RESUMEN
BACKGROUND: Because lymphatic filariasis (LF) elimination efforts are hampered by a dearth of economic information about the cost of mass drug administration (MDA) programs (using either albendazole with diethylcarbamazine [DEC] or albendazole with ivermectin), a multicenter study was undertaken to determine the costs of MDA programs to interrupt transmission of infection with LF. Such results are particularly important because LF programs have the necessary diagnostic and treatment tools to eliminate the disease as a public health problem globally, and already by 2006, the Global Programme to Eliminate LF had initiated treatment programs covering over 400 million of the 1.3 billion people at risk. METHODOLOGY/PRINCIPAL FINDINGS: To obtain annual costs to carry out the MDA strategy, researchers from seven countries developed and followed a common cost analysis protocol designed to estimate 1) the total annual cost of the LF program, 2) the average cost per person treated, and 3) the relative contributions of the endemic countries and the external partners. Costs per person treated ranged from $0.06 to $2.23. Principal reasons for the variation were 1) the age (newness) of the MDA program, 2) the use of volunteers, and 3) the size of the population treated. Substantial contributions by governments were documented - generally 60%-90% of program operation costs, excluding costs of donated medications. CONCLUSIONS/SIGNIFICANCE: MDA for LF elimination is comparatively inexpensive in relation to most other public health programs. Governments and communities make the predominant financial contributions to actual MDA implementation, not counting the cost of the drugs themselves. The results highlight the impact of the use of volunteers on program costs and provide specific cost data for 7 different countries that can be used as a basis both for modifying current programs and for developing new ones.
Asunto(s)
Antihelmínticos/uso terapéutico , Filariasis Linfática/tratamiento farmacológico , Albendazol/economía , Albendazol/uso terapéutico , Antihelmínticos/economía , Burkina Faso/epidemiología , Costos y Análisis de Costo , Dietilcarbamazina/economía , Dietilcarbamazina/uso terapéutico , República Dominicana/epidemiología , Quimioterapia/economía , Quimioterapia/métodos , Egipto/epidemiología , Elefantiasis/tratamiento farmacológico , Elefantiasis/prevención & control , Filariasis Linfática/prevención & control , Ghana/epidemiología , Haití/epidemiología , Humanos , Grupo de Atención al Paciente , Filipinas/epidemiología , Tanzanía/epidemiologíaRESUMEN
The pathological manifestations of parasitization by Wucheria bancrofti appear to result from a combination of three causes namely: (a) an allergic reaction to the parasite evidenced by oedema, urticaria and itching of the skin with occasionally arthritis and synovitis. (b) invasion of the oedematous and devitalized tissues by pathogenic micro-organisms. (c) lymphatic obstruction caused by the parasite itself and partly by a reactive fibrosis. Treatment by streptococcal vaccines is useful but symptoms recur sooner or later. Treatment of the allergic symptoms by desensitization with extracts of Dirofilaria immitis may be helpful. Treatment by a combination of vaccines and desensitizing extracts promises to be of value in amelioration of symptoms, prevention of attacks and prevention of elephantiasis (Summary)