Health, financial, and education gains of investing in preventive chemotherapy for schistosomiasis, soil-transmitted helminthiases, and lymphatic filariasis in Madagascar: A modeling study.

Authors:
Kevin Croke
Kevin Croke
University of Illinois at Chicago
United States
Johannes Krisam
Johannes Krisam
Institute of Medical Biometry and Informatics
Linda Schultz
Linda Schultz
Emory University School of Medicine
United States

PLoS Negl Trop Dis 2018 12 27;12(12):e0007002. Epub 2018 Dec 27.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, United States of America.

Background: Neglected tropical diseases (NTDs) account for a large disease burden in sub-Saharan Africa. While the general cost-effectiveness of NTD interventions to improve health outcomes has been assessed, few studies have also accounted for the financial and education gains of investing in NTD control.

Methods: We built on extended cost-effectiveness analysis (ECEA) methods to assess the health gains (e.g. infections, disability-adjusted life years or DALYs averted), household financial gains (out-of-pocket expenditures averted), and education gains (cases of school absenteeism averted) for five NTD interventions that the government of Madagascar aims to roll out nationally. The five NTDs considered were schistosomiasis, lymphatic filariasis, and three soil-transmitted helminthiases (Ascaris lumbricoides, Trichuris trichiura, and hookworm infections).

Results: The estimated incremental cost-effectiveness for the roll-out of preventive chemotherapy for all NTDs jointly was USD125 per DALY averted (95% uncertainty range: 65-231), and its benefit-cost ratio could vary between 5 and 31. Our analysis estimated that, per dollar spent, schistosomiasis preventive chemotherapy, in particular, could avert a large number of infections (176,000 infections averted per $100,000 spent), DALYs (2,000 averted per $100,000 spent), and cases of school absenteeism (27,000 school years gained per $100,000 spent).

Conclusion: This analysis incorporates financial and education gains into the economic evaluation of health interventions, and therefore provides information about the efficiency of attainment of three Sustainable Development Goals (SDGs). Our findings reveal how the national scale-up of NTD control in Madagascar can help address health (SDG3), economic (SDG1), and education (SDG4) goals. This study further highlights the potentially large societal benefits of investing in NTD control in low-resource settings.

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http://dx.plos.org/10.1371/journal.pntd.0007002
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http://dx.doi.org/10.1371/journal.pntd.0007002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307713PMC
December 2018
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References

(Supplied by CrossRef)
Disease Control Priorities Network
C Fitzpatrick et al.
2017
The effect of Schistosoma mansoni infection of the productivity of cane cutters on a sugar estate in Tanzania
A Fenwick et al.
Bull World Health Organ 1972
Priority setting and the ‘neglected’ tropical diseases
D. Canning et al.
Transactions of the Royal Society of Tropical Medicine and Hygiene 2006
Worms, wisdom, and wealth: why deworming can make economic sense
DAP Bundy et al.
Trends in Parasitology 2013

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