Cost-effectiveness of triple drug administration (TDA) with praziquantel, ivermectin and albendazole for the prevention of neglected tropical diseases in Nigeria
Identifieur interne : 003023 ( Pmc/Checkpoint ); précédent : 003022; suivant : 003024Cost-effectiveness of triple drug administration (TDA) with praziquantel, ivermectin and albendazole for the prevention of neglected tropical diseases in Nigeria
Auteurs : D. Evans [États-Unis] ; D. Mcfarland [États-Unis] ; W. Adamani [Nigeria] ; A. Eigege [Nigeria] ; E. Miri [Nigeria] ; J. Schulz [États-Unis] ; E. Pede [Nigeria] ; C. Umbugadu [Nigeria] ; P. Ogbu-Pearse [Nigeria] ; F O Richards [États-Unis]Source :
- Annals of Tropical Medicine and Parasitology [ 0003-4983 ] ; 2011.
Abstract
Onchocerciasis, lymphatic filariasis (LF), schistosomiasis and soil transmitted, helminthiasis (STH) are all co-endemic in Nigeria. Annual mass drug administration (MDA) with ivermectin (for onchocerciasis), albendazole (for STH and with ivermectin for LF) and praziquantel (for schistosomiasis) is the WHO-recommended treatment strategy for preventive chemotherapy. Separate delivery rounds for distribution of these drugs have been the usual approach to MDA. All three drugs, however, have now been shown to be clinically and programmatically safe for co-administration with what has come to be known as triple drug administration (TDA). We examined the cost savings of converting from separate delivery rounds to TDA in two states in Nigeria. In 2008, eight local government areas received a single round of ivermectin with albendazole followed at least 1 week later by a single round of praziquantel to school-aged children. The following year, a single round was administered with TDA. The number of treated individuals was essentially unchanged during both years (1 301 864 in 2008 and 1 297 509 in 2009) and no change in adverse events was reported. The total programmatic costs for the MDA, not including drug and overhead costs, reduced by 41% from $123, 624 to $72, 870. Cost savings were limited in larger populations due to economies of scale. TDA is recommended for mature MDA.
Url:
DOI: 10.1179/2047773211Y.0000000010
PubMed: 22325813
PubMed Central: 4089800
Affiliations:
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<front><div type="abstract" xml:lang="en"><p>Onchocerciasis, lymphatic filariasis (LF), schistosomiasis and soil transmitted, helminthiasis (STH) are all co-endemic in Nigeria. Annual mass drug administration (MDA) with ivermectin (for onchocerciasis), albendazole (for STH and with ivermectin for LF) and praziquantel (for schistosomiasis) is the WHO-recommended treatment strategy for preventive chemotherapy. Separate delivery rounds for distribution of these drugs have been the usual approach to MDA. All three drugs, however, have now been shown to be clinically and programmatically safe for co-administration with what has come to be known as triple drug administration (TDA). We examined the cost savings of converting from separate delivery rounds to TDA in two states in Nigeria. In 2008, eight local government areas received a single round of ivermectin with albendazole followed at least 1 week later by a single round of praziquantel to school-aged children. The following year, a single round was administered with TDA. The number of treated individuals was essentially unchanged during both years (1 301 864 in 2008 and 1 297 509 in 2009) and no change in adverse events was reported. The total programmatic costs for the MDA, not including drug and overhead costs, reduced by 41% from $123, 624 to $72, 870. Cost savings were limited in larger populations due to economies of scale. TDA is recommended for mature MDA.</p>
</div>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Trop Med Parasitol</journal-id>
<journal-id journal-id-type="iso-abbrev">Ann Trop Med Parasitol</journal-id>
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<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
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<title-group><article-title>Cost-effectiveness of triple drug administration (TDA) with praziquantel, ivermectin and albendazole for the prevention of neglected tropical diseases in Nigeria</article-title>
<alt-title alt-title-type="running-head">COST-EFFECTIVENESS OF TDA</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Evans</surname>
<given-names>D</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mcfarland</surname>
<given-names>D</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>†</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Adamani</surname>
<given-names>W</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>‡</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Eigege</surname>
<given-names>A</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>‡</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Miri</surname>
<given-names>E</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>‡</sup>
</xref>
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<contrib contrib-type="author"><name><surname>Schulz</surname>
<given-names>J</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>†</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pede</surname>
<given-names>E</given-names>
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<xref ref-type="aff" rid="aff4"><sup>§</sup>
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</contrib>
<contrib contrib-type="author"><name><surname>Umbugadu</surname>
<given-names>C</given-names>
</name>
<xref ref-type="aff" rid="aff5"><sup>¶</sup>
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</contrib>
<contrib contrib-type="author"><name><surname>Ogbu-Pearse</surname>
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<given-names>F O</given-names>
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<xref ref-type="aff" rid="aff1"><sup>*</sup>
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<addr-line>The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, USA</addr-line>
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<aff id="aff2"><label>†</label>
<addr-line>Emory University, Rollings School of Public Health, Atlanta, GA, USA</addr-line>
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<aff id="aff3"><label>‡</label>
<addr-line>The Carter Center, Nigeria</addr-line>
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<aff id="aff4"><label>§</label>
<addr-line>Plateau State Ministry of Health, Jos, Nigeria</addr-line>
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<aff id="aff5"><label>¶</label>
<addr-line>Nasarawa State Ministry of Health, Lafia, Nigeria</addr-line>
</aff>
<aff id="aff6"><label>&</label>
<addr-line>Federal Ministry of Health, Abuja, Nigeria</addr-line>
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<author-notes><corresp>Reprint requests to: D. Evans, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, USA. E-mail: <email>dsevans@emory.edu</email>
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<pub-date pub-type="ppub"><month>12</month>
<year>2011</year>
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<volume>105</volume>
<issue>8</issue>
<fpage>537</fpage>
<lpage>547</lpage>
<history><date date-type="received"><day>5</day>
<month>7</month>
<year>2011</year>
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<date date-type="rev-recd"><day>10</day>
<month>11</month>
<year>2011</year>
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<date date-type="accepted"><day>10</day>
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<permissions><copyright-statement>© W. S. Maney & Son Ltd 2011</copyright-statement>
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<abstract><p>Onchocerciasis, lymphatic filariasis (LF), schistosomiasis and soil transmitted, helminthiasis (STH) are all co-endemic in Nigeria. Annual mass drug administration (MDA) with ivermectin (for onchocerciasis), albendazole (for STH and with ivermectin for LF) and praziquantel (for schistosomiasis) is the WHO-recommended treatment strategy for preventive chemotherapy. Separate delivery rounds for distribution of these drugs have been the usual approach to MDA. All three drugs, however, have now been shown to be clinically and programmatically safe for co-administration with what has come to be known as triple drug administration (TDA). We examined the cost savings of converting from separate delivery rounds to TDA in two states in Nigeria. In 2008, eight local government areas received a single round of ivermectin with albendazole followed at least 1 week later by a single round of praziquantel to school-aged children. The following year, a single round was administered with TDA. The number of treated individuals was essentially unchanged during both years (1 301 864 in 2008 and 1 297 509 in 2009) and no change in adverse events was reported. The total programmatic costs for the MDA, not including drug and overhead costs, reduced by 41% from $123, 624 to $72, 870. Cost savings were limited in larger populations due to economies of scale. TDA is recommended for mature MDA.</p>
</abstract>
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