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52Ukrainian Journal of
Veterinary and Agricultural Sciences!
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Volume 4 Number 3
Stepan Gzhytskyi National University of Veterinary Medicine and Biotechnologies Lviv
original article | UDC 619:616.993.19:636.8 doi: 10.32718/ujvas4-3.10
Economic efficiency of different treatment schemes of cats microsporia
Ya. V. Kisera, Yu. V. Martyniv
Stepan Gzhytskyi National University of Veterinary Medicine and Biotechnologies Lviv, Pekarska Str., 50, Lviv, 79010, Ukraine
Article info Received 22.08.2021 Received in revised form
26.09.2021 Accepted 27.09.2021
Correspondence author Yulia Martyniv Tel.: +38-097-155-47-53 E-mail: juliajyush@ukr. net
2021 Martyniv Y., & Kisera Ya. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Contents
1. Introduction................. .. 58
2. Materials and methods .... .. 59
3. Results and discussion .... .. 59
4. Conclusions................ .. 60
.. 60
Abstract
The most common fungal skin disease in animals is microsporia; the principal causative agent is the fungus Mi-crosporum canis. The disease is of fungal etiology and highly contagious. The pathogen can stay in the environment for a long time and pose a risk of human infection. Cats, especially those walking on the street, are a significant factor in transmitting the infection. Spores of Microsporum canis can persist on the surface of the cat's body for a long time and, under favorable conditions, can provoke clinical manifestations of the disease. Under these circumstances, they are intensively distributed in the environment. Therefore, choosing the optimal therapeutic approach to solving this problem is essential. Treatment of sick animals should be practical and aimed at preventing the spread of the pathogen and cost-effective and beneficial to both veterinary specialists and owners of sick cats, as the duration of treatment is on average 14-21 days in order to determine the cost-effectiveness of treatment of microsporia in cats with the antifungal agent "Micromar" and immunostimulant "Biogluk" in comparison with other schemes, the calculation of the cost-effectiveness ratio CER. This made it possible to obtain accurate and complete data, as it took into account the cost of treatment and the number of animals that recovered during the complex therapy.
Sick animals were divided into three groups. Each sick animal received treatment for 21 days. The first group was treated with the systemic antifungal itraconazole and treated with a 1 % solution of clotrimazole. The second group was vaccinated twice with Vakderm antifungal vaccine and treated daily with a topical antifungal agent (1 % clotrimazole solution). The third group used the antifungal agent "Micromar" and immunostimulant "Biogluk". To control the quality of therapy, culture was performed on the nutrient medium for dermatophytes from the affected areas of the animal's body. The calculation of cost-effectiveness indicators showed that the treatment of cats with microsporia is effective in all groups of studied animals, as recovery occurred in each patient. However, the costs of therapy are different. In particular, in the first group, the CER coefficient is - 48.00 hryvnias, in the second - 42.00 hryvnias, in the third - 13.00 hryvnias.
Keywords: cats, microsporia, economic efficiency, coefficient.
Citation:
Kisera, Ya. V., & Martyniv, Yu. V. (2021). Economic efficiency of different treatment schemes of cats microsporia. Ukrainian Journal of Veterinary and Agricultural Sciences, 4(3), 58-61. V....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................J
1. Introduction
Among skin diseases of fungal etiology, microsporia is in the first place. The disease is highly contagious and dangerous not only for animals but also for humans. Cats, which are the reservoir of the pathogen in the environment, are most often affected by microsporia. The pathogen's spores are on the body of the animal and spread in the environment. About 50-70 % of stray cats tolerate microspores (Golovina, 1988; Ginger, 2004). The disease most often occurs due to contact with a sick animal. In this case, the pathogen's spores can be found in grass, soil, and infection can occur through infected toys, care items, shoes, clothing, and air (Golovina, 1988; Klymko, 2007; Ramsey, 2007). However, the symptoms of the disease can not always be diagnosed in time because microsporia is characterized not only by generalized and localized clinical forms but also hidden form, which poses a greater risk of infection and
spread of the pathogen (Scott et al., 2001). The site of parasitism of the pathogen is the surface of the animal's body, and spores can penetrate the upper layers of the epidermis. Often the disease in carriers of the pathogen occurs against the background of favorable factors. There is a decrease in immune resistance when taking immunosuppressive drugs and as a complication of other dermatological diseases (atopic dermatitis, pyoderma, skin allergic reactions). The prolonged incubation period is also a favorable factor for the pathogen's spread (Ginger, 2004; Kharchenko & Volkov, 2008).
