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“同一健康”背景下人畜共患病监测的经济学:瑞士弯曲杆菌监测评估

Economics of zoonoses surveillance in a 'One Health' context: an assessment of Campylobacter surveillance in Switzerland.

作者信息

Babo Martins S, Rushton J, Stärk K D C

机构信息

Department of Production and Population Health,Veterinary Epidemiology, Economics and Public Health Group,Royal Veterinary College,Hatfield,UK.

出版信息

Epidemiol Infect. 2017 Apr;145(6):1148-1158. doi: 10.1017/S0950268816003320. Epub 2017 Jan 23.

Abstract

Cross-sectorial surveillance and general collaboration between the animal and the public health sectors are increasingly recognized as needed to better manage the impacts of zoonoses. From 2009, the Swiss established a Campylobacter mitigation system that includes human and poultry surveillance data-sharing within a multi-sectorial platform, in a 'One Health' approach. The objective of this study was to explore the economics of this cross-sectorial approach, including surveillance and triggered interventions. Costs and benefits of the One Health and of the uni-sectorial approach to Campylobacter surveillance were identified using an economic assessment framework developed earlier. Cost information of surveillance activities and interventions was gathered and disability-adjusted life years (DALYs) associated with the disease estimated for 2008 and 2013. In the first 5 years of this One Health approach to Campylobacter mitigation, surveillance contributed with information mainly used to perform risk assessments, monitor trends and shape research efforts on Campylobacter. There was an increase in costs associated with the mitigation activities following integration, due mainly to the allocation of additional resources to research and implementation of poultry surveillance. The overall burden of campylobacteriosis increased by 3·4-8·8% to 1751-2852 DALYs in 2013. In the timing of the analysis, added value associated with this cross-sectorial approach to surveillance of Campylobacter in the country was likely generated through non-measurable benefits such as intellectual capital and social capital.

摘要

动物卫生与公共卫生部门之间的跨部门监测和全面合作日益被认为是更好地管理人畜共患病影响所必需的。自2009年以来,瑞士建立了一个弯曲杆菌缓解系统,该系统采用“同一健康”方法,在一个多部门平台内实现人类和家禽监测数据共享。本研究的目的是探讨这种跨部门方法的经济学,包括监测和触发的干预措施。使用先前开发的经济评估框架确定了弯曲杆菌监测的“同一健康”方法和单一部门方法的成本和效益。收集了监测活动和干预措施的成本信息,并估计了2008年和2013年与该疾病相关的伤残调整生命年(DALYs)。在这种针对弯曲杆菌缓解的“同一健康”方法的前5年中,监测提供的信息主要用于进行风险评估、监测趋势以及指导弯曲杆菌研究工作。整合后缓解活动的成本有所增加,主要原因是为家禽监测的研究和实施分配了额外资源。2013年,弯曲杆菌病的总体负担增加了3.4%-8.8%,达到1751-2852个伤残调整生命年。在分析时,该国这种跨部门弯曲杆菌监测方法带来的附加值可能来自智力资本和社会资本等不可衡量的效益。

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