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尼日利亚的非伤寒性:“多部门”监测、治疗和控制的结果是否证明干预成本合理?

Non-typhoidal in Nigeria: do outcomes of 'multisectoral' surveillance, treatment and control justify the intervention costs?

作者信息

Sanni Abdullahi O, Jibril Abdurrahman H, Fasanmi Olubunmi G, Adebowale Oluwawemimo O, Jambalang Alexander R, Shittu Aminu, Jonker Annelize, Abdulkarim Latifah O, Fasina Folorunso O

机构信息

Department of Veterinary Tropical Diseases, University of Pretoria, Pretoria, South Africa.

Agro-Processing, Productivity Enhancement and Livelihood Improvement Support (APPEALS) Project, Lokoja, Nigeria.

出版信息

Int J Vet Sci Med. 2024 Jul 14;12(1):48-59. doi: 10.1080/23144599.2024.2365567. eCollection 2024.

Abstract

Non-typhoidal salmonellosis (NTS) is significant and an economic burden in Nigeria. To determine whether investment in NTS control is economically justifiable, Outbreak Costing Tool (OCT) was used to estimate the robust funding of public and animal health systems for epidemio-surveillance and control of multisectoral NTS outbreaks in Nigeria. Health, production, and economic data were collected and used to populate the tool for evaluation. The multisectoral NTS burden for the year 2020 in Nigeria was US$ 930,887,379.00. Approximately 4,835 technical officers, and 3,700 non-technical staff ( = 8,535) were needed with an investment of >2.2 million work hours. The investment cost for NTS control was US$ 53,854,660.87. The non-labour-related cost was 89.21% of the total intervention costs. The overall intervention's investment was 374.15% of the estimated national and subnational systems' annual budget for diarrhoeal diseases, and the outbreak response period attracted the highest costs (53%) of the total intervention. In conclusion, intervention against NTS was beneficial (benefit - cost ratio: 17.29), hence justifying the need for multisectoral surveillance-response against NTS in Nigeria. Complex sectoral silos must give way to coordinated collaborations to optimize benefits; and over-centralization of health interventions' associated delays must be removed through decentralized sub-national-focused framework that empowers rapid investigation, response, control, data collection, and analyses. It should assist anticipatory planning, and outbreak investigation and reduce critical response time. Anticipatory planning tools, when applied pre-emptively, can benefit budgeting, identify gaps, and assist in the delivery of cost-saving and effective measures against infectious disease.

摘要

非伤寒沙门氏菌病(NTS)在尼日利亚是一个严重的问题且带来经济负担。为了确定对NTS控制的投资在经济上是否合理,使用了疫情成本核算工具(OCT)来估计为尼日利亚多部门NTS疫情的流行病学监测和控制而对公共卫生和动物卫生系统进行有力资助的情况。收集了卫生、生产和经济数据,并用于填充该工具以进行评估。2020年尼日利亚多部门NTS负担为9.30887379亿美元。大约需要4835名技术人员和3700名非技术人员(共计8535人),投资超过220万个工时。NTS控制的投资成本为53854660.87美元。与劳动力无关的成本占总干预成本的89.21%。总体干预投资是估计的国家和次国家系统年度腹泻病预算的374.15%,疫情应对期占总干预成本的比例最高(53%)。总之,针对NTS的干预是有益的(效益成本比为17.29),因此证明了在尼日利亚对NTS进行多部门监测应对的必要性。复杂的部门壁垒必须让位于协调合作以优化效益;必须通过以次国家为重点的分散框架消除卫生干预相关延误的过度集中化,该框架能够促进快速调查、应对、控制、数据收集和分析。它应有助于前瞻性规划、疫情调查并减少关键应对时间。前瞻性规划工具如能预先应用,可有利于预算编制、识别差距,并有助于采取节省成本和有效的传染病防控措施。

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