A new cost-benefit analysis by Mathematica, published in Tropical Diseases, Travel Medicine and Vaccines, explores the economic advantages of using wastewater monitoring to inform typhoid vaccine campaigns in developing countries. The study, which focused on a hypothetical campaign in the Rohingya refugee community in Cox’s Bazar, Bangladesh, found that wastewater monitoring could provide an early warning of a typhoid outbreak up to 13 days before clinical case counts increase. This lead time allows for an earlier launch of a vaccination campaign, which the researchers found to be highly cost-effective. For every $100 spent on wastewater monitoring, a 13-day early campaign launch could yield $295 in societal benefits by year five, primarily from averted deaths.
The analysis highlights that while the benefits of an early campaign launch are substantial, the costs and benefits balance out at a 5-day lead time. An early launch of four days or less would not generate enough benefits to outweigh the costs of the monitoring program. The researchers conclude that if wastewater surveillance methods for typhoid can be advanced to provide reliable early warnings, governments in high-aid countries with routine enteric disease outbreaks could see significant returns on their investment, justifying the sustained allocation of resources for such programs.
Thumbnail image credit: Gavi
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