Authors: Marina Antillon, Ching-I Huang, Ronald E. Crump, Paul E. Brown, Rian Snijders, Erick Mwamba Miaka, Matt J. Keeling, Kat S. Rock, Fabrizio Tediosi
Published: 2022-02-25
DOI: 10.1038/s41467-022-28598-w
Source: Full article
AbstractGambiense 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.