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Table 1 Overview of the identified costs
| Study | Country | Target of intervention | Primary distribution method | Age-groups targeted | Treatment frequency | Perspective explicitly stated | Year of price | Currency | Economic costs collected | Costs itemised | Results |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | |||||||||||
| [24] | Uganda | STH and Schistosomiasis | School-based | SAC | Annual | Y (Service provider) | 2005 | US$ | Y | Y | The overall economic cost per child treated in the six districts was US$0.54, which ranged between the districts from US$0.41 to US$0.91 (delivery costs: US$0.19–0.69). The overall financial cost per child treated was US$0.39. |
| [25] | Haiti | STH and Lymphatic filariasis | Combination | Mass treatment (all persons greater than two years of age) | Annual | Y (Service provider) | 2008–2009 | US$ | Y | Y | The economic cost was US$0.64 per person treated, which included the value of the donated drugs. The programme cost (which excluded the value of the donated drugs) was US$0.42 per person treated. |
| [26] | Niger | STH and Schistosomiasis | Combination | SAC and targeted adults | Annual | N | 2005 | US$ | Y | Y | The total economic delivery cost of the school-based and community-based treatment was US$0.76, and US$0.46 respectively. Including only the programme costs and the values change to US$0.47 and US$0.41 respectively. The average drug (albendazole and praziquantel) cost was US$0.28 per treatment; not clear which results included the drugs costs. |
| [27] | Niger | STH, Schistosomiasis, Lymphatic filariasis, and Trachoma | Combination | SAC and adults (not clear if Pre-SAC were treated) | Annual | N | 2009 | US$ | Y | Y | The average economic cost of integrated preventive chemotherapy was US$0.19 (excluding drug costs). The average financial cost per treatment of the vertical schistosomiasis and STH programme (before the NTD programmes integrated) was US$0.10. |
| Medium | |||||||||||
| [19] | Lao PDR | STH within an immunisation and vitamin A supplementation campaign | Child Health Days | Pre SAC and women of child-bearing age (SAC were targeted though the national deworming campaign) | Annual | N | 2009 | US$ | Y | Y | The incremental cost of adding deworming into the national immunisation campaign was US$0.03 per treatment (delivery costs: US$0.007). This is compared to US$0.23 per treatment for the vertical national school-based deworming campaign (targeting SAC). |
| [20] | Nigeria | STH, Schistosomiasis, Lymphatic filariasis, and Onchocerciasis | Community drug distributers (CDDs) | SAC for praziquantel and SAC and adults for ivermectin/albendazole | Annual | Y (Service provider) | 2008–2009 | US$ | N | Y | In 2008, eight local government areas received a single round of ivermectin and albendazole followed at least one week later by praziquantel to SAC. The following year, a single round of triple drug administration was given. When using the latter the programmatic costs for MDA (not including drug and overhead costs), were reduced by 41.1 % (from US$0.078 to US$0.046 per treatment). |
| [22] | Ethiopia | STH | Child Health Days | Pre-SAC | One round | N | 2006 | US$ | Y | Partial | The average cost per child reached by the Child Health Day programme was US$0.56 (per round) of which deworming was estimated to represent 29 % of the cost (US$0.162). |
| [23] | Uganda | STH within an vitamin A supplementation campaign | Child Health Days | SAC and Pre-SAC | One round | Y (Service provider) | 2010 | US$ | Y | Partial# | The average cost per child reached by the Child Health Day programme was US$0.22 (per round) – including the cost of vitamin A. |
| # Although detailed itemised costs were provided they pertained to the Child Health Day programme as a whole (the purpose of that study) and not the deworming arm. | |||||||||||
| [21] | Based on data from Montserrat | STH | Mobile teams | Mass treatment | Not applicable | Y (Service provider) | 1988 | US$ | N | Y | Presented in a cost menu. |
| [17] | Tanzania | STH | School-based | SAC | One round | Y (Service provider) | 1996 | US$ | Y | Partial† | See [16] |
| [16] | Ghana and Tanzania | STH | School-based | SAC | One round | Y (Service provider) | 1996 | US$ | Y | Partial† | The economic cost per treatment in Ghana, and Tanzania was US$0.27, and US$0.26 (delivery: US$0.07, and US$0.06), respectively. The financial cost per person treated in Ghana, and Tanzania was US$0.24, and US$0.023 (delivery: US$0.04, and US$0.03), respectively. |
| † Note that the results are artificially low because they did not include the external costs of the UK-based coordinating centre [39]. | |||||||||||
| Low | |||||||||||
| [37] | Seychelles | STH and other intestinal parasitic infections | Schools and (crèches for 3–5 year olds) | SAC and Pre-SAC (3–5 year olds) | Four monthly | N | 1993–1994 | US$ | N | Y | The financial cost of the programme in 1994 was estimated to be US$0.40 per person treated; unclear if the start-up costs from 1993 were included or if this is a cost per round or per year. |
| [29] | India | STH (primarily Ascaris) | Mobile teams | Pre-SAC | Biannual (six monthly) | Y (Patient) | 1995–1997 | Indian Rupees (₹) | N | N | The incremental financial cost of treating 5,000 Pre-SAC with six monthly albendazole for two years was ₹122,091 (including the drug cost of ₹20 per dose). |
| [30] | Vietnam | STH (within a weekly iron-folic acid supplementation campaign) | Village health workers | Non-pregnant women of child-bearing age | four monthly in the first year and six monthly thereafter | Partial | 2010 | US$ | N | Partial | The yearly financial cost of the programme was US$0.76 per woman treated; including the cost of weekly iron supplementation. |
| [74] | Egypt | STH, Schistosomiasis and other intestinal parasitic infections | Mobile teams | SAC | Annual | N | 2000 | US$ | N | Partial | The incremental financial cost of STH control was US$0.07 per treatment (delivery costs: US$0.03), when integrated into the national schistosomiasis control programme. |
| [33] | Burundi | STH, Schistosomiasis and other intestinal parasitic infections | Mobile teams (via the school) | SAC (selective treatment) | Annual | N | 1984–1992 | US$ | N | Partial | The financial cost per person protected in 1984–1985, 1989–1990, and 1991–1992 was US$2.7, US$1.2, and US$0.70, respectively. The reported costs per treatment related to only schistosomiasis. |
| [75] | Burkina Faso | STH and Schistosomiasis | Combination | SAC | One round | N | 2004–2005 | US$ | N | Y | The financial cost per child treated was US$0.308 for the school-based component and US$0.33 for the community-based component (delivery: US$0.084, US$0.107 respectively). |
| [39] | Based on data from Tanzania | STH and Schistosomiasis | School-based | SAC | Not applicable | N | Not clear | US$ | N | Y | Presented in a cost menu [39]. |
| [31] | Nigeria | Ascaris | Mobile teams | Varied: A) selective treatment (treating the 20 % most heavily infected), B) targeted treatment to Pre-SAC and SAC and C) mass treatment to all (excluding <1 and pregnant women) | Three monthly | N | 1989 | Naira | N | Partial | The total financial costs (and delivery costs) were; A) Selective treatment: 2,491 (12,414), B) Targeted treatment: 3,956 (3,550), C) Mass treatment: 4,701 (3,809). |
| (Total costs are shown as it is misleading to compare the cost per treatment for a selective treatment strategy to that of mass/targeted treatment.) | |||||||||||
| [18] | Uganda | STH | School-based | SAC | Annual | Y (Service provider) | 2004 | US$ | N | Partial‡ | The estimated financial cost per treatment in the four districts ranged from US$0.063 to S$0.105 (delivery costs: US$0.04 to US$0.08). ‡ These cost estimates do not include the start-up costs or those incurred at the central level. |
| [32] | Bangladesh | STH | Mobile teams | First dose mass (i.e. children and household members) other doses just children (2–8 years old) | Varied: See legend (Treatment frequency Note 1) | Y (Service provider) | Not clear | Takas (৳) | N | Partial | Project cost per household: A) ৳301 B) ৳1,897 C) ৳332 D) ৳1,909 |
| [28] | Nepal | STH within an vitamin A supplementation campaign | Child Health Days | Pre-SAC | Biannual | NA | NA | US$ | NA | NA | An additional US$80,000 (4 % of the total cost of the vitamin A campaign) covered the cost of biannual deworming). |
| [62] | Zanzibar | STH and Schistosomiasis | School-based (“sibling approach*”) | Non-enrolled SAC | One round | N | 2000 | US$ | N | N | The costs linked to drug transport, training and drug administration were not increased by the inclusion of non-enrolled children. Therefore, the additional financial cost of including non-enrolled SAC using the sibling approach” consisted only of the extra drugs treatments needed. It was noted that a negligible additional cost may be incurred for storage of leftover drugs. |
| *Enrolled children invited tell parents, siblings and friends of school-age when the next deworming day is. | |||||||||||
| [76] | Myanmar | STH | School-based | SAC | One round | N | Not clear | US$ | N | Y | A crude calculation estimated that the financial cost per treatment was approximately US$0.05 (delivery: US$0.03). |
| [77] | Vietnam | STH | School-based | SAC | Annual | N | Not clear | US$ | N | Y | The financial costs per treatment in 2000–2001, 2002–2003, and 2005–2006 were US$0.71, US$0.11, and US$0.03 (delivery: US$0.683, US$0.0857 and US$0.0128) respectively. |
| [78] | Yemen | STH and Schistosomiasis | Combination (school-based for SAC and CDDs/health workers for adults and non-enrolled SAC) | SAC and adults | Annual | N | 2008–2009 | US$ | N | Y | The financial cost per person treated in 2008, and 2009 was US$0.79, and US$0.66 (delivery: US$0.44 and US$0.37), respectively. |
| [36] | Lao PDR | STH | School-based | SAC | Biannual | N | 2007 | US$ | N | Y | In the provinces treating twice a year the financial cost (capital costs not annualised) was US$0.23 per child per year, while in provinces treating once a year the cost was US$0.17 per child per year. |
| [35] | Cambodia | STH | School-based | SAC | Biannual | N | 2003–2004 | US$ | N | Y | The financial cost per treatment in 2003 and 2004 was US$0.122, and US$0.057 (delivery: US$0.096 and US$0.033), respectively. |
| [34] | Notional | STH and Schistosomiasis | Mobile teams (via the school) | SAC | Annual | N | Not clear | US$ | N | N | Treating for ten years would cost between US$8 and US$18 per child (US$0.8- US$1.8 per year). (Assumes that four treatments of praziquantel and eight of albendazole are given in the ten year period. |
