IDEAS home Printed from https://ideas.repec.org/a/plo/pntd00/0000363.html
   My bibliography  Save this article

Cost-Effectiveness of Chagas Disease Vector Control Strategies in Northwestern Argentina

Author

Listed:
  • Gonzalo M Vazquez-Prokopec
  • Cynthia Spillmann
  • Mario Zaidenberg
  • Uriel Kitron
  • Ricardo E Gürtler

Abstract

Background: Control and prevention of Chagas disease rely mostly on residual spraying of insecticides. In Argentina, vector control shifted from a vertical to a fully horizontal strategy based on community participation between 1992 and 2004. The effects of such strategy on Triatoma infestans, the main domestic vector, and on disease transmission have not been assessed. Methods and Findings: Based on retrospective (1993–2004) records from the Argentinean Ministry of Health for the Moreno Department, Northwestern Argentina, we performed a cost-effectiveness (CE) analysis and compared the observed CE of the fully horizontal vector control strategy with the expected CE for a vertical or a mixed (i.e., vertical attack phase followed by horizontal surveillance) strategy. Total direct costs (in 2004 US$) of the horizontal and mixed strategies were, respectively, 3.3 and 1.7 times lower than the costs of the vertical strategy, due to reductions in personnel costs. The estimated CE ratios for the vertical, mixed and horizontal strategies were US$132, US$82 and US$45 per averted human case, respectively. When per diems were excluded from the costs (i.e., simulating the decentralization of control activities), the CE of vertical, mixed and horizontal strategies was reduced to US$60, US$42 and US$32 per averted case, respectively. Conclusions and Significance: The mixed strategy would have averted between 1.6 and 4.0 times more human cases than the fully horizontal strategy, and would have been the most cost-effective option to interrupt parasite transmission in the Department. In rural and dispersed areas where waning vertical vector programs cannot accomplish full insecticide coverage, alternative strategies need to be developed. If properly implemented, community participation represents not only the most appealing but also the most cost-effective alternative to accomplish such objectives. Author Summary: Despite decreasing rates of prevalence and incidence, Chagas disease remains a serious problem in Latin America, especially for the rural poor. Without vaccines, control and prevention rely mostly on residual spraying of insecticides. Under the aegis of the Southern Cone Initiative, and in agreement with global trends in decentralization of the health systems, in 1992 the Argentinean vector control launched a new vector control program based on community participation. The present study represents the first thorough evaluation of the overall performance of such vector control program and the first comparative assessment of the cost-effectiveness of different vector control strategies in a highly endemic rural area of northwestern Argentina. Supported by results of independent studies, the present work shows that in rural, poor and dispersed areas of the Gran Chaco region, the implementation of a mixed (i.e., vertical attack phase followed by horizontal surveillance) strategy constantly supervised and supported by national or local vector control programs would be the most cost-effective option to interrupt vector-borne transmission of Chagas disease.

Suggested Citation

  • Gonzalo M Vazquez-Prokopec & Cynthia Spillmann & Mario Zaidenberg & Uriel Kitron & Ricardo E Gürtler, 2009. "Cost-Effectiveness of Chagas Disease Vector Control Strategies in Northwestern Argentina," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 3(1), pages 1-11, January.
  • Handle: RePEc:plo:pntd00:0000363
    DOI: 10.1371/journal.pntd.0000363
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0000363
    Download Restriction: no

    File URL: https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0000363&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pntd.0000363?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Christopher J.L. Murray & David B. Evans & Arnab Acharya & Rob M.P.M. Baltussen, 2000. "Development of WHO guidelines on generalized cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 235-251, April.
    2. Rick L Tarleton & Richard Reithinger & Julio A Urbina & Uriel Kitron & Ricardo E Gürtler, 2007. "The Challenges of Chagas Disease— Grim Outlook or Glimmer of Hope?," PLOS Medicine, Public Library of Science, vol. 4(12), pages 1-6, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Michaël Schwarzinger & Jean‐Louis Lanoë & Erik Nord & Isabelle Durand‐Zaleski, 2004. "Lack of multiplicative transitivity in person trade‐off responses," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 171-181, February.
    2. Siying Wang & Liubao Peng & Jianhe Li & Xiaohui Zeng & Lihui Ouyang & Chongqing Tan & Qiong Lu, 2013. "A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-9, March.
    3. Quartey, Jonathan D. & Nyarko, Lydia Gyamea, 2022. "Economic Sustainability of Mobile Money Payments in Ghana: Does a Tax on Transactions Matter?," African Journal of Economic Review, African Journal of Economic Review, vol. 10(5), December.
    4. Lai, Taavi & Habicht, Jarno & Reinap, Marge & Chisholm, Dan & Baltussen, Rob, 2007. "Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia," Health Policy, Elsevier, vol. 84(1), pages 75-88, November.
    5. Baltussen, Rob, 2006. "Priority setting of public spending in developing countries: Do not try to do everything for everybody," Health Policy, Elsevier, vol. 78(2-3), pages 149-156, October.
    6. Rutten, Frans & Bleichrodt, Han & Brouwer, Werner & Koopmanschap, Marc & Schut, Erik, 2001. "Handbook of Health Economics," Journal of Health Economics, Elsevier, vol. 20(5), pages 855-879, September.
    7. Kapiriri, Lydia & Razavi, Donya, 2017. "How have systematic priority setting approaches influenced policy making? A synthesis of the current literature," Health Policy, Elsevier, vol. 121(9), pages 937-946.
    8. Mei-Chuan Hung & Hsin-Ming Lu & Likwang Chen & Ming-Shian Lin & Cheng-Ren Chen & Chong-Jen Yu & Jung-Der Wang, 2012. "Cost per QALY (Quality-Adjusted Life Year) and Lifetime Cost of Prolonged Mechanical Ventilation in Taiwan," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-10, September.
    9. Shepherd, Keith D. & Shepherd, Gemma & Walsh, Markus G., 2015. "Land health surveillance and response: A framework for evidence-informed land management," Agricultural Systems, Elsevier, vol. 132(C), pages 93-106.
    10. Cheol Yong Han & Habeeb Issa & Jan Rychtář & Dewey Taylor & Nancy Umana, 2020. "A voluntary use of insecticide treated nets can stop the vector transmission of Chagas disease," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 14(11), pages 1-19, November.
    11. Jennifer M Manne & Callae S Snively & Janine M Ramsey & Marco Ocampo Salgado & Till Bärnighausen & Michael R Reich, 2013. "Barriers to Treatment Access for Chagas Disease in Mexico," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 7(10), pages 1-10, October.
    12. Graham Scotland & Stirling Bryan, 2017. "Why Do Health Economists Promote Technology Adoption Rather Than the Search for Efficiency? A Proposal for a Change in Our Approach to Economic Evaluation in Health Care," Medical Decision Making, , vol. 37(2), pages 139-147, February.
    13. Llanos, Adolfo & Hertrampf, Eva & Cortes, Fanny & Pardo, Andrea & Grosse, Scott D. & Uauy, Ricardo, 2007. "Cost-effectiveness of a folic acid fortification program in Chile," Health Policy, Elsevier, vol. 83(2-3), pages 295-303, October.
    14. Raymond C.W. Hutubessy & Rob M.P.M. Baltussen & David B. Evans & Jan J. Barendregt & Christopher J.L. Murray, 2001. "Stochastic league tables: communicating cost‐effectiveness results to decision‐makers," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 473-477, July.
    15. Milton C. Weinstein, 2012. "Decision Rules for Incremental Cost-effectiveness Analysis," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 47, Edward Elgar Publishing.
    16. Elahe Khorasani & Majid Davari & Abbas Kebriaeezadeh & Farshad Fatemi & Ali Akbari Sari & Vida Varahrami, 2022. "A comprehensive review of official discount rates in guidelines of health economic evaluations over time: the trends and roots," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(9), pages 1577-1590, December.
    17. Samia Laokri & Maxime Koiné Drabo & Olivier Weil & Benoît Kafando & Sary Mathurin Dembélé & Bruno Dujardin, 2013. "Patients Are Paying Too Much for Tuberculosis: A Direct Cost-Burden Evaluation in Burkina Faso," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-6, February.
    18. Ezzati, Majid & Kammen, Daniel M., 2002. "Evaluating the health benefits of transitions in household energy technologies in Kenya," Energy Policy, Elsevier, vol. 30(10), pages 815-826, August.
    19. David B. Evans & Dan Chisholm & Tessa Tan-Torres Edejer, 2012. "Generalized Cost-effectiveness Analysis: Principles and Practice," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 48, Edward Elgar Publishing.
    20. Baltussen, Rob & Youngkong, Sitapon & Paolucci, Francesco & Niessen, Louis, 2010. "Multi-criteria decision analysis to prioritize health interventions: Capitalizing on first experiences," Health Policy, Elsevier, vol. 96(3), pages 262-264, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pntd00:0000363. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosntds (email available below). General contact details of provider: https://journals.plos.org/plosntds/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.