Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR

摘要

Author summary A study was conducted in northern Lao PDR to ascertain the cost-effectiveness of controlling Taenia solium (T. solium taeniasis/cysticercosis) using five approaches namely: i) T. solium taeniasis/cysticercosis alone in the human population (the base comparator), ii) T. solium taeniasis/cysticercosis and soil transmitted helminths (STH) in the human population, iii) T. solium taeniasis/cysticercosis alone in the human and pig population, iv) T. solium taeniasis/cysticercosis in the pig population and STH in humans, and v) T. solium taeniasis/cysticercosis, STH and Classical Swine Fever (CSF) in humans and pigs. Using cost-effectiveness ratio (after aggregating the net cost and using zDALY approach as an alternative method), the study found that the simultaneous control of T. solium taeniasis/cysticercosis, STH and CSF in human and pig population was USD 14 per DALY averted and USD 234 per zDALY averted thus considered highly cost-effective whereas control of T. solium taeniasis/cysticercosis alone in the human and pig population was the least cost-effective as it was found to be USD 3,672 per DALY averted using the aggregate net cost method and USD 3,662 using the zDALY approach,. We concluded that inclusion of STH and CSF to T. solium taeniasis/cysticercosis mitigation efforts drastically improved the overall cost-effectiveness of the intervention in northern Laos where all the three diseases are endemic.