June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Provision of Mass Drug Administration for Trachoma Control: Cost per gain in coverage
Author Affiliations & Notes
  • Sheila West
    Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, MD
  • Harran Mkocha
    Kongwa Trachoma Project, Kongwa, United Republic of Tanzania
  • Beatriz Munoz
    Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, MD
  • Kevin Frick
    Health Services Research Division, Johns Hopkins University, Baltimore, MD
  • Footnotes
    Commercial Relationships Sheila West, None; Harran Mkocha, None; Beatriz Munoz, None; Kevin Frick, Center for Applied Value Analysis (C), National Association for Eye and Vision Research (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4420. doi:
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      Sheila West, Harran Mkocha, Beatriz Munoz, Kevin Frick; Provision of Mass Drug Administration for Trachoma Control: Cost per gain in coverage. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4420.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: The World Health Organization recommends Mass Drug Administration (MDA) when the prevalence of follicular trachoma in children is ≥ 10%. The recommendation is coverage with antibiotic at least at 80%. The costs to achieve this level of coverage is unknown.

Methods: MDA was provided to 48 communities as part of the PRET trial in Kongwa, Tanzania. In the first four communities detailed records were kept of all costs associated with the provision of azithromycin, hiring and training of Community Drug Distributors, drug distribution, and supervision. Data were collected on persons treated over the days of the MDA. Azithromycin is donated so the cost of the drug was not included. Topical tetracycline costs were included. We calculated the cost per person treated, and additional cost per days of MDA.

Results: Coverage of children in these communities was above 80%. The cost per person treated was estimated as $0.22. The largest cost drivers were supervision and transportation. Cost per unit of coverage increases markedly after three days, from $3/1% increase to $35/1% increase. Adding days beyond three days of MDA increases costs for limited gains in coverage.

Conclusions: Costs per person treated, under a program where Community Drug Distributors provide drug and are paid, are reasonable and similar to other MDA programs.

Keywords: 459 clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology • 736 trachoma  

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