Cost Analysis of Tests for the Detection of Schistosoma mansoni Infection in Children in Western Kenya

Caitlin M. Worrell Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

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Monina Bartoces Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

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Diana M. S. Karanja Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

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Elizabeth A. Ochola Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

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Daniel O. Matete Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

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Pauline N. M. Mwinzi Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

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Susan P. Montgomery Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

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W. Evan Secor Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

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Financial resources tend to be limited in schistosomiasis endemic areas, forcing program managers to balance financial and scientific considerations when selecting detection assays. Therefore, we compared the costs of using single stool Kato-Katz, triplicate stool Kato-Katz, and point-of-contact circulating cathodic antigen (POC-CCA) assays for the detection of Schistosoma mansoni infection. Economic and financial costs were estimated from the viewpoint of a schistosomiasis control program using the ingredients approach. Costs related to specimen collection, sample processing and analysis, and treatment delivery were considered. Analysis inputs and assumptions were tested using one-way and two-way sensitivity analysis. The total per-person cost of performing the single Kato-Katz, triplicate Kato-Katz, and POC-CCA was US$6.89, US$17.54, and US$7.26, respectively. Major cost drivers included labor, transportation, and supplies. In addition, we provide a costing tool to guide program managers in evaluating detection costs in specific settings, as costs may vary temporally and spatially.

Author Notes

* Address correspondence to W. Evan Secor, 1600 Clifton Rd., MS: D-65, Atlanta, GA 30329-4027. E-mail: was4@cdc.gov

Financial support: This study received financial support from The University of Georgia Research foundation that is funded by the Bill and Melinda Gates Foundation and also by USAID-supported NTD control activities at the Centers for Disease Control and Prevention, Atlanta, GA.

Authors' addresses: Caitlin M. Worrell, Susan P. Montgomery, and W. Evan Secor, Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: cworrell@cdc.gov, zqu6@cdc.gov, and was4@cdc.gov. Monina Bartoces, Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: jze8@cdc.gov. Diana M. S. Karanja, Elizabeth A. Ochola, Daniel O. Matete, and Pauline N. M. Mwinzi, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya, E-mails: dkaranja@kemricdc.org, eakinyi@kemricdc.org, dmatete@kemricdc.org, and pmwinzi@kemricdc.org.

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