It is known that the clinical manifestation of microsporia is characterized by lesions of the hair shafts most often caused by Microsporum canis. The affected hair is surrounded by a mycelium of the fungus, which multiplies intensively and spreads over a large area of the body of the sick animal. As a result, infected arthrospores enter the environment from the surface of the animal's body, thus continu-
ing the epizootic chain. In the environment, infected arthro-spores can be infected for one and a half years. This process ensures stable circulation of the fungus Microsporum canis. Cats and carriers of the pathogen are dangerous to humans because the disease is anthropozoonic and highly contagious (Ginger, 2004; Kharchenko & Volkov, 2008). The main danger for human infection is homeless cats and domestic dogs walking on the street (Golovina, 1988). It is essential to diagnose the disease in time and provide quality and effective treatment. Therefore, therapeutic methods aim to prevent the spread of the pathogen in the environment and effective treatment of sick animals (Hovorushko, 2007; Demchenko & Momot, 2013). The average course of treatment for microsporia is 14-21 days and involves the isolation of patients and regular treatment of the affected areas of the animal's body. In this regard, veterinarians face the problem of choosing an effective and safe drug and cost-effective, as the owner of a sick animal for a long time will carry out therapeutic measures (Brown & Silverman, 1999; Stefanova et al., 2001). The current strategy for treating microsporia involves safe and comprehensive therapy (Nakonechna, 2016). The use of new means of efferent therapy indicates the feasibility of economic calculations of the optimal combination of efficiency and cost of treatment of microsporia in cats to ensure the most effective and cost-effective treatment for all sick animals (Kharchenko & Volkov, 2008). The pharmacoeconomic approach makes it possible to clinically and economically justify appropriate treatment methods of microsporia and select the optimal treatment according to different criteria (Golovina, 1988; Brown & Silverman, 1999; Klymko, 2007).
The introduction of new veterinary drugs involves studies of the comparative effectiveness of a new drug with already known drugs. These data are obtained during clinical trials, an experiment on target animals (Krukovska, 2009; Zhyla, 2011). Economic efficiency is an essential marker of evaluation in implementing any innovative approach to treatment, as it determines the viability, market competitiveness, and feasibility of use in veterinary practice (Kobina, 1999; Jaremchuk et al., 2010). Determining cost-effectiveness allows veterinarians to select the most effective and cost-effective treatment for a sick animal and further reduce the owner's costs throughout therapy. This gives several objective indicators of the cost of practical drug therapy when using different treatment regimens for microsporia in cats (Krukovska, 2009; Shcherbatiuk, 2016).
The antifungal agent "Micromar" and the immunostimu-lant "Biogluk" for the treatment of microsporia in cats were tested to determine the cost-effectiveness of these drugs compared to other treatments regimens. Clinical trials have made it possible to determine the criteria for assessing the cost-effectiveness of "Micromar" and "Biogluk" by calculating the cost-effectiveness ratio CER compared to other drugs (Kobina, 1999; Hovorushko, 2007; Ponomar et al., 2008).
The purpose of the study was to conduct an economic evaluation of the effectiveness of treatment of microsporia in cats with drugs "Micromar" and "Biogluk" in comparison with other schemes.
2. Materials and methods
The research was conducted in the conditions of the private veterinary clinic "Impulse" in Lviv on 15 cats sick with microsporia, treated according to different schemes.
Sick animals were divided into three groups of 5 heads each. Each of the study groups received microsporia therapy for 21 days. The first group received treatment with the systemic antifungal itraconazole at a dose of 5-10 mg/kg once a day, which was administered orally, and local treatments of the affected areas of the skin with 1 % solution clotrimazole once a day for 21 days. The second group -received topical treatments with the antifungal agent (1 % solution of clotrimazole) once a day for 21 days and vaccination with antifungal vaccine "Vakderm" 2 times with an interval of 10 days (Zhyla, 2011). The third group - applied the drug "Micromar" on the affected areas of the skin once a day for 21 days and drank once a day the drug "Biogluk" for 21 days (Zhyla, 2011; Martyniv & Kisera, 2020; 2021).
Diagnosis of microsporia was carried out by clinical and epizootiological analysis of disease indicators and laboratory studies. Mercury-quartz lamp "Wood" and selective medium with pH indicator "DERMAKIT" from Biopronix were used for research in the clinic.
Quality control of treatment was performed by seeding on nutrient-selective medium for dermatophytes "DERMAKIT" on the 10th and 20th day after the start of drug use (Krukovska, 2009). The studied animals were considered clinically healthy after receiving two negative seeding results on a selective medium.
Calculations of the effectiveness of the use of drugs "Micromar" and "Biogluk" were performed by calculating the indicator "cost-effectiveness ratio" CER (Kobina, 1999).
CER = (DC = IC) : Ef
Where: DC - direct costs;
IC - indirect costs;
Ef - effectiveness of treatment.
Indicators such as the cost of each drug and consumables used for its use were considered.
All calculations were performed according to 2020 prices.
