{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:26:29Z","timestamp":1759332389224},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T00:00:00Z","timestamp":1335830400000},"content-version":"vor","delay-in-days":6149,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Health Economics"],"published-print":{"date-parts":[[1995,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>African trypanosomiasis, or sleeping sickness, is a tropical disease caused by trypanosome parasites transmitted by tsetse flies. The focus of this paper is on the cost\u2010effectiveness of alternative drug treatments for patients in the late stage of the disease. Melarsoprol has been used for many decades. More recently, eflornithine has been developed. It has fewer side effects and improves the overall cure rate. It is much more expensive than melarsoprol, however.<\/jats:p><jats:p>The objective of the present cost\u2010effectiveness is to identify the costs and benefits that would be involved in switching from melarsoprol to eflornithine in the treatment of late stage sleeping sickness. Benefits are expressed in lives saved as well as in disability adjusted life years (DALYs). The analysis is applied to the case of Uganda. The implications for affordability are also considered, by taking account of how the treatment costs would be shared between the national government, donors and patients.<\/jats:p><jats:p>The baseline results indicate that melarsoprol treatment is associated with an incremental cost per life and DALY saved of $209 and $8, respectively. Each additional life saved by switching from melarsoprol alone to a combination of melarsoprol and eflornithine would cost an extra $1,033 per life saved, and an extra $40.9 per DALY gained. Shifting from this second alternative to treatment of all patients with eflornithine leads to an incremental cost per life saved of $4,444 and an incremental cost of $166.8 per DALY gained.<\/jats:p>","DOI":"10.1002\/hec.4730040404","type":"journal-article","created":{"date-parts":[[2012,5,2]],"date-time":"2012-05-02T04:37:44Z","timestamp":1335933464000},"page":"273-287","source":"Crossref","is-referenced-by-count":20,"title":["Cost\u2010effectiveness analysis of alternative treatments of African gambiense trypanosomiasis in Uganda"],"prefix":"10.1002","volume":"4","author":[{"given":"Claudio","family":"Politi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Carrin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.A.S.","family":"Kuzoe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.D.","family":"Cattand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,5]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0001-706X(93)90089-T"},{"key":"e_1_2_1_3_2","volume-title":"TDR News","year":"1992"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/00034983.1991.11812528"},{"key":"e_1_2_1_5_2","series-title":"Technical Report Series","first-page":"739","volume-title":"Epidemiology and control of African trypanosomiasis","author":"WHO.","year":"1986"},{"key":"e_1_2_1_6_2","volume-title":"Tropical disease research 1991\u201392.","author":"UNDP\/World Bank\/WHO.","year":"1993"},{"key":"e_1_2_1_7_2","first-page":"299","article-title":"Situation actuelle de la lutte contre la maladie du sommeil au Zaire","volume":"57","author":"Ruppol J. 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Sebina\u2010Nalwanga A.andLubanga R.Costs resources use and financing of health care services in Arua District Uganda in Anonymous (ed)Study conducted by the research team of the health planning unit of the Ministry under the International Health Policy Programme (IHPP)\u2014Uganda Project in collaboration with CUAMM 1994."},{"key":"e_1_2_1_15_2","volume-title":"Implementing the Bamako initiative in Africa. A review and five case studies","author":"McPake B.","year":"1992"},{"key":"e_1_2_1_16_2","volume-title":"Crisis in Uganda: the breakdown of health services","author":"Alnwick D. J.","year":"1985"},{"key":"e_1_2_1_17_2","volume-title":"The african trypanosomiases","author":"Mulligan H. W.","year":"1970"},{"issue":"1","key":"e_1_2_1_18_2","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/00034983.1989.11812413","article-title":"Treatment of rhodensian sleeping sickness in Kenya","volume":"83","author":"Wellde B. T.","year":"1989","journal-title":"Annals of Tropical Medicine and Parasitology"},{"issue":"3","key":"e_1_2_1_19_2","doi-asserted-by":"crossref","first-page":"525","DOI":"10.4269\/ajtmh.1987.37.525","article-title":"Treatment of human late stage gambiense trypanosomiasis with alpha\u2010Difluoromethylornithine (eflornithine): efficacy and tolerance in 14 cases in Cote d'Ivoire","volume":"37","author":"Doua F.","year":"1987","journal-title":"American Journal of Tropical Medicine and Hygiene"},{"issue":"611","key":"e_1_2_1_20_2","article-title":"Resultados do tratamento da trypanosomiase humana africana com o arsobal","volume":"16","author":"Ferreira F. 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