title: Impact and cost-effectiveness of a comprehensive Schistosomiasis japonica control program in the Poyang Lake region of China.
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.
authors.affiliation: Department of Schistosomiasis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, 207 Rui Jin Er Road, Shanghai 200025, China. ealutz@email.arizona.edu.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yu
authors.forename: Geng-Ming
authors.initials: GM
authors.lastname: Zhao
authors.forename: Xian-Lin
authors.initials: XL
authors.lastname: Hong
authors.forename: Eric A
authors.initials: EA
authors.lastname: Lutz
authors.forename: Jia-Gang
authors.initials: JG
authors.lastname: Guo
mesh_terms: D000818:Animals; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003140:Communicable Disease Control / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D006801:Humans; D058751:Livestock / Q000469:parasitology; D018803:Models, Economic; D008962:Models, Theoretical; D015995:Prevalence; D012189:Retrospective Studies; D012554:Schistosomiasis japonica / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D012621:Seasons; D012908:Snails / Q000469:parasitology*