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Proc Natl Acad Sci U S A. 2013 May 7;110(19):7952-7. doi: 10.1073/pnas.1221396110. Epub 2013 Apr 15.

Cost-effectiveness of a community-based intervention for reducing the transmission of Schistosoma haematobium and HIV in Africa.

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1
School of Public Health, and Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT 06520, USA.

Erratum in

  • Proc Natl Acad Sci U S A. 2013 May 21;110(21):8750.

Abstract

Epidemiological studies from sub-Saharan Africa show that genital infection with Schistosoma haematobium [corrected] may increase the risk for HIV infection in young women. Therefore, preventing schistosomiasis has the potential to reduce HIV transmission in sub-Saharan Africa. We developed a transmission model of female genital schistosomiasis and HIV infections that we fit to epidemiological data of HIV and female genital schistosomiasis prevalence and coinfection in rural Zimbabwe. We used the model to evaluate the cost-effectiveness of a multifaceted community-based intervention for preventing schistosomiasis and, consequently, HIV infections in rural Zimbabwe, from the perspective of a health payer. The community-based intervention combined provision of clean water, sanitation, and health education (WSH) with administration of praziquantel to school-aged children. Considering variation in efficacy between 10% and 70% of WSH for reducing S. haematobium [corrected] transmission, our model predicted that community-based intervention is likely to be cost-effective in Zimbabwe at an aggregated WSH cost corresponding to US $725-$1,000 per individual over a 20-y intervention period. These costs compare favorably with empirical measures of WSH provision in developing countries, indicating that integrated community-based intervention for reducing the transmission of S. haematobium [corrected] is an economically attractive strategy for reducing schistosomiasis and HIV transmission in sub-Saharan Africa that would have a powerful impact on averting infections and saving lives.

KEYWORDS:

cost-effectiveness analysis; mathematical modeling; schistosomiasis control

PMID:
23589884
PMCID:
PMC3651507
DOI:
10.1073/pnas.1221396110
[Indexed for MEDLINE]
Free PMC Article
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