3つのサハラ以南のアフリカ諸国における肺結核に対する化学療法の費用対効果
C J Murray1, E DeJonghe, H J Chum
1Center for Population Studies, Harvard University, Cambridge, Massachusetts 02138.
Lancet (London, England)
|November 23, 1991
まとめ
開発途上国の肺結核の化学療法プログラムは,費用対効果が高い. アムブレーター短期化学療法は,重要な価値を提供しており,他の重要な医療介入よりも低コストで長年の命を救うことができます.
科学分野:
- 公衆衛生は公衆衛生である.
- 感染症のコントロール・コントロール
- 健康経済学 医療経済学
背景:
- 開発途上国における肺結核対策プログラムの費用対効果については議論されている.
- スプートムスミア陽性結核は,これらの地域で重要な公衆衛生上の課題であり続けている.
研究 の 目的:
- マラウイ,モザンビーク,タンザニアにおける肺結核の唾液塗布陽性肺結核に対する化学療法プログラムの費用対効果を評価する.
- 異なる化学療法のレジメンと投与方法によって1年に節約される生命のコストを比較する.
主な方法:
- マラウィ,モザンビーク,タンザニアの化学療法プログラムのデータを用いて費用対効果の分析.
- 短期化学療法と標準化学療法で,入院後も入院後も節約された1年あたりの増加コストの計算.
- 他の確立された費用対効果の高い医療介入との比較.
主要な成果:
- 短期化学療法は86-90%の治癒率を達成し,標準化学療法は60-66%を達成しました.
- 外出短期化学療法は,救命の1年あたりの最も低いコスト (0.9-1.1ドル) を有しており,次に外出標準化学療法は (0.9-1.3ドル) であった.
- スプレー陽性結核に対する化学療法は,麻疹予防接種と口腔再水分療法よりも費用対効果が優れています.
結論:
- 肺結核を治療する化学療法は,開発途上国では非常に費用対効果の高い介入です.
- 歩行治療戦略,特に短期間の化学療法は,最も優れた経済的価値を提供します.
- 結核を患ったHIV陽性患者の治療は,伝播効果が低下したため,費用対効果がわずかに低下するだけです.
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