3. Results and discussion
Considering the cost of drugs and the peculiarities of the scheme of their set during the treatment period, the economic efficiency in treating microsporia by different methods was established. The duration of treatment for each sick cat was 21 days using each of the therapeutic regimens. Clinical trials have elucidated the cost-effectiveness of "Micromar" and "Biogluc" compared to other agents, including the use of the systemic antifungal itraconazole, the antifungal vaccine Vakderm, and a topical treatment based on a 1 % clot-rimazole solution.
Table 1 shows the initial data on the cost of drugs and consumables for their use, which was used in subsequent calculations.
Table 2 shows the results of the calculation of the cost-effectiveness ratio (CER) for the complex treatment of microspores in cats with different schemes.
Table 1
The cost of drugs and consumables for 2020
Drug, consumables
For 1 unit of goods
Price (UAH)
For the course of treatment 1 cat
Itraconazole, tablets (250 mg) №10 202.00 202.00
1 % clotrimazole solution, 50 ml vial 14.00 14.00
Vakderm vaccine, 1 dose 85.00 170.00
Micromar, 100 ml vial 16.17 16.17
Biogluk, 100 ml vial 24.78 24.78
Syringe 2 ml 1.10 2.20
Non-sterile bandage 7x14 6.00 12.00
Cotton, 50 g 12.00 12.00
Table 2
Calculation of the CER coefficient
Group I - Group 2 - Group 3 -
№ Indexes Intraconazole + Vakderm + Micromar +
clotrimazole clotrimazole Biogluc
Direct costs in UAH (DC)*
1. The cost of medication for 1 day according to the protocol 10.27 8.75 1.94
2. Only for 1 day 11.41 9.99 3.05
3. The cost of treatment 216.00 184.00 40.95
Indirect costs in UAH (IC)**
4. Cost of expenses for 1 day 1.14 1.15 1.14
5. The cost of the curs of treatment 24.00 26.20 24.0
Final calculations
6. Total costs (direct + indirect, DC + IC) 240.00 210.20 64.95
7. Number of patients who recovered (Ef) 5 5 5
8. Costs - efficiency CER=(DC+IC):Ef 48.00 42.00 13.00
Notes: * - the cost of 1 day of treatment according to the protocol: Itraconazole - UAH 9.61; 1 % clotrimazole - UAH 0.66; "Vakderm" -UAH 8.09; "Micromar" - UAH 0.77; "Biogluk" - UAH 1.18, only UAH 20.31; ** - consumables
The approbation of the antifungal drug Micromar and the immunostimulant Biogluc in cats with microsporia allowed us to determine the criteria for assessing the cost-effectiveness of these drugs by calculating the cost-effectiveness ratio CER compared to other treatment regimens.
Direct costs in treating patients with microsporia of cats using intraconazole and clotrimazole are 216 hryvnias, vaccines Vakderm and clotrimazole - 184 hryvnias and Micro-mar with Biogluk - 40 hryvnias 95 kopecks (table 2). According to the protocol, the cost of 1 day of treatment: Itra-conazole - UAH 9.61; 1 % clotrimazole - UAH 0.66; Vakderm - UAH 8.09; "Micromar" - UAH 0.77; "Biogluk" -UAH 1.18. Indirect costs for the entire course of treatment in the first group amounted to 24 hryvnias, in the second -26 hryvnias 20 kopecks, in the third - 24 hryvnias.
Direct and indirect costs amounted to 240 hryvnias for the treatment of animals of the 1st group, 210 hryvnias 20 kopecks - the 2nd group, and 64 hryvnias 95 kopecks - the 3rd group.
The calculation of cost-effectiveness indicators showed that the treatment of cats with microsporia is effective in all groups of studied animals, as recovery occurred in each sick cat. However, the costs of therapy are different.
When treated with antifungal drugs (intraconazole and clotrimazole), the cost-effectiveness ratio of CER is 48 hryvnias.
In the treatment of microsporia by treatment with 1 % solution of clotrimazole and vaccination with the vaccine "Vakderm", the obtained results of the calculation showed the value of the CER coefficient - 42 hryvnias.
When using the antifungal drug "Micromar" and im-munostimulant "Biogluk" CER (cost-effectiveness ratio) is 13 hryvnias.
Thus, the determination of the CER indicator shows that the treatment of microsporia in cats using the antifungal agent "Micromar" and the immunostimulant "Biogluk" is the optimal combination of effectiveness and cost of complex therapy.
4. Conclusions
The use of drugs "Micromar" and "Biogluk" for treating microsporia in cats has the highest economic efficiency compared to other proposed schemes.
The economic efficiency of the drug "Micromar" and the immunostimulant "Biogluk" is 3.7 times higher than that of intraconazole and clotrimazole and 3.2 times higher than that of clotrimazole with vaccination with the vaccine "Vakderm."
Conflict of interest
The authors declare that there is no conflict of interest. References
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