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Reviews of "Cost-effectiveness of End-game Strategies Against Sleeping Sickness across the Democratic Republic of Congo"

Reviewers: D Holtgrave (Johns Hopkins University) | 📘📘📘📘📘 • S Maya (UCSF) | 📗📗📗📗◻️

Published onApr 30, 2024
Reviews of "Cost-effectiveness of End-game Strategies Against Sleeping Sickness across the Democratic Republic of Congo"
key-enterThis Pub is a Review of
Cost-effectiveness of end-game strategies against sleeping sickness across the Democratic Republic of Congo
Cost-effectiveness of end-game strategies against sleeping sickness across the Democratic Republic of Congo
Description

Gambiense human African trypanosomiasis (gHAT) is marked for elimination of transmission (EoT) by 2030. We examined the cost-effectiveness (CE) of EoT in the Democratic Republic of Congo, which has the highest global gHAT burden. In 166 health zones (HZs), we modelled the transmission dynamics, health outcomes, and economic costs of six strategies during 2024-40, including the cessation of activities after case reporting reduces to zero. Uncertainty in CE was assessed within the net monetary framework, presented as the optimal strategies at a range of willingness-to-pay (WTP) values, denominated in costs per disability-adjusted life-year averted. Status quo strategies, CE strategies (WTP=$500), and strategies with a high probability of EoT by 2030 are predicted to yield EoT by 2030 in 117 HZs, 130 HZs, and 138 HZs respectively, at a cost by 2040 of \$159M (82M--266M), $175M ($98M-$285M), $206M ($114M-$339M). A more lenient timeline of EoT by 2040 could lead to EoT in 153 HZs at a cost of $189M ($105M-$311M), leaving 13 HZs shy of the goal. Investing in EoT by 2030 is predicted to reduce gHAT deaths from 34,770 (14,113-71,118) with status quo strategies to 8,214 (3,284-18,507).

To read the original manuscript, click the link above.

Summary of Reviews: This preprint presents a cost-effectiveness analysis of various interventions against sleeping sickness (or African trypanosomiasis) in the Congo. Using a novel stochastic model, the authors found that while elimination was epidemiologically possible, it will likely require a substantial increase in financial investment. Reviewers found the methodology used in this analysis to be robust and reliable in general though one reviewer had concerns that limitations were not discussed in enough detail. 

Reviewer 1 (David H…) | 📘📘📘📘📘

Reviewer 2 (Sigal M…) | 📗📗📗📗◻️

RR:C19 Strength of Evidence Scale Key

📕 ◻️◻️◻️◻️ = Misleading

📙📙 ◻️◻️◻️ = Not Informative

📒📒📒 ◻️◻️ = Potentially Informative

📗📗📗📗◻️ = Reliable

📘📘📘📘📘 = Strong

To read the reviews, click the links below. 

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