{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:12:29Z","timestamp":1784761949557,"version":"3.55.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Bando 2016 per finanziamento di progetti competitivi per ricercatori a tempo determinato dell\u2019Universit\u00e0 di Firenze"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Schistosomiasis can lead to severe irreversible complications and death if left untreated. Italian and European guidelines recommend serological screening for this infection in migrants from Sub-Saharan Africa (SSA). However, studies on clinical and economic impact of this strategy in the Italian and European settings are lacking. This study aims to compare benefits and costs of different strategies to manage schistosomiasis in migrants from SSA to Italy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A decision tree and a Markov model were developed to assess the health and economic impacts of three interventions: (i) passive diagnosis for symptomatic patients (current practice in Italy); (ii) serological screening of all migrants and treating those found positive and (iii) presumptive treatment for all migrants with praziquantel in a single dose. The time horizon of analysis was one year to determine the exact expenses, and 28\u00a0years to consider possible sequelae, in the Italian health-care perspective. Data input was derived from available literature; costs were taken from the price list of Careggi University Hospital, Florence, and from National Hospitals Records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Assuming a population of 100\u2009000 migrants with schistosomiasis prevalence of 21\u00b72%, the presumptive treatment has a greater clinical impact with 86.3% of the affected being cured (75.2% in screening programme and 44.9% in a passive diagnosis strategy). In the first year, the presumptive treatment and the screening strategy compared with passive diagnosis prove cost-effective (299 and 595 cost\/QALY, respectively). In the 28-year horizon, the two strategies (screening and presumptive treatment) compared with passive diagnosis become dominant (less expensive with more QALYs) and cost-saving.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of the model suggest that presumptive treatment and screening strategies are more favourable than the current passive diagnosis in the public health management of schistosomiasis in SSA migrants, especially in a longer period analysis.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jtm\/taac140","type":"journal-article","created":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T13:56:16Z","timestamp":1669211776000},"source":"Crossref","is-referenced-by-count":14,"title":["Presumptive treatment or serological screening for schistosomiasis in migrants from Sub-Saharan Africa could save both lives and money for the Italian National Health System: results of an economic evaluation"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0892-8404","authenticated-orcid":false,"given":"Lorenzo","family":"Zammarchi","sequence":"first","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence , Florence , Italy"},{"name":"Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital , Florence , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annarita","family":"Botta","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence , Florence , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Tilli","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence , Florence , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Gobbi","sequence":"additional","affiliation":[{"name":"Department of Infectious\u2014Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital , Negrar, Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Bartoloni","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence , Florence , Italy"},{"name":"Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital , Florence , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Boccalini","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence , Florence , 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