Cost-effectiveness of combining drug and environmental treatments for environmentally transmitted diseases

Abstract

Control of neglected tropical diseases (NTDs) via mass drug administration (MDA) has increased considerably over the past decade, but strategies focused exclusively on human treatment show limited efficacy. This paper investigated trade-offs between drug and environmental treatments in the fight against NTDs by using schistosomiasis as a case study. We use optimal control techniques where the planner’s objective is to treat the disease over a time horizon at the lowest possible total cost, where the total costs include treatment, transportation and damages (reduction in human health). We show that combining environmental treatments and drug treatments reduces the dependency on MDAs and that this reduction increases when the planners take a longer-run perspective on the fight to reduce NTDs. Our results suggest that NTDs with environmental reservoirs require moving away from a reliance solely on MDA to integrated treatment involving investment in both drug and environmental controls.

Optimal spatial evaluation of a pro rata vaccine distribution rule for COVID-19

“…As the workability cost parameter goes to zero, the problem becomes linear in the controls where the optimal allocations in linear problems follow singular solutions. We use pseudospectral collocation to solve for the optimal dynamics of vaccine and infection over time, which converts the continuous time optimal control problem into a constrained non-linear programming problem solving for the coefficients of the approximating polynomials at the collocation nodes (see 41 , 42 for other applications, and see Appendix B for more details on this technique).…”

Current evidence of the economic value of One Health initiatives: A systematic literature review

“… One Health initiative and level of implementation Sectors involved in the initiative One Health JPA action track ⁎ addressed Economic evaluation method Type and quantification of positive economic value. For all studies the counterfactual for evaluation was a uni-sectoral initiative H7N9 vaccination program in poultry in Guangxi, China implemented in multiple provinces/states [ 20 ] Human health, agricultural/veterinary services Action track 2 CBA (ex-post) BCR ⁎⁎ of the three-year H7N9 vaccination program was 18.6 (90 %PI: 15.4; 21.8) Total NPV ⁎⁎⁎ reached CNY 1.63 billion (90 %PI: 1.37 billion; 1.89 billion) Combining drug and environmental treatments for environmentally transmitted NTDs (using schistosomiasis as case study), in Senegal implemented at local level [ 21 ] Human health and environment services Action track 3 CBA (ex-ante) Implementing environmental controls with mass drug administration (MDA) can significantly reduce the time span over which one has to administer drug treatment, resulting in about a 10% reduction in MDA expenditures. Human health benefits from livestock vaccination for brucellosis, in Mongolia implemented at national level [ 22 ] Human health, agricultural/veterinary services Action track 3 CEA (ex-post) Societal average BCR ⁎⁎ of 3.2 (95% CI 2.27–4.37) over ten-year mass vaccination program Integrated control program for Taenia solium, soil transmitted helminths (STH) and classical swine fever in northern Lao PDR implemented at local level [ 23 ] Human health, agricultural/veterinary services Action track 3 CEA (ex-post) US $14 per DALY a averted for all combined interventions i.e., cysticercosis in humans and pigs, STH in humans and CSF in pigs (classified as very cost-effective based on WHO cost-effectiveness thresholds) over 1.5-year program Dog anthelmintic prophylaxis combined with a sheep and goat vaccination program for echinococcosis control in the Tibetan Plateau [ 24 ] Human health, agricultural/veterinary services Action track 3 CEA (ex-ante) U.S.$106.88 per DALY a averted (95% CI U.S.$88.63–127.99) with the proposed dog deworming and sheep and goat vaccination program over five-year period ...…”

Spatial Allocation of Scarce COVID-19 Vaccines*†‡

“…As the workability cost parameter c A goes to zero, the problem becomes linear in the controls where the optimal allocations in linear problems follow singular solutions. We use pseudospectral collocation to solve for the optimal dynamics of vaccine and infection over time, which converts the continuous time optimal control problem into a constrained non-linear programming problem solving for the coefficients of the approximating polynomials at the collocation nodes (see [44; 45] for other applications, and see Appendix B for more details on this technique).…”

“…Pseudospectral collocation approximates the continuous time optimal control model with a constrained nonlinear programming problem (see Castonguay and Lasserre, 2019; Castonguay et al, 2020; Kling et al, 2016; Sanchirico and Springborn, 2011, for other applications of this technique). The dynamic controls to our problem—i.e.…”