Townsend Joy, Greenland Katie, Curtis Val
Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
Department for Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
Trop Med Int Health. 2017 Jan;22(1):74-81. doi: 10.1111/tmi.12808.
To estimate the national costs relating to diarrhoea and acute respiratory infections from not handwashing with soap after contact with excreta and the costs and benefits of handwashing behaviour change programmes in India and China.
Data on the reduction in risk of diarrhoea and acute respiratory infection attributable to handwashing with soap were used, together with World Health Organization (WHO) estimates of disability-adjusted life years (DALYs) due to diarrhoea and acute respiratory infection, to estimate DALYs due to not handwashing in India and China. Costs and benefits of behaviour change handwashing programmes and the potential returns to investment are estimated valuing DALYs at per capita GDP for each country.
Annual net costs to India from not handwashing are estimated at US$ 23 billion (16-35) and to China at US$ 12 billion (7-23). Expected net returns to national behaviour change handwashing programmes would be US$ 5.6 billion (3.4-8.6) for India at US$ 23 (16-35) per DALY avoided, which represents a 92-fold return to investment, and US$ 2.64 billion (2.08-5.57) for China at US$ 22 (14-31) per DALY avoided - a 35-fold return on investment.
Our results suggest large economic gains relating to decreases in diarrhoea and acute respiratory infection for both India and China from behaviour change programmes to increase handwashing with soap in households.
估算印度和中国因接触排泄物后未用肥皂洗手导致的腹泻和急性呼吸道感染的国家成本，以及洗手行为改变项目的成本和效益。
使用了因用肥皂洗手而导致腹泻和急性呼吸道感染风险降低的数据，以及世界卫生组织（WHO）对腹泻和急性呼吸道感染所致残疾调整生命年（DALYs）的估计，来估算印度和中国因未洗手导致的DALYs。通过以每个国家的人均国内生产总值对DALYs进行估值，估算了行为改变洗手项目的成本和效益以及潜在投资回报。
印度因未洗手造成的年度净成本估计为230亿美元（160 - 350亿美元），中国为120亿美元（70 - 230亿美元）。印度国家行为改变洗手项目的预期净回报为56亿美元（34 - 86亿美元），每避免一个DALY可节省23美元（16 - 35美元），这意味着投资回报率为92倍；中国为26.4亿美元（20.8 - 55.7亿美元），每避免一个DALY可节省22美元（14 - 31美元），投资回报率为35倍。
我们的结果表明，印度和中国通过开展家庭用肥皂洗手行为改变项目，在减少腹泻和急性呼吸道感染方面可获得巨大的经济收益。
