TY - JOUR AU - Lutumba, Pascal AU - Meheus, Filip AU - Robays, Jo AU - Miaka, Constantin AU - Kande, Victor AU - Büscher, Philippe AU - Dujardin, Bruno AU - Boelaert, Marleen T1 - Cost-effectiveness of Algorithms for Confirmation Test of Human African Trypanosomiasis T2 - Emerging Infectious Disease journal PY - 2007 VL - 13 IS - 10 SP - 1484 SN - 1080-6059 AB - The control of Trypanosoma brucei gambiense human African trypanosomiasis (HAT) is compromised by low sensitivity of the routinely used parasitologic confirmation tests. More sensitive alternatives, such as mini-anion exchange centrifugation technique (mAECT) or capillary tube centrifugation (CTC), are more expensive. We used formal decision analysis to assess the cost-effectiveness of alternative HAT confirmation algorithms in terms of cost per life saved. The effectiveness of the standard method, a combination of lymph node puncture (LNP), fresh blood examination (FBE), and thick blood film (TBF), was 36.8%; the LNP-FBE-CTC-mAECT sequence reached almost 80%. The cost per person examined ranged from €1.56 for LNP-FBE-TBF to €2.99 for LNP-TBF-CTC-mAECT-CATT (card agglutination test for trypanosomiasis) titration. LNP-TBF-CTC-mAECT was the most cost-effective in terms of cost per life saved. HAT confirmation algorithms that incorporate concentration techniques are more effective and efficient than the algorithms that are currently and routinely used by several T.b. gambiense control programs. KW - Human trypanosomiasis KW - diagnostic accuracy KW - Africa KW - sensitivity KW - specificity KW - Trypanosoma brucei gambiense KW - screening KW - algorithm KW - research DO - 10.3201/eid1310.060358 UR - https://wwwnc.cdc.gov/eid/article/13/10/06-0358_article ER - End of Reference