Tália Machado de Assis1,2, André Luís Ferreira de Azeredo-da-Silva3,4, Gláucia Cota2, Marília Fonseca Rocha5,6, Guilherme Loureiro Werneck7. 1. Centro Federal de Educação Tecnológica de Minas Gerais, Contagem, MG, Brasil. 2. Fundação Oswaldo Cruz,Instituto René Rachou, Pesquisas Clínicas e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil. 3. Instituto para Avaliação de Tecnologias em Saúde, Porto Alegre, RS, Brasil. 4. Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil. 5. Universidade Estadual de Montes Claros, Centro de Ciências Biológicas e da Saúde, Departamento de Saúde Mental e Saúde Coletiva, Montes Claros, MG, Brasil. 6. Secretaria Municipal de Saúde, Centro de Controle de Zoonoses, Programa de Controle das Leishmanioses, Montes Claros, MG, Brasil. 7. Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Departamento de Epidemiologia, Rio de Janeiro, RJ, Brasil.
Abstract
INTRODUCTION: The use of insecticide-impregnated dog collars is a potentially useful tool for the control of visceral leishmaniasis. The objective of the present study was to perform a cost-effectiveness analysis of a program based on insecticide-impregnated collars compared to traditional visceral leishmaniasis control strategies used in Brazil. METHODS: A cost-effectiveness analysis was performed from the perspective of the Unified Health System, using data from the Visceral Leishmaniasis Control Program implemented in the municipality of Montes Claros, Minas Gerais. The direct costs of the three control strategies, which were 1) canine infection screening + sacrifice, 2) residual chemical control of the vector, and 3) insecticide-impregnated dog collars (Scalibor®), were evaluated over the two-year study period. RESULTS: The total cost of the program in the area subjected to the traditional control strategies (strategies 1 and 2; control area) was R$ 1,551,699.80, and in the area subjected to all three control strategies (intervention area), it was R$ 1,898,190.16. The collar program was considered highly cost-effective at preventing canine visceral leishmaniasis (incremental cost-effectiveness ratio of approximately R$ 578 per avoided dog sacrifice). CONCLUSIONS: These results provide support for the decision by the Brazilian Ministry of Health in 2019 to provide insecticide-impregnated collars for the control of canine visceral leishmaniasis in a pilot project.
INTRODUCTION: The use of insecticide-impregnated dog collars is a potentially useful tool for the control of visceral leishmaniasis. The objective of the present study was to perform a cost-effectiveness analysis of a program based on insecticide-impregnated collars compared to traditional visceral leishmaniasis control strategies used in Brazil. METHODS: A cost-effectiveness analysis was performed from the perspective of the Unified Health System, using data from the Visceral Leishmaniasis Control Program implemented in the municipality of Montes Claros, Minas Gerais. The direct costs of the three control strategies, which were 1) canineinfection screening + sacrifice, 2) residual chemical control of the vector, and 3) insecticide-impregnated dog collars (Scalibor®), were evaluated over the two-year study period. RESULTS: The total cost of the program in the area subjected to the traditional control strategies (strategies 1 and 2; control area) was R$ 1,551,699.80, and in the area subjected to all three control strategies (intervention area), it was R$ 1,898,190.16. The collar program was considered highly cost-effective at preventing caninevisceral leishmaniasis (incremental cost-effectiveness ratio of approximately R$ 578 per avoided dog sacrifice). CONCLUSIONS: These results provide support for the decision by the Brazilian Ministry of Health in 2019 to provide insecticide-impregnated collars for the control of caninevisceral leishmaniasis in a pilot project.
Authors: Jose Diego Brito-Sousa; Henry M Peixoto; Angela Devine; Alexandre V Silva-Neto; Patricia C S Balieiro; Vanderson S Sampaio; Sheila Vitor-Silva; Maxwell O Mendes; Brenda K A Souza; Marcus V G Lacerda; Wuelton M Monteiro Journal: PLoS Negl Trop Dis Date: 2022-03-24