Cost-Effective Analysis of Control Strategies to Reduce the Prevalence of Cutaneous Leishmaniasis, Based on a Mathematical Model

Abstract

Leishmaniasis is a neglected tropical vector-borne epidemic disease, and its transmission is a complex process. Zoonotic transmission to humans or animals occurs through the bites of female Phlebotominae sand flies. Here, reservoir is considered as a major source of endemic pathogen pool for disease outbreak, and the role of more than one reservoir animal becomes indispensable. To study the role of the reservoir animals on disease dynamics, a mathematical model was constructed consisting of susceptible and infected populations of humans and two types of reservoir (animal) and vector populations, respectively. Our aim is to prevent the disease by applying a control theoretic approach, when more than one type of reservoir animal exists in the region. We use drugs like sodium stibogluconate and meglumine antimoniate to control the disease for humans and spray insecticide to control the sand fly population. Similarly, drugs are applied for infected reservoir animals of Types A and B. We calculated the cost-effectiveness of all possible combinations of the intervention and control policies. One of our findings is that the most cost-effective case for Leishmania control is the spray of insecticides for infected sand fly vector. Alternate strategic cases were compared to address the critical shortcomings of single strategic cases, and a range of control strategies were estimated for effective control and economical benefit of the overall control strategy. Our findings provide the most innovative techniques available for application to the successful eradication of cutaneous leishmaniasis in the future.

Keywords

• vector borne disease
• cutaneous leishmaniasis (CL)
• transmission probability
• reservoir population
• insecticide spraying
• cost-effectiveness