Cost-Effectiveness of a Targeted Disinfection Program in Household Kitchens To Prevent Foodborne Illnesses in the United States, Canada, and the United Kingdom

Abstract

Foodborne illnesses impose a substantial economic and quality-of-life burden on society by way of acute morbidity and chronic sequelae. We developed an economic model to evaluate the potential cost-effectiveness of a disinfection program that targets high-risk food preparation activities in household kitchens. For the United States, Canada, and the United Kingdom, we used published literature and expert opinion to estimate the cost of the program (excluding the educational component); the number of cases of Salmonella, Campylobacter, and Escherichia coli O157:H7 infections prevented; and the economic and quality-of-life outcomes. In our primary analysis, the model estimated that approximately 80,000 infections could be prevented annually in U.S. households, resulting in 138 million dollars in direct medical cost savings (e.g., physician office visits and hospitalizations avoided), 15,845 quality-adjusted life-years (QALYs) gained, 788 million dollars in program costs, and a favorable cost-effectiveness ratio of 41,021 dollars/QALY gained. Results were similar for households in Canada and the United Kingdom (21,950 dollars Can/QALY gained and 86,341 pounds sterling/QALY gained, respectively). When we evaluated implementing the program only in U.S. households with high-risk members (those less than 5 years of age, greater than 65 years of age, or immunocompromised), the cost-effectiveness ratio was more favorable (10,163 dollars/QALY gained). Results were similar for high-risk households in Canada and the United Kingdom (1,915 dollars Can/QALY gained and 28,158 pounds sterling/QALY gained, respectively). Implementing a targeted disinfection program in household kitchens in the United States, Canada, and the United Kingdom appears to be a cost-effective strategy, falling within the range generally considered to warrant adoption and diffusion (<100,000 dollars/QALY gained).

Extent of microbial contamination of sausages sold in two Nigerian cities

“…Food-borne illness imposes a substantial economic and quality of life burden on society by way of acute morbidity and chronic sequela (Duff et al, 2003).Staphylococcal intoxication is a leading cause of food-borne intoxication and enterotoxigenic Staphylococcus strains have been isolated from foods implicated in illnesses (Adesiyun, 1995;Cencil et al, 2003). Salmonella spp has been reported by the United States Department of Agriculture Food Safety and Inspection Service (FSIS) as one of the most common causes of food-borne illness associated with meat and poultry products .Yersinia enterocolitica is a salt-tolerant, pschrotrophic rod that is widely distributed in nature, in aquatic and animal reservoir for human pathogenic strains (Hillers et al, 2003).…”

Food Safety and Foodborne Disease in the 21st Century

“…In the United States, foodborne diseases cause an estimated 76 million episodes of illness annually (2). Although the vast majority of cases are mild, a significant number of deaths do occur and the high levels of acute infections and chronic sequelae lead to billions of dollars in medical costs and lost productivity (3).…”

Detection of enteric bacteria in the popular street food chotpoti in Dhaka, Bangladesh

“…In our setting, contamination might be primarily due to the water used for food preparation, since chotpoti vendors use municipal tap water which is often contaminated (Faruque et al, 2010;Nahar et al, 2011). Contamination might also occur due to poor food handling practices of the vendors as most vendors lack awareness and knowledge of food safety and have not been formally trained in food safety (Fang et al, 2003;Duff SP, 2003;Barro et al, 2006b;Chukuezi, 2010;Al Mamun et al, 2013). Bacterial transmission via flies might also occur (De Jesús et al, 2004;Barro et al, 2006a).…”