Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Imperial College London, Norfolk Place, London, United Kingdom.
PLoS Negl Trop Dis. 2013 Sep 19;7(9):e2452. doi: 10.1371/journal.pntd.0002452. eCollection 2013.
It has been proposed that switching from annual to biannual (twice yearly) mass community-directed treatment with ivermectin (CDTI) might improve the chances of onchocerciasis elimination in some African foci. However, historically, relatively few communities have received biannual treatments in Africa, and there are no cost data associated with increasing ivermectin treatment frequency at a large scale. Collecting cost data is essential for conducting economic evaluations of control programmes. Some countries, such as Ghana, have adopted a biannual treatment strategy in selected districts. We undertook a study to estimate the costs associated with annual and biannual CDTI in Ghana.
The study was conducted in the Brong-Ahafo and Northern regions of Ghana. Data collection was organized at the national, regional, district, sub-district and community levels, and involved interviewing key personnel and scrutinizing national records. Data were collected in four districts; one in which treatment is delivered annually, two in which it is delivered biannually, and one where treatment takes place biannually in some communities and annually in others. Both financial and economic costs were collected from the health care provider's perspective.
The estimated cost of treating annually was US Dollars (USD) 0.45 per person including the value of time donated by the community drug distributors (which was estimated at USD 0.05 per person per treatment round). The cost of CDTI was approximately 50-60% higher in those districts where treatment was biannual than in those where it was annual. Large-scale mass biannual treatment was reported as being well received and considered sustainable.
CONCLUSIONS/SIGNIFICANCE: This study provides rigorous evidence of the different costs associated with annual and biannual CDTI in Ghana which can be used to inform an economic evaluation of the debate on the optimal treatment frequency required to control (or eliminate) onchocerciasis in Africa.
有人提出，将年度大规模社区药物治疗（MDA）用伊维菌素改为每半年（每年两次）进行，可能会增加在一些非洲流行区消灭盘尾丝虫病的机会。然而，历史上，非洲相对较少的社区接受过半年一次的治疗，而且也没有大规模增加伊维菌素治疗频率的成本数据。收集成本数据对于进行控制规划的经济评估至关重要。一些国家，如加纳，在一些地区采取了半年一次的治疗策略。我们进行了一项研究，以估计加纳年度和半年一次 MDA 相关的成本。
该研究在加纳的布隆-阿哈福和北部地区进行。数据收集在国家、地区、区、分区和社区各级组织进行，包括访谈关键人员和审查国家记录。在四个地区收集数据；一个地区每年进行一次治疗，两个地区每半年进行一次治疗，一个地区部分社区每半年进行一次治疗，其他社区每年进行一次治疗。从卫生保健提供者的角度收集了财务和经济成本。
每年治疗的估计成本为每人 0.45 美元，包括社区药物分发人员捐赠的时间价值（估计为每人每次治疗轮次 0.05 美元）。在那些每半年进行一次治疗的地区，CDTI 的成本比每年进行一次治疗的地区高出约 50-60%。大规模的半年一次的治疗被报道为受到欢迎，并被认为是可持续的。
结论/意义：本研究提供了加纳年度和半年一次 MDA 相关成本的严格证据，可用于为非洲控制（或消除）盘尾丝虫病所需的最佳治疗频率的辩论提供经济评估。
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