02577nas a2200265   4500000000100000008004100001260001200042653002100054653001900075653002000094653004100114653001300155100001400168700001200182700001500194700001100209700001600220700001600236700001100252245012700263856005800390490000600448520184300454022001402297       2021                            d  c08/202110ahealth economics10aonchocerciasis10aschistosomiasis10asoil-transmitted helminth infections10atrachoma1 aTurner HC1 aStolk W1 aSolomon AW1 aKing J1 aMontresor A1 aMolyneux DH1 aToor J00aAre current preventive chemotherapy strategies for controlling and eliminating neglected tropical diseases cost-effective?  uhttps://gh.bmj.com/content/bmjgh/6/8/e005456.full.pdf0 v63 a<p>Neglected tropical diseases (NTDs) remain a significant cause of morbidity and mortality in many low-income and middle-income countries. Several NTDs, namely lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH) and trachoma, are predominantly controlled by preventive chemotherapy (or mass drug administration), following recommendations set by the WHO. Over one billion people are now treated for NTDs with this strategy per year. However, further investment and increased domestic healthcare spending are urgently needed to continue these programmes. Consequently, it is vital that the cost-effectiveness of preventive chemotherapy is understood. We analyse the current estimates on the cost per disability-adjusted life year (DALY) of the preventive chemotherapy strategies predominantly used for these diseases and identify key evidence gaps that require further research. Overall, the reported estimates show that preventive chemotherapy is generally cost-effective, supporting WHO recommendations. More specifically, the cost per DALY averted estimates relating to community-wide preventive chemotherapy for lymphatic filariasis and onchocerciasis were particularly favourable when compared with other public health interventions. Cost per DALY averted estimates of school-based preventive chemotherapy for schistosomiasis and STH were also generally favourable but more variable. Notably, the broader socioeconomic benefits are likely not being fully captured by the DALYs averted metric. No estimates of cost per DALY averted relating to community-wide mass antibiotic treatment for trachoma were found, highlighting the need for further research. These findings are important for informing global health policy and support the need for continuing NTD control and elimination efforts.</p>  a2059-7908