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Abstract
The purpose of this paper was to present estimates of costs and effects of selected interventions for hearing impairment in Africa and Asia. The method used mathematical simulation models on the basis of WHO burden of disease information, and WHO-CHOICE costing databases. Findings showed that in both regions, screening strategies for hearing impairment and delivery of hearing aids cost between I$1000 and I$1600 per DALY, with passive screening being the most efficient intervention. Active screening at schools and in the community are somewhat less cost-effective. In the treatment of chronic otitis media, aural toilet in combination with topical antibiotics costs is more efficient than aural toilet alone, and costs between I$11 and I$59 in both regions. The treatment of meningitis with ceftriaxone costs between I$55 and I$217 at low coverage levels, in both regions. In more absolute terms, the vast majority of all considered intervention strategies are cost-effective strategies according to international benchmarks, in both regions concerned. In conclusion, various strategies are economically attracti&v;e to reduce the disease burden of hearing impairment around the world.
| Abbreviations | ||
| ACER | = | Average cost-effectiveness ratio |
| CEA | = | Cost-effectiveness analysis |
| CHOICE | = | Choosing Interventions that are cost-effective |
| CMH | = | Commission on macroeconomics and health |
| COM | = | Chronic otitis and media |
| DALY | = | Disability-adjusted life year |
| ICER | = | Incremental cost- effectiveness ratio |
| Abbreviations | ||
| ACER | = | Average cost-effectiveness ratio |
| CEA | = | Cost-effectiveness analysis |
| CHOICE | = | Choosing Interventions that are cost-effective |
| CMH | = | Commission on macroeconomics and health |
| COM | = | Chronic otitis and media |
| DALY | = | Disability-adjusted life year |
| ICER | = | Incremental cost- effectiveness ratio |
Sumario
El propósito de este trabajo fue presentar información que estima los costos y efectos de intervenciones seleccionadas para los impedimentos auditivos en África y Asia. El método usó modelos de simulación matemática con base en la información de la WHO sobre el peso de las enfermedades y las bases de datos de costos WHOCHOICE. Los hallazgos mostraron que en ambas regiones, las estrategias de tamiz de impedimentos auditivos y la provisión de auxiliares auditivos cuesta entre I$1000 y I$1600 por DALY, siendo el tamiz pasivo la intervención más eficiente. El tamiz activo en las escuelas y en la comunidad tiene un costo-efectividad un tanto menor. En el tratamiento de la otitis media crónica, los costos de la higiene auricular en combinación con antibióticos tópicos es más eficiente que la higiene aislada, que van de I$11 a I$59 en ambas regiones. Los costos del tratamiento de la meningitis con cefriaxona fueron de entre I$55 y I$217, en niveles de baja cobertura en ambas regiones. En términos más absolutos, la amplia mayoría de todas las estrategias de intervención consideradas, en lo que concierne a las dos regiones, son costo-efectivas, de acuerdo con los patrones internacionales.