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Schistosomiasis screening in non-endemic countries from a cost perspective: knowledge gaps and research priorities: the case of African long-term residents in a Metropolitan Area, Spain

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dc.contributor.author Roure, Sílvia
dc.contributor.author López Seguí, Francesc, 1991-
dc.contributor.author Vallès, Xavier
dc.date.accessioned 2023-07-10T06:55:37Z
dc.date.available 2023-07-10T06:55:37Z
dc.date.issued 2023
dc.identifier.citation Roure S, López F, Oliva I, Pérez-Quílez O, March O, Chamorro A, et al. Schistosomiasis screening in non-endemic countries from a cost perspective: knowledge gaps and research priorities: the case of African long-term residents in a Metropolitan Area, Spain. PLoS Negl Trop Dis. 2023;17(4):e0011221. DOI: 10.1371/journal.pntd.0011221
dc.identifier.issn 1935-2727
dc.identifier.uri http://hdl.handle.net/10230/57513
dc.description.abstract Background: Imported schistosomiasis is an emerging issue in European countries as a result of growing global migration from schistosomiasis-endemic countries, mainly in sub-Saharan Africa. Undetected infection may lead to serious long-term complications with an associated high cost for public healthcare systems especially among long-term migrants. Objective: To evaluate from a health economics perspective the introduction of schistosomiasis screening programs in non-endemic countries with high prevalence of long-term migrants. Methodology: We calculated the costs associated with three approaches—presumptive treatment, test-and-treat and watchful waiting—under different scenarios of prevalence, treatment efficacy and the cost of care resulting from long-term morbidity. Costs were estimated for our study area, in which there are reported to reside 74,000 individuals who have been exposed to the infection. Additionally, we methodically reviewed the potential factors that could affect the cost/benefit ratio of a schistosomiasis screening program and need therefore to be ascertained. Results: Assuming a 24% prevalence of schistosomiasis in the exposed population and 100% treatment efficacy, the estimated associated cost per infected person of a watchful waiting strategy would be €2,424, that of a presumptive treatment strategy would be €970 and that of a test-and-treat strategy would be €360. The difference in averted costs between test-and-treat and watchful waiting strategies ranges from nearly €60 million in scenarios of high prevalence and treatment efficacy, to a neutral costs ratio when these parameters are halved. However, there are important gaps in our understanding of issues such as the efficacy of treatment in infected long-term residents, the natural history of schistosomiasis in long-term migrants and the feasibility of screening programs. Conclusion: Our results support the roll-out of a schistosomiasis screening program based on a test-and-treat strategy from a health economics perspective under the most likely projected scenarios, but important knowledge gaps should be addressed for a more accurate estimations among long-term migrants.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Public Library of Science (PLoS)
dc.relation.ispartof PLOS Neglected Tropical Diseases. 2023;17(4):e0011221.
dc.rights © 2023 Roure et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Schistosomiasis screening in non-endemic countries from a cost perspective: knowledge gaps and research priorities: the case of African long-term residents in a Metropolitan Area, Spain
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1371/journal.pntd.0011221
dc.subject.keyword Schistosomiasis
dc.subject.keyword Morbidity
dc.subject.keyword Serology
dc.subject.keyword Urine
dc.subject.keyword Economic analysis
dc.subject.keyword Schistosoma
dc.subject.keyword Schistosoma haematobium
dc.subject.keyword Schistosoma mansoni
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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