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Impact and Cost-Effectiveness of a Comprehensive Schistosomiasis japonica Control Program in the Poyang Lake Region of China
Department of Schistosomiasis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, 207 Rui Jin Er Road, Shanghai 200025, China
World Health Organization Collaborating Center for Malaria, Schistosomiasis, and Filariasis—Key Laboratory of Parasite and Vector Biology, Ministry of Health, 207 Rui Jin Er Road, Shanghai 200025, China
Department of Epidemiology, School of Public Health, Fudan University, 130 Dong An Road, Shanghai 200032, China
Jingxian Schistosomiasis Control Station, JingXian 331700, China
Environmental and Occupational Health Section, Division of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1656 E. Mabel Street, Room 113, Tucson, AZ 85724, USA
World Health Organization 20, Avenue Appia, CH-1211 Geneva 27, Switzerland
* Authors to whom correspondence should be addressed.
Received: 1 August 2013; in revised form: 8 October 2013 / Accepted: 21 October 2013 / Published: 28 November 2013
Abstract: Schistosomiasis japonica remains a significant public-health problem in China. This study evaluated cost-effectiveness of a comprehensive schistosomiasis control program (2003–2006). The comprehensive control program was implemented in Zhangjia and Jianwu (cases); while standard interventions continued in Koutou and Xiajia (controls). Incurred costs were documented and the schistosomiasis comprehensive impact index (SCI) and cost-effectiveness ratio (Comprehensive Control Program Cost/SCI) were applied. In 2003, prevalence of Schistosoma japonicum infection was 11.3% (Zhangjia), 6.7% (Jianwu), 6.5% (Koutou), and 8.0% (Xiajia). In 2006, the comprehensive control program in Zhangjia and Jianwu reduced infection to 1.6% and 0.6%, respectively; while Koutou and Xiajia had a schistosomiasis prevalence of 3.2% and 13.0%, respectively. The year-by-year SCIs in Zhangjia were 0.28, 105.25, and 47.58, with an overall increase in cost-effectiveness ratio of 374.9%–544.8%. The SCIs in Jianwu were 16.21, 52.95, and 149.58, with increase in cost-effectiveness of 226.7%–1,149.4%. Investment in Koutou and Xiajia remained static (US$10,000 unit cost). The comprehensive control program implemented in the two case villages reduced median prevalence of schistosomiasis 8.5-fold. Further, the cost effectiveness ratio demonstrated that the comprehensive control program was 170% (Zhangjia) and 922.7% (Jianwu) more cost-effective. This work clearly shows the improvements in both cost and disease prevention effectiveness that a comprehensive control program-approach has on schistosomiasis infection prevalence.
Keywords: Schistosomiasis japonica; comprehensive control program; cost-effectiveness; Poyang Lake region
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Yu, Q.; Zhao, G.-M.; Hong, X.-L.; Lutz, E.A.; Guo, J.-G. Impact and Cost-Effectiveness of a Comprehensive Schistosomiasis japonica Control Program in the Poyang Lake Region of China. Int. J. Environ. Res. Public Health 2013, 10, 6409-6421.
Yu Q, Zhao G-M, Hong X-L, Lutz EA, Guo J-G. Impact and Cost-Effectiveness of a Comprehensive Schistosomiasis japonica Control Program in the Poyang Lake Region of China. International Journal of Environmental Research and Public Health. 2013; 10(12):6409-6421.
Yu, Qing; Zhao, Geng-Ming; Hong, Xian-Lin; Lutz, Eric A.; Guo, Jia-Gang. 2013. "Impact and Cost-Effectiveness of a Comprehensive Schistosomiasis japonica Control Program in the Poyang Lake Region of China." Int. J. Environ. Res. Public Health 10, no. 12: 6409-6421.