Centro Federal de Educação Tecnológica de Minas Gerais, Contagem, MG, Brasil.
Fundação Oswaldo Cruz,Instituto René Rachou, Pesquisas Clínicas e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil.
Rev Soc Bras Med Trop. 2020 Dec 11;53:e20200680. doi: 10.1590/0037-8682-0680-2020. eCollection 2020.
The use of insecticide-impregnated dog collars is a potentially useful tool for the control of visceral leishmaniasis. The objective of the present study was to perform a cost-effectiveness analysis of a program based on insecticide-impregnated collars compared to traditional visceral leishmaniasis control strategies used in Brazil.
A cost-effectiveness analysis was performed from the perspective of the Unified Health System, using data from the Visceral Leishmaniasis Control Program implemented in the municipality of Montes Claros, Minas Gerais. The direct costs of the three control strategies, which were 1) canine infection screening + sacrifice, 2) residual chemical control of the vector, and 3) insecticide-impregnated dog collars (Scalibor®), were evaluated over the two-year study period.
The total cost of the program in the area subjected to the traditional control strategies (strategies 1 and 2; control area) was R$ 1,551,699.80, and in the area subjected to all three control strategies (intervention area), it was R$ 1,898,190.16. The collar program was considered highly cost-effective at preventing canine visceral leishmaniasis (incremental cost-effectiveness ratio of approximately R$ 578 per avoided dog sacrifice).
These results provide support for the decision by the Brazilian Ministry of Health in 2019 to provide insecticide-impregnated collars for the control of canine visceral leishmaniasis in a pilot project.
使用驱虫项圈是控制内脏利什曼病的一种潜在有效工具。本研究旨在对基于驱虫项圈的方案进行成本效益分析，该方案与巴西目前用于内脏利什曼病控制的传统策略进行比较。
从统一卫生系统的角度进行成本效益分析，使用在米纳斯吉拉斯州蒙蒂斯克拉鲁斯市实施的内脏利什曼病控制计划的数据。对三种控制策略的直接成本进行了评估，这三种策略是 1）犬感染筛查+扑杀，2）媒介的残留化学控制，以及 3）驱虫项圈（Scalibor®），评估期为两年。
在传统控制策略（策略 1 和 2；对照区）覆盖的区域中，该计划的总成本为 1551699.80 雷亚尔，而在所有三种控制策略（干预区）覆盖的区域中，总成本为 1898190.16 雷亚尔。项圈方案在预防犬内脏利什曼病方面被认为具有很高的成本效益（避免每只犬扑杀的增量成本效益比约为 578 雷亚尔）。
这些结果支持了 2019 年巴西卫生部的决定，即在试点项目中提供驱虫项圈，以控制犬内脏利什曼病。
