African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost.
<h4>Background</h4>Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the...
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2013
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oai:doaj.org-article:0496d73682e9493196fc9f9cc1a2feba2021-11-18T09:15:24ZAfrican Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost.1935-27271935-273510.1371/journal.pntd.0002032https://doaj.org/article/0496d73682e9493196fc9f9cc1a2feba2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23383355/pdf/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015.<h4>Methods and findings</h4>With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million.<h4>Conclusions</h4>Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future.Luc E CoffengWilma A StolkHonorat G M ZouréJ Lennert VeermanKoffi B AgblewonuMichele E MurdochMounkaila NomaGrace FobiJan Hendrik RichardusDonald A P BundyDik HabbemaSake J de VlasUche V AmazigoPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 7, Iss 1, p e2032 (2013) |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Luc E Coffeng Wilma A Stolk Honorat G M Zouré J Lennert Veerman Koffi B Agblewonu Michele E Murdoch Mounkaila Noma Grace Fobi Jan Hendrik Richardus Donald A P Bundy Dik Habbema Sake J de Vlas Uche V Amazigo African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost. |
| description |
<h4>Background</h4>Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015.<h4>Methods and findings</h4>With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million.<h4>Conclusions</h4>Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future. |
| format |
article |
| author |
Luc E Coffeng Wilma A Stolk Honorat G M Zouré J Lennert Veerman Koffi B Agblewonu Michele E Murdoch Mounkaila Noma Grace Fobi Jan Hendrik Richardus Donald A P Bundy Dik Habbema Sake J de Vlas Uche V Amazigo |
| author_facet |
Luc E Coffeng Wilma A Stolk Honorat G M Zouré J Lennert Veerman Koffi B Agblewonu Michele E Murdoch Mounkaila Noma Grace Fobi Jan Hendrik Richardus Donald A P Bundy Dik Habbema Sake J de Vlas Uche V Amazigo |
| author_sort |
Luc E Coffeng |
| title |
African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost. |
| title_short |
African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost. |
| title_full |
African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost. |
| title_fullStr |
African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost. |
| title_full_unstemmed |
African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost. |
| title_sort |
african programme for onchocerciasis control 1995-2015: model-estimated health impact and cost. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2013 |
| url |
https://doaj.org/article/0496d73682e9493196fc9f9cc1a2feba |
| work_keys_str_mv |
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