A cost-benefit analisys of chagas disease control

Abstract

Chagas disease transmission can be effectively interrupted by insecticidal control of its triatomine bug vectors. We present here a simple model comparing the costs and benefits of such a programme, designed to eliminate domestic populations of Triatoma infestans throughout its known area of distribution over the seven southernmost countries of Latin America. The model has been simplified to require only four financial estimates relating to the unit cost of housing spraying and benefits due to avoidance of premature death in the acute phase of the disease, avoidance of supportive treatment and care in the chronic phase of the disease, and avoidance of corrective digestive and cardiac surgery. Except for these direct medical costs, all other potential benefits have been ignored. Nevertheless, the model shows that the direct financial benefits of such a programme would far outweigh the costs, and the project would support a remarkably high internal rate of return under the least optimistic estimates.

Chagas' heart disease

“…These are figures that thoroughly substantiate the concept that elimination of Chagas' disease vectorial (by improving the quality of housing and use of residual insecticides) and of transfusional transmission in both endemic and nonendemic areas [11][12][13] , is a highly cost-effective public health policy 7,10 . Despite being hindered by financial limitations, these goals have been attained in scattered regions [14][15][16] .…”

The evolution of Chagas disease (American Trypanosomiasis) control after 90 years since Carlos Chagas discovery

“…In planning the Southern Cone programme, it was estimated that an investment in Chagas disease control would produce an annual economic return equivalent to 14% in medical savings alone (Schofield & Dias 1991). Since then, studies in Brazil have shown a real economic rate of return of over 30% (Akhavan 1997) while studies in Argentina indicate rates of return in excess of 60% (Del Rey et al 1995, Basombrio et al 1998.…”

Vigilância epidemiológica em doença de Chagas

“…), na medida em que se esvai a fase de ataque em termos da progressiva redução dos índices triatomínico-tripanosômicos em nível domiciliar. Trata-se também de adequar a boa relação de custo-efetividade dos clássicos programas verticais (Dias, 1987;Oliveira Filho, 1989;Schofield & Dias, 1991;Akhavan, 1996;Basombrio et al, no prelo). Em geral, até aqui, os países têm-se restringido à vigilância contra o vetor, não se encontrando sistemas participativos envolvendo a população nos campos da transmissão transfusional ou congênita, tampouco em um sistema organizado para atenção médica.…”