A Literature Review of Economic Evaluations for a Neglected Tropical Disease: Human African Trypanosomiasis (“Sleeping Sickness”)

Abstract

Human African trypanosomiasis (HAT) is a disease caused by infection with the parasite Trypanosoma brucei gambiense or T. b. rhodesiense. It is transmitted to humans via the tsetse fly. Approximately 70 million people worldwide were at risk of infection in 1995, and approximately 20,000 people across Africa are infected with HAT. The objective of this review was to identify existing economic evaluations in order to summarise cost-effective interventions to reduce, control, or eliminate the burden of HAT. The studies included in the review were compared and critically appraised in order to determine if there were existing standardised methods that could be used for economic evaluation of HAT interventions or if innovative methodological approaches are warranted. A search strategy was developed using keywords and was implemented in January 2014 in several databases. The search returned a total of 2,283 articles. After two levels of screening, a total of seven economic evaluations were included and underwent critical appraisal using the Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist 6: Economic Evaluations. Results from the existing studies focused on the cost-effectiveness of interventions for the control and reduction of disease transmission. Modelling was a common method to forecast long-term results, and publications focused on interventions by category, such as case detection, diagnostics, drug treatments, and vector control. Most interventions were considered cost-effective based on the thresholds described; however, the current treatment, nifurtomix-eflornithine combination therapy (NECT), has not been evaluated for cost-effectiveness, and considerations for cost-effective strategies for elimination have yet to be completed. Overall, the current evidence highlights the main components that play a role in control; however, economic evaluations of HAT elimination strategies are needed to assist national decision makers, stakeholders, and key funders. These analyses would be of use, as HAT is currently being prioritized as a neglected tropical disease (NTD) to reach elimination by 2020.

Past and Ongoing Tsetse and Animal Trypanosomiasis Control Operations in Five African Countries: A Systematic Review

“…Documentation of economic aspects was even scarcer, only one of the articles identified included a full economic evaluation and was conducted in the 1980’s [116]. Economic evaluations are more common for HAT control programmes (see a review by Sutherland, Yukich [126]).…”

Evaluation of the TbgI<sub>2</sub> and TbgI<sub>17</sub> Tandem Repeat Antigens as Potential Antigens for the Diagnosis of <i>Trypanosoma brucei rhodesiense</i>

“…Human African trypanosomiasis (HAT) is a vector born disease caused by flagellated protozoa of the genus Trypanosoma which is transmitted to humans through the bite of a tsetse fly [1] [2]. The disease exists in two forms: a chronic form of HAT caused by Trypanosoma brucei gambiense (Tbg), predominantly found in the Central and West Africa and the acute form of HAT caused by Trypanosoma brucei rhodesiense (Tbr) which is present in East and Southern Africa.…”

Genome Sequence of Phytomonas françai , a Cassava ( Manihot esculenta ) Latex Parasite

“…Most trypanosomatids are transmitted between hosts by biting insects, and several species cause economic and health losses in developing countries (1). Members of a large and diverse subgroup of plant-infecting trypanosomatids known as Phytomonas are relatively poorly understood and comparatively little is known of their biology or how they have adapted to life inside plants (2, 3).…”