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Volume 13, Number 10—October 2007
Global Poverty and Human Development


Cost-effectiveness of Algorithms for Confirmation Test of Human African Trypanosomiasis

Pascal Lutumba*†, Filip Meheus‡, Jo Robays†, Constantin Miaka*, Victor Kande*, Philippe Büscher†, Bruno Dujardin§, and Marleen Boelaert†Comments to Author 
Author affiliations: *Programmed National de Lutte contre la Trypanosomiase Humaine Africaine, Kinshasa, Democratic Republic of Congo; †Institute of Tropical Medicine, Antwerp, Belgium; ‡Royal Tropical Institute, Amsterdam, the Netherlands; §Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium;

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Table 4

Cost, incremental cost, effectiveness, incremental effectiveness, cost-effectiveness, and incremental cost-effectiveness ratio of HAT screening-treatment algorithms in baseline scenario*

Algorithm Effectiveness† Incremental effectiveness‡ Cost per examined person, € Incremental cost, €‡ Efficiency§ Incremental cost-effectiveness ratio¶
LNP-FBE-TBF 36.80 1.56 423.91
LNP-CTC 55.00 18.20 1.74 0.18 316.36 98.90
LNP-CATT titration-CTC-mAECT 64.50 9.50 1.96 0.22 303.88 231.58
LNP-CTC-mAECT 77.60 13.10 2.06 0.10 265.46 76.34
LNP-CTC-CATT titration 77.80 0.20 2.82 0.76 362.47 Dominated
LNP-TBF-CTC-mAECT 79.60 2.00 2.1 0.04 263.82 200.00
LNP-TBF-CTC-mAECT-CATT titration 83.00 3.40 2.99 0.89 360.24 2617.65

*HAT prevalence 1%. HAT, human African trypanosomiasis; LNP, lymph node puncture; FBE, fresh blood examination; TBF, thick blood film; CTC, capillary tube centrifugation; CATT, card agglutination test for trypanosomiasis; CATT titration, CATT titration at end-titer 8; mAECT, mini-anion-exchange centrifugation technique. Cost/effectiveness ratio calculated as cost / (effectiveness × prevalence). Differences due to rounding in table. US $1 = Euro 0.79, Feb 2004.
†% HAT deaths averted.
‡Cost and effectiveness calculated incremental to next least effective nondominated algorithm after ranking all algorithms by effectiveness.
§Cost-effectiveness per life saved.
¶Incremental cost-effectiveness ratio calculated as incremental cost / (incremental effectiveness × HAT prevalence). Differences due to rounding in table. All incremental changes expressed in comparison with LNP-FBE-TBF algorithm.

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