1921
Volume 103, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Trachoma programs use annual antibiotic mass drug administration (MDA) in evaluation units (EUs) that generally encompass 100,000–250,000 people. After one, three, or five MDA rounds, programs undertake impact surveys. Where impact survey prevalence of trachomatous inflammation—follicular (TF) in 1- to 9-year-olds is ≥ 5%, ≥ 1 additional MDA rounds are recommended before resurvey. Impact survey costs, and the proportion of impact surveys returning TF prevalence ≥ 5% (the failure rate or, less pejoratively, the MDA continuation rate), therefore influence the cost of eliminating trachoma. We modeled, for illustrative EU sizes, the financial cost of undertaking MDA with and without conducting impact surveys. As an example, we retrospectively assessed how conducting impact surveys affected costs in the United Republic of Tanzania for 2017–2018. For EUs containing 100,000 people, the median (interquartile range) cost of continuing MDA without doing impact surveys is USD 28,957 (17,581–36,197) per EU per year, whereas continuing MDA solely where indicated by impact survey results costs USD 17,564 (12,158–21,694). If the mean EU population is 100,000, then continuing MDA without impact surveys becomes advantageous in financial cost terms only when the continuation rate exceeds 71%. For the United Republic of Tanzania in 2017–2018, doing impact surveys saved enough money to provide MDA for > 1,000,000 people. Although trachoma impact surveys have a nontrivial cost, they generally save money, providing EUs have > 50,000 inhabitants, the continuation rate is not excessive, and they generate reliable data. If all EUs pass their impact surveys, then we have waited too long to do them.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.20-0686
2020-10-05
2021-01-16
Loading full text...

Full text loading...

/deliver/fulltext/14761645/103/6/tpmd200686.html?itemId=/content/journals/10.4269/ajtmh.20-0686&mimeType=html&fmt=ahah

References

  1. Habtamu E et al., 2015. Trachoma and relative poverty: a case-control study. PLoS Negl Trop Dis 9: e0004228.
    [Google Scholar]
  2. Taylor HR, Burton MJ, Haddad D, West S, Wright H, 2014. Trachoma. Lancet 384: 21422152.
    [Google Scholar]
  3. World Health Organization, 2010. Report of the 3rd Global Scientific Meeting on Trachoma. Johns Hopkins University, Baltimore, MA, July 19–20, 2010, WHO/PBD/2.10. Geneva, Switzerland: WHO.
    [Google Scholar]
  4. Thabit AA et al., 2018. Prevalence of trachoma in Yemen: results of population-based prevalence surveys of 42 evaluation units in nine governorates. Ophthalmic Epidemiol 25: 6269.
    [Google Scholar]
  5. Amer K et al., 2018. Prevalence of trachoma in four marakez of Elmenia and Bani Suef Governorates, Egypt. Ophthalmic Epidemiol 25: 7078.
    [Google Scholar]
  6. Evans JR, Solomon AW, Kumar R, Perez A, Singh BP, Srivastava RM, Harding-Esch E, 2019. Antibiotics for trachoma. Cochrane Database Syst Rev 9: CD001860.
    [Google Scholar]
  7. Thylefors B, Dawson CR, Jones BR, West SK, Taylor HR, 1987. A simple system for the assessment of trachoma and its complications. Bull World Health Organ 65: 477483.
    [Google Scholar]
  8. International Trachoma Initiative, 2019. Zithromax Management Guide 2019: How to Successfully Apply for, Administer and Manage the Zithromax Donation for Trachoma Elimination. Decatur, GA: International Trachoma Initiative.
    [Google Scholar]
  9. Bailey RL, Arullendran P, Whittle HC, Mabey DC, 1993. Randomised controlled trial of single-dose azithromycin in treatment of trachoma. Lancet 342: 453456.
    [Google Scholar]
  10. Atik B, Thanh TT, Luong VQ, Lagree S, Dean D, 2006. Impact of annual targeted treatment on infectious trachoma and susceptibility to reinfection. JAMA 296: 14881497.
    [Google Scholar]
  11. Blake IM, Burton MJ, Solomon AW, West SK, Basanez MG, Gambhir M, Bailey RL, Mabey DC, Grassly NC, 2010. Targeting antibiotics to households for trachoma control. PLoS Negl Trop Dis 4: e862.
    [Google Scholar]
  12. Solomon AW, Akudibillah J, Abugri P, Hagan M, Foster A, Bailey RL, Mabey DCW, 2001. Pilot study of the use of community volunteers to distribute azithromycin for trachoma control in Ghana. Bull World Health Organ 79: 814.
    [Google Scholar]
  13. Solomon AW, Zondervan M, Kuper H, Buchan JC, Mabey DCW, Foster A, 2006. Trachoma Control: A Guide for Programme Managers. Geneva, Switzerland: World Health Organization.
    [Google Scholar]
  14. Ejere HO, Alhassan MB, Rabiu M, 2015. Face washing promotion for preventing active trachoma. Cochrane Database Syst Rev 2: CD003659.
    [Google Scholar]
  15. Rabiu M, Alhassan MB, Ejere HO, Evans JR, 2012. Environmental sanitary interventions for preventing active trachoma. Cochrane Database Syst Rev 2012: CD004003.
    [Google Scholar]
  16. Correia M et al., 2018. A search for trachoma in Timor-Leste: no evidence to justify undertaking population-based prevalence surveys. Ophthalmic Epidemiol 25: 131137.
    [Google Scholar]
  17. Abdala M et al., 2017. The epidemiology of trachoma in Mozambique: results of 96 population-based prevalence surveys. Ophthalmic Epidemiol 25: 201210.
    [Google Scholar]
  18. Bero B et al., Global Trachoma Mapping Project, 2016. Prevalence of and risk factors for trachoma in Oromia regional state of Ethiopia: results of 79 population-based prevalence surveys conducted with the global trachoma mapping project. Ophthalmic Epidemiol 23: 392405.
    [Google Scholar]
  19. Kilangalanga J et al., Global Trachoma Mapping Project, 2018. Trachoma in the Democratic Republic of the Congo: results of 46 baseline prevalence surveys conducted with the global trachoma mapping project. Ophthalmic Epidemiol 25: 192200.
    [Google Scholar]
  20. Mpyet C et al., Global Trachoma Mapping Project, 2017. Prevalence of trachoma in Kano state, Nigeria: results of 44 local government area-level surveys. Ophthalmic Epidemiol 24: 195203.
    [Google Scholar]
  21. Kalua K, Chisambi A, Chinyanya D, Kamwendo Z, Masika M, Willis R, Flueckiger RM, Pavluck AL, Solomon AW; Global Trachoma Mapping Project, 2016. Completion of baseline trachoma mapping in Malawi: results of eight population-based prevalence surveys conducted with the global trachoma mapping project. Ophthalmic Epidemiol 23: 3238.
    [Google Scholar]
  22. Solomon AW et al., 2015. The global trachoma mapping project: methodology of a 34-country population-based study. Ophthalmic Epidemiol 22: 214225.
    [Google Scholar]
  23. Solomon AW et al., Global Trachoma Mapping Project, 2018. Quality assurance and quality control in the global trachoma mapping project. Am J Trop Med Hyg 99: 858863.
    [Google Scholar]
  24. Solomon AW, Le Mesurier RT, Williams WJ, 2018. A diagnostic instrument to help field graders evaluate active trachoma. Ophthalmic Epidemiol 25: 399402.
    [Google Scholar]
  25. Boisson S, Engels D, Gordon BA, Medlicott KO, Neira MP, Montresor A, Solomon AW, Velleman Y, 2016. Water, sanitation and hygiene for accelerating and sustaining progress on neglected tropical diseases: a new global strategy 2015–20. Int Health 8 (Suppl 1): i19i21.
    [Google Scholar]
  26. World Health Organization, Strategic and Technical Advisory Group on Neglected Tropical Diseases, 2015. Technical Consultation on Trachoma Surveillance. Task Force for Global Health, September 11−12, 2014, Decatur, GA, WHO/HTM/NTD/2015.02. Geneva, Switzerland: WHO.
    [Google Scholar]
  27. Mpyet C et al., 2018. Impact survey results after SAFE strategy implementation in fifteen local government areas of Kebbi, Sokoto and Zamfara states, Nigeria. Ophthalmic Epidemiol 25: 103114.
    [Google Scholar]
  28. Debrah O et al., 2017. Elimination of trachoma as a public health problem in Ghana: providing evidence through a pre-validation survey. PLoS Negl Trop Dis 11: e0006099.
    [Google Scholar]
  29. World Health Organization, Strategic and Technical Advisory Group on Neglected Tropical Diseases, 2018. Design Parameters for Population-Based Trachoma Prevalence Surveys. WHO/HTM/NTD/PCT/2018.07. Geneva, Switzerland: WHO.
    [Google Scholar]
  30. Chen C, Cromwell EA, King JD, Mosher A, Harding-Esch EM, Ngondi JM, Emerson PM, 2011. Incremental cost of conducting population-based prevalence surveys for a neglected tropical disease: the example of trachoma in 8 national programs. PLoS Negl Trop Dis 5: e979.
    [Google Scholar]
  31. Trotignon G et al., 2017. The cost of mapping trachoma: data from the global trachoma mapping project. PLoS Negl Trop Dis 11: e0006023.
    [Google Scholar]
  32. Stelmach RD, Flueckiger RM, Shutt J, Davide-Smith M, Solomon AW, Rotondo L, Mosher AW, Baker M, Willis R, Ngondi J, 2019. The costs of monitoring trachoma elimination: evaluating the costs of trachoma impact, surveillance, and trachomatous trichiasis (TT)-only surveys. PLoS Negl Trop Dis 13: e0007605.
    [Google Scholar]
  33. Solomon AW, Emerson PM, Resnikoff S, 2017. Trachoma then and now: update on mapping and control. Community Eye Health 30: 9091.
    [Google Scholar]
  34. World Health Assembly, 1998. Global Elimination of Blinding Trachoma. 51st World Health Assembly, May 16, 1998, Geneva, Switzerland, Resolution WHA51.11. Geneva, Switzerland: WHO.
    [Google Scholar]
  35. Fitzpatrick C, Fleming FM, Madin-Warburton M, Schneider T, Meheus F, Asiedu K, Solomon AW, Montresor A, Biswas G, 2016. Benchmarking the cost per person of mass treatment for selected neglected tropical diseases: an approach based on literature review and meta-regression with web-based software application. PLoS Negl Trop Dis 10: e0005037.
    [Google Scholar]
  36. Mwingira UJ et al., 2016. Progress of trachoma mapping in Mainland Tanzania: results of baseline surveys from 2012 to 2014. Ophthalmic