Cost-effectiveness of trachoma control measures: comparing targeted household treatment and mass treatment of children.
OBJECTIVE
The present study compares the cost-effectiveness of targeted household treatment and mass treatment of children in the most westerly part of Nepal.


METHODS
Effectiveness was measured as the percentage point change in the prevalence of trachoma. Resource measures included personnel time required for treatment, transportation, the time that study subjects had to wait to receive treatment, and the quantity of azithromycin used. The costs of the programme were calculated from the perspectives of the public health programme sponsor, the study subjects, and the society as a whole.


RESULTS
Previous studies have indicated no statistically significant differences in effectiveness, and the present work showed no significant differences in total personnel and transportation costs per child aged 1-10 years, the total time that adults spent waiting, or the quantity of azithromycin per child. However, the mass treatment of children was slightly more effective and used less of each resource per child aged 1-10 years than the targeted treatment of households.


CONCLUSIONS
From all perspectives, the mass treatment of children is at least as effective and no more expensive than targeted household treatment, notwithstanding the absence of statistically significant differences. Less expensive targeting methods are required in order to make targeted household treatment more cost-effective.
Frick
K D
KD
Department of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, 624 N. Broadway, Room 606, Baltimore, MD 21205-1901, USA. kfrick@jhsph.edu
Lietman
T M
TM
Holm
S O
SO
Jha
H C
HC
Chaudhary
J S
JS
Bhatta
R C
RC
D000900:Anti-Bacterial Agents / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use; D017963:Azithromycin / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000458:organization & administration*; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D008297:Male; D009390:Nepal / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D014141:Trachoma / Q000188:drug therapy* / Q000191:economics
D000900:Anti-Bacterial Agents; D017963:Azithromycin