title: Cost-effectiveness of prevention strategies for American tegumentary leishmaniasis in Argentina.
abstract: The aim of this study was to estimate the cost-effectiveness of reducing tegumentary leishmaniasis transmission using insecticide-impregnated clothing and curtains, and implementing training programs for early diagnosis. A societal perspective was adopted, with outcomes assessed in terms of costs per disability adjusted life years (DALY). Simulation was structured as a Markov model and costs were expressed in American dollars (US$). The incremental cost-effectiveness ratio of each strategy was calculated. One-way and multivariate sensitivity analyses were performed. The incremental cost-effectiveness ratio for early diagnosis strategy was estimated at US$ 156.46 per DALY averted, while that of prevention of transmission with insecticide-impregnated curtains and clothing was US$ 13,155.52 per DALY averted. Both strategies were more sensitive to the natural incidence of leishmaniasis, to the effectiveness of mucocutaneous leishmaniasis treatment and to the cost of each strategy. Prevention of vectorial transmission and early diagnosis have proved to be cost-effective measures.
authors.affiliation: Instituto Nacional de Medicina Tropical, Puerto Iguazu,, Argentina.
authors.forename: Pablo Wenceslao
authors.initials: PW
authors.lastname: Orellano
authors.affiliation: Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Nestor
authors.initials: N
authors.lastname: Vazquez
authors.affiliation: Instituto Nacional de Medicina Tropical, Puerto Iguazu,, Argentina.
authors.forename: Oscar Daniel
authors.initials: OD
authors.lastname: Salomon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina; D002648:Child; D002675:Child, Preschool; D003020:Clothing; D003362:Cost-Benefit Analysis; D042241:Early Diagnosis; D006801:Humans; D007223:Infant; D007306:Insecticides; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000191:economics / Q000517:prevention & control* / Q000635:transmission; D008390:Markov Chains; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D055815:Young Adult
chemical_list: D007306:Insecticides