The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
Health economic impacts and cost-effectiveness of aflatoxin-reduction strategies in Africa: case studies in biocontrol and post-harvest interventions
Open accessAbstract
Advances in health economics have proven useful in evaluating the cost-effectiveness of interventions, where the benefit usually takes the form of improved health outcomes rather than market outcomes. The paper performs health-based cost-effectiveness analyses of two potential aflatoxin control strategies in Africa: (1) pre-harvest biocontrol, using atoxigenic strains of Aspergillus flavus competitively to exclude toxigenic strains from colonizing maize in Nigeria; and (2) post-harvest interventions in a package to reduce aflatoxin accumulation in groundnuts in Guinea. It is described how health benefits gained from each intervention, in terms of fewer aflatoxin-induced hepatocellular carcinoma cases, can be compared with the costs of implementing the interventions. It is found that both interventions would be extremely cost-effective if applied widely in African agriculture. That is, the monetized value of lives saved and quality of life gained by reducing aflatoxin-induced hepatocellular carcinoma far exceeds the cost of either biocontrol or the post-harvest intervention package to achieve those health benefits. The estimated cost-effectiveness ratio (CER; gross domestic product multiplied by disability-adjusted life years saved per unit cost) for biocontrol in Nigerian maize ranged from 5.10 to 24.8; while the estimated CER for the post-harvest intervention package in Guinean groundnuts ranged from 0.21 to 2.08. Any intervention with a CER > 1 is considered by the World Health Organization (WHO) to be 'very cost-effective', while an intervention with a CER > 0.33 is considered 'cost-effective'. Aside from cost-effectiveness, public health interventions must be readily accepted by the public, and must have financial and infrastructural support to be feasible in the parts of the world where they are most needed.
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Cites
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Science and Decisions: Advancing Risk Assessment
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Workgroup Report: Public Health Strategies for Reducing Aflatoxin Exposure in Developing Countries
Strosnider, H., Azziz-Baumgartner, E., Banziger, M., Bhat, R. V., Breiman, R., Brune, M.-N., DeCock, K., Dilley, A., Groopman, J., Hell, K., et al. (2006) · Environmental Health Perspectives · doi:10.1289/ehp.9302 · Cited by 538
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Case–Control Study of an Acute Aflatoxicosis Outbreak, Kenya, 2004
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Modification of immune function through exposure to dietary aflatoxin in Gambian children.
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Cited by
Global burden of aflatoxin-induced hepatocellular carcinoma: A risk assessment
Liu, Y., & Wu, F. (2010) · Environmental Health Perspectives · doi:10.1289/ehp.0901388 · Cited by 1,224
Self-citationHODGES, R. J., BUZBY, J. C., & BENNETT, B. (2011) · The Journal of Agricultural Science · doi:10.1017/s0021859610000936 · Cited by 777
Aflatoxin: a 50-year odyssey of mechanistic and translational toxicology
Kensler, T. W., Roebuck, B. D., Wogan, G. N., & Groopman, J. D. (2011) · Toxicological Sciences · doi:10.1093/toxsci/kfq283 · Cited by 703
Bandyopadhyay, R., Ortega-Beltran, A., Akande, A., Mutegi, C., Atehnkeng, J., Kaptoge, L., Senghor, A. L., Adhikari, B. N., & Cotty, P. J. (2016) · World Mycotoxin Journal · doi:10.3920/wmj2016.2130 · Cited by 331
Ortega, D. L., & Tschirley, D. L. (2017) · Journal of Agribusiness in Developing and Emerging Economies · doi:10.1108/jadee-12-2014-0045 · Cited by 141
Metadata
- Authors
- Wu, F., & Khlangwiset, P.
- Venue
- Food Additives & Contaminants: Part A
- Publisher
- Informa UK Limited
- Published
- 2010-04
- Volume
- 27
- Issue
- 4
- Pages
- 496-509
- ISSN
- 1944-0049 (ISSN-L)
- 1944-0057
- OpenAlex
- W1968009529
- Cited by
- 253
- References
- 31
- FWCI
- 14.19
- Type
- journal article
- Language
- en
- Open access
- green
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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