title: Cost-effectiveness of Chagas disease interventions in latin america and the Caribbean: Markov models.
abstract: Chagas disease is a parasitic disease in Latin America. Despite vector control programs that have reduced incidence by 70%, there are at least 12-14 million prevalent cases. We used a Markov model to examine strategies for control and treatment of Chagas disease that compared annual costs, life expectancies, and cost-effectiveness of three vector control and drug treatment strategies. Vector control programs alone and vector control plus drug treatment are dominant over no vector control (i.e., less costly and save more lives), and vector control plus drug is highly cost-effective compared with vector control alone. We demonstrated expected changes in deaths over time resulting from various prevention approaches. Vector control affects primarily incidence, not decreasing deaths and prevalence for 30 years, while drug treatment affects prevalence and deaths immediately. The best strategy to combat Chagas disease is combinations of vector control and a potential new drug.
authors.affiliation: Departments of Medicine and Pharmacy, University of California, San Francisco, California 94143, USA. lwilson@itsa.ucsf.edu
authors.forename: Leslie S
authors.initials: LS
authors.lastname: Wilson
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Strosberg
authors.forename: Kimberly
authors.initials: K
authors.lastname: Barrio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000981:Antiprotozoal Agents / Q000191:economics* / Q000627:therapeutic use; D017691:Caribbean Region / Q000453:epidemiology; D014355:Chagas Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007300:Insect Control / Q000191:economics*; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D008954:Models, Biological; D015995:Prevalence
chemical_list: D000981:Antiprotozoal Agents