Economic evaluations of human schistosomiasis interventions: a systematic review and identification of associated research needs

Abstract

Background: Schistosomiasis is one of the most prevalent neglected tropical diseases (NTDs) with an estimated 229 million people requiring preventive treatment worldwide. Recommendations for preventive chemotherapy strategies have been made by the World Health Organization (WHO) whereby the frequency of treatment is determined by the settings prevalence. Despite recent progress, many countries still need to scale up treatment and important questions remain regarding optimal control strategies. This paper presents a systematic review of the economic evaluations of human schistosomiasis interventions. Methods: A systematic review of the literature was conducted on 22nd August 2019 using the PubMed (MEDLINE) and ISI Web of Science electronic databases. The focus was economic evaluations of schistosomiasis interventions, such as cost-effectiveness and cost-benefit analyses. No date or language stipulations were applied to the searches. Results: We identified 53 relevant health economic analyses of schistosomiasis interventions. Most studies related to Schistosoma japonicum followed by S. haematobium. Several studies also included other NTDs. In Africa, most studies evaluated preventive chemotherapy, whereas in China they mostly evaluated programmes using a combination of interventions (such as chemotherapy, snail control and health education). There was wide variation in the methodology and epidemiological settings investigated. A range of effectiveness metrics were used by the different studies. Conclusions: Due to the variation across the identified studies, it was not possible to make definitive policy recommendations. Although, in general, the current WHO recommended preventive chemotherapy approach to control schistosomiasis was found to be cost-effective. This finding has important implications for policymakers, advocacy groups and potential funders. However, there are several important inconsistencies and research gaps (such as how the health benefits of interventions are quantified) that need to be addressed to identify the resources required to achieve schistosomiasis control and elimination.

Short-, Mid-, and Long-Term Epidemiological and Economic Effects of the World Bank Loan Project on Schistosomiasis Control in the People’s Republic of China

“…The burden of schistosomiasis, expressed in DALYs, decreased by 68.7% from 1990 to 2017. Over the same period, the number of deaths attributable to schistosomiasis declined by 79.5% [ 29 ]. The prevalence of human schistosomiasis had dropped from 17.3% in 1992 to 2.1% by 2017.…”

Establishing and Integrating a Female Genital Schistosomiasis Control Programme into the Existing Health Care System

“…Health care worker knowledge, case-by-case therapy, and prevention chemotherapy with praziquantel have been proven to be effective and can improve individuals' health in the affected communities [45,72]. In 2016, schistosomiasis caused an estimated 24,000 deaths and 2.4 million disability-adjusted life years (DALYs) worldwide [45].…”

A cluster randomized controlled trial for assessing POC-CCA test based praziquantel treatment for schistosomiasis control in pregnant women and their young children: study protocol of the freeBILy clinical trial in Madagascar

“…A cost-effectiveness analysis accompanies the trial and compares costs and health impact associated with TBST with the status quo. The cost-effectiveness will generate knowledge in the context of very few economic evaluations conducted on human schistosomiasis interventions [ 17 ].…”