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