Cost-effectiveness analysis of routine case detection and leprosy elimination campaigns in Myanmar

Abstract

The current problem in the Leprosy Elimination Programme in Myanmar is low coverage of registered cases and there is evidence that backlog (hidden cases) are remained in the community. So there is a need for intensification of case finding activities in the implementation of the leprosy elimination programme. Leprosy Elimination Campaigns (LEC) is a strategy to detect hidden cases, remained in the community. The major objective ot this study is to assess the cost and effectiveness of different case finding activities: Routine Case Detection and LECs from the provider as well as patient's perspective. In this study, effectiveness in term of newly cases detected were used to find out which method of case finding activities is better. The cost effectiveness ratio are found out from three different endemic areas. The study shows that both provider as well as patient's perspective LECs activities is more cost effectiveness than Routine Case Detection activities. In low divisional endemic area, the cost-effectiveness ratio of 1998 LEC Township (Htantabin) is US 75 per newly detected case, but the cost-effectiveness ratio of 1998 Routine Case Detection Township (Kawhmu) is US 95.3. In medium divisional endemic area, the C\E ratio of LEC (Myaung) is US 17.5 and Routine Township (Salingyi) is US 39.9 In high divisional endemic area, LEC Township (Okpo) is US 24 and Routine Township (Gyobingauk) is US 52.1 So LEC activities are 1.7 to 2.3 times cost effective than routine Case Detection activities.