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Table 1 Overview of the identified costs

From: Cost and cost-effectiveness of soil-transmitted helminth treatment programmes: systematic review and research needs

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.
  1. The costing studies were grouped into three categories, low, medium and high, reflecting their applicability for use in forthcoming economic evaluations. This grouping was based on three factors; 1) whether the cost year and currency exchange rates were clearly stated, 2) economic costs collected, and 3) detailed itemised costs reported for the STH control component of the programme (i.e. no major costs sources were excluded). Those that provided/did all three were grouped into high, two into medium, and only one or none into low. CDDs; Community drug distributers, Pre-SAC; Pre-school aged children, SAC; School aged children. School-based delivery systems were defined as those utilising teachers and other school officials (not just distributing the drugs at the school NA: Not available. Treatment frequency Note 1: Varied; A) Chemotherapy to all household members at the start of the study, B) same as Group A, but with regular health education, C) Chemotherapy to all household members and subsequent six monthly chemotherapy to all children, D) same as Group C but also with regular health education