistosomiasis as a case study. We use optimal control techniques where the planner's objective is to treat the disease over a time horizon at the lowest possible total cost, where the total costs include treatment, transportation and damages (reduction in human health). We show that combining environmental treatments and drug treatments reduces the dependency on MDAs and that this reduction increases when the planners take a longer-run perspective on the fight to reduce NTDs. Our results suggest that NTDs with environmental reservoirs require moving away from a reliance solely on MDA to integrated treatment involving investment in both drug and environmental controls.