Abstract:
BACKGROUND:The objective of study was to estimate the incremental cost-effectiveness ratio (ICER) of diagnostic options for visceral leishmaniasis (VL) in Brazil. METHODS:Six diagnostic tests were considered: IT LEISH, Kalazar Detect, DAT-LPC (DAT made in the Laboratório de Pesquisas Clínicas), IFAT, PCR and direct examination of bone marrow aspirate performed in either an ambulatory or a hospital setting. A database was built using the cost and effectiveness. The perspective of this study was the Brazilian public healthcare system and the results were expressed in costs per correctly diagnosed cases. RESULTS:In a favorable hypothetical scenario, DAT-LPC presented the lowest cost (US$4.92) and highest effectiveness (99%). Paired analyses showed that IT LEISH was dominant compared to IFAT, microscopy and Kalazar Detect and that Kalazar Detect was dominant over IFAT and microscopy. PCR was dominant over the bone marrow aspirate in the hospital and showed an ICER of 57.76 compared with aspirate in an ambulatory setting. CONCLUSIONS:These results highlight the need for the revision of algorithm for VL diagnostic in Brazil. Replacements of IFAT with DAT-LPC, Kalazar Detect with IT LEISH and bone marrow aspirate performed in a hospital setting with PCR are cost-effective public health measures.
journal_name
Trans R Soc Trop Med Hygauthors
Machado de Assis TS,Azeredo-da-Silva AL,Werneck GL,Rabello Adoi
10.1093/trstmh/trw050subject
Has Abstractpub_date
2016-08-01 00:00:00pages
464-71issue
8eissn
0035-9203issn
1878-3503pii
trw050journal_volume
110pub_type
杂志文章abstract::Diarrhoeal morbidity was studied during a 15-week period of the rainy season in 244 children aged 6 to 35 months in an urban Gambian community. The average prevalence of diarrhoea was 12.0% and the mean number of episodes per child varied between 2.4 and 2.9 depending on the definition of an episode. The number of chr...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(87)90052-6
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(87)90005-8
更新日期:1987-01-01 00:00:00
abstract::During a four-year study on Grenada, 4,754 mongooses were examined, of which 100 (2.1%) were rabid. Of 1,675 mongooses tested for rabies serum neutralizing (SN) antibody, 498 (30%) were positive. During these four years (1971-74) the antibody prevalence rate increased from 20.8% to 43.2%, whereas the number of rabid m...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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doi:10.1016/0035-9203(81)90143-7
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章,随机对照试验
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章,多中心研究
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更新日期:2009-06-01 00:00:00
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
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更新日期:2009-07-01 00:00:00
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journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/s0035-9203(96)90512-x
更新日期:1996-07-01 00:00:00