title: Cost and cost-effectiveness of soil-transmitted helminth treatment programmes: systematic review and research needs.
abstract: BACKGROUND
  In this time of rapidly expanding mass drug administration (MDA) coverage and the new commitments for soil-transmitted helminth (STH) control, it is essential that resources are allocated in an efficient manner to have the greatest impact. However, many questions remain regarding how best to deliver STH treatment programmes; these include which age-groups should be targeted and how often. To perform further analyses to investigate what the most cost-effective control strategies are in different settings, accurate cost data for targeting different age groups at different treatment frequencies (in a range of settings) are essential.
  
  
  METHODS
  Using the electronic databases PubMed, MEDLINE, and ISI Web of Knowledge, we perform a systematic review of costing studies and cost-effectiveness evaluations for potential STH treatment strategies. We use this review to highlight research gaps and outline the key future research needs.
  
  
  RESULTS
  We identified 29 studies reporting costs of STH treatment and 17 studies that investigated its cost-effectiveness. The majority of these pertained to programmes only targeting school-aged children (SAC), with relatively few studies investigating alternative preventive chemotherapy (PCT) treatment strategies. The methods of cost data collection, analysis and reporting were highly variable among the different studies. Only four of the costing studies were found to have high applicability for use in forthcoming economic evaluations. There are also very few studies quantifying the costs of increasing the treatment frequency.
  
  
  CONCLUSIONS
  The absence of cost data and inconsistencies in the collection and analysis methods constitutes a major research gap for STH control. Detailed and accurate costs of targeting different age groups or increasing treatment frequency will be essential to formulate cost-effective public health policy. Defining the most cost-effective control strategies in different settings is of high significance during this period of expanding MDA coverage and new resource commitments for STH control.
authors.affiliation: London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK. hugo.turner@imperial.ac.uk.
authors.forename: Hugo C
authors.initials: HC
authors.lastname: Turner
authors.affiliation: London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK. j.truscott@imperial.ac.uk.
authors.forename: James E
authors.initials: JE
authors.lastname: Truscott
authors.affiliation: Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK. Deirdre.Hollingsworth@warwick.ac.uk.|School of Life Sciences, University of Warwick, Coventry, CV4 7AL, UK. Deirdre.Hollingsworth@warwick.ac.uk.
authors.forename: T Déirdre
authors.initials: TD
authors.lastname: Hollingsworth
authors.affiliation: London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK. a.bettis@imperial.ac.uk.
authors.forename: Alison A
authors.initials: AA
authors.lastname: Bettis
authors.affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. Simon.Brooker@lshtm.ac.uk.|Kenya Medical Research Institute, Nairobi, Kenya. Simon.Brooker@lshtm.ac.uk.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Brooker
authors.affiliation: London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK. roy.anderson@imperial.ac.uk.
authors.forename: Roy M
authors.initials: RM
authors.lastname: Anderson
mesh_terms: D000871:Anthelmintics / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D006373:Helminthiasis / Q000517:prevention & control*; D006801:Humans; D012106:Research
chemical_list: D000871:Anthelmintics