title: Integration of deworming into an existing immunisation and vitamin A supplementation campaign is a highly effective approach to maximise health benefits with minimal cost in Lao PDR.
abstract: Infection with soil-transmitted helminths (STH) is a major public health problem in many developing countries, with pregnant women and children particularly at risk. Preventive chemotherapy, which is the intervention currently recommended by the WHO against the main helminth infections including those caused by STHs, aims at reducing morbidity through periodical administration of anthelminthic drugs either alone or in combination. The Expanded Programme on Immunization is one of the most widely implemented health programmes in the world and has well established access to children and women. The present study investigated the cost of the provision of anthelminthic drugs during existing immunisation campaigns. In Lao PDR, use of this integrated approach compared with implementation of the vertical deworming campaign alone allowed a reduction of the individual cost of deworming by 10 times (from US$0.23 in the vertical deworming campaign to US$0.03 in the integrated campaign). When drug cost was excluded, the cost of deworming an individual was US$0.007, implying that deworming 100 children would cost less than US$1 if drug donation was in place. The burden posed on health workers by the integration process was perceived as minimal and manageable. Moreover, delivery of anthelminthic drugs during immunisation campaigns enabled campaign teams to observe drug intake directly, which assured safety. These findings prove that integration is an opportunity to maximise health benefits through the delivery of multiple health products and the attainment of high coverage.
authors.affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland.
authors.forename: Giulia
authors.initials: G
authors.lastname: Boselli
authors.forename: Aya
authors.initials: A
authors.lastname: Yajima
authors.forename: Padmasiri Eswara
authors.initials: PE
authors.lastname: Aratchige
authors.forename: Keith Ernest
authors.initials: KE
authors.lastname: Feldon
authors.forename: Anonh
authors.initials: A
authors.lastname: Xeuatvongsa
authors.forename: Kongxay
authors.initials: K
authors.lastname: Phounphenghak
authors.forename: Khampiou
authors.initials: K
authors.lastname: Sihakhang
authors.forename: Chanthavisouk
authors.initials: C
authors.lastname: Chitsavang
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authors.lastname: Phengkeo
authors.forename: Albis Francesco
authors.initials: AF
authors.lastname: Gabrielli
authors.forename: Claudio
authors.initials: C
authors.lastname: Politi
authors.forename: Antonio
authors.initials: A
authors.lastname: Montresor
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