Dataset Information

Economic effects of introducing alternative Salmonella control strategies in Sweden.

ABSTRACT: The objective of the study was to analyse the economic effects of introducing alternative Salmonella control strategies in Sweden. Current control strategies in Denmark and the Netherlands were used as benchmarks. The true number of human Salmonella cases was estimated by reconstructing the reporting pyramids for the various scenarios. Costs were calculated for expected changes in human morbidity (Salmonella and two of its sequelae), for differences in the control programmes and for changes in cattle morbidity. The net effects (benefits minus costs) were negative in all scenarios (€ -5 to -105 million), implying that it would not be cost-effective to introduce alternative control strategies in Sweden. This result was mainly due to an expected increase in the incidence of Salmonella in humans (6035-57108 reported and unreported new cases/year), with expected additional costs of € 5-55 million. Other increased costs were due to expected higher incidences of sequelae (€ 3-49 million) and a higher cattle morbidity (€ 4-8 million). Benefits in terms of lower control costs amounted to € 4-7 million.

SUBMITTER: Sundstrom K

PROVIDER: S-EPMC4022667 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Economic effects of introducing alternative Salmonella control strategies in Sweden.

Sundström Kristian K Wahlström Helene H Ivarsson Sofie S Sternberg Lewerin Susanna S

PloS one 20140515 5

The objective of the study was to analyse the economic effects of introducing alternative Salmonella control strategies in Sweden. Current control strategies in Denmark and the Netherlands were used as benchmarks. The true number of human Salmonella cases was estimated by reconstructing the reporting pyramids for the various scenarios. Costs were calculated for expected changes in human morbidity (Salmonella and two of its sequelae), for differences in the control programmes and for changes in c ...[more]

PMID: 24831797

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Project description:BackgroundAn estimated 2·5 billion people are at risk of dengue. Incidence of dengue is especially high in resource-constrained countries, where control relies mainly on insecticides targeted at larval or adult mosquitoes. We did epidemiological and economic assessments of different vector control strategies.MethodsWe developed a dynamic model of dengue transmission that assesses the evolution of insecticide resistance and immunity in the human population, thus allowing for long-term evolutionary and immunological effects of decreased dengue transmission. We measured the dengue health burden in terms of disability-adjusted life-years (DALYs) lost. We did a cost-effectiveness analysis of 43 insecticide-based vector control strategies, including strategies targeted at adult and larval stages, at varying efficacies (high-efficacy [90% mortality], medium-efficacy [60% mortality], and low-efficacy [30% mortality]) and yearly application frequencies (one to six applications). To assess the effect of parameter uncertainty on the results, we did a probabilistic sensitivity analysis and a threshold analysis.FindingsAll interventions caused the emergence of insecticide resistance, which, with the loss of herd immunity, will increase the magnitude of future dengue epidemics. In our model, one or more applications of high-efficacy larval control reduced dengue burden for up to 2 years, whereas three or more applications of adult vector control reduced dengue burden for up to 4 years. The incremental cost-effectiveness ratios of the strategies for two high-efficacy adult vector control applications per year was US$615 per DALY saved and for six high-efficacy adult vector control applications per year was $1267 per DALY saved. Sensitivity analysis showed that if the cost of adult control was more than 8·2 times the cost of larval control then all strategies based on adult control became dominated.InterpretationSix high-efficacy adult vector control applications per year has a cost-effectiveness ratio that will probably meet WHO's standard for a cost-effective or very cost-effective intervention. Year-round larval control can be counterproductive, exacerbating epidemics in later years because of evolution of insecticide resistance and loss of herd immunity. We suggest the reassessment of vector control policies that are based on larval control only.FundingThe Fulbright Programme, CAPES (Brazilian federal agency for post-graduate education), the Miriam Burnett trust, and the Notsew Orm Sands Foundation.

Project description:To minimize the potential consequences of an introduction of foot-and-mouth disease (FMD) in Europe, European Union (EU) member states are required to present a contingency plan. This study used a simulation model to study potential outbreak scenarios in Sweden and evaluate the best control strategies. The model was informed by the Swedish livestock structure using herd information from cattle, pig, and small ruminant holdings in the country. The contact structure was based on animal movement data and studies investigating the movements between farms of veterinarians, service trucks, and other farm visitors. All scenarios of outbreak control included depopulation of detected herds, 3 km protection and 10 km surveillance zones, movement tracing, and 3 days national standstill. The effect of availability of surveillance resources, i.e., number of field veterinarians per day, and timeliness of enforcement of interventions, was assessed. With the estimated currently available resources, an FMD outbreak in Sweden is expected to be controlled (i.e., last infected herd detected) within 3 weeks of detection in any evaluated scenario. The density of farms in the area where the epidemic started would have little impact on the time to control the outbreak, but spread in high density areas would require more surveillance resources, compared to areas of lower farm density. The use of vaccination did not result in a reduction in the expected number of infected herds. Preemptive depopulation was able to reduce the number of infected herds in extreme scenarios designed to test a combination of worst-case conditions of virus introduction and spread, but at the cost of doubling the number of herds culled. This likely resulted from a combination of the small outbreaks predicted by the spread model, and the high efficacy of the basic control measures evaluated, under the conditions of the Swedish livestock industry, and considering the assumed control resources available. The results indicate that the duration and extent of FMD outbreaks could be kept limited in Sweden using the EU standard control strategy and a 3 days national standstill.

Dataset Information

Economic effects of introducing alternative Salmonella control strategies in Sweden.

Publications

Economic effects of introducing alternative Salmonella control strategies in Sweden.

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