Description of programmes for control and elimination
| Programme | Cost-effectiveness threshold | Detailed description |
| Control | Reference | In alignment with the EIC methodology3 we use the ‘control’ as the counterfactual scenario which equates to recommendations by the WHO during 2013: total reliance on passive reporting in low transmission areas, biennial screening in moderate areas and annual screening in high transmission with the screening and treatment of CATT and pentamidine (stage1)/NECT (stage 2), respectively |
| Elimination I | ~US$200 per DALY averted’ | Involves the recommended surveillance levels for HAT Tbg by ‘Control’, but switching to new technologies for treatment (fexinidazole and oxaboroles) and diagnostics (rapid diagnostics with motorbike screening campaigns) in all areas but not implementing vector control strategies including ‘tiny targets’ (small insecticide-impregnated screens38) |
| Elimination II | ~US$700 per DALY averted | Involves biennial surveillance in low risk transmission areas, currently recommended surveillance levels for HAT Tbg by WHO in moderate and high risk areas, switching to new technologies for treatment and diagnostics in all areas, and implementing vector control strategies including ‘tiny targets’ but only in high risk transmission areas |
| Elimination III | ~US$1500 per DALY averted | Involves biennial surveillance in low risk transmission areas, currently recommended surveillance levels for HAT Tbg by WHO in moderate and high risk areas, switching to new technologies for treatment and diagnostics in all areas, and implementing vector control strategies including ‘tiny targets’ but only in moderate and high risk transmission areas |
*WHO surveillance recommendations: low risk (no active surveillance, passive surveillance only), moderate—biennial surveillance, high—annual surveillance.
CATT, card agglutination trypanosomiasis test;DALY, disability adjusted life years;EIC, eradication investment case; HAT Tbg, human African trypanosomiasis Trypanosoma brucei gambiense;NECT, nifurtomix-eflornithine combination therapy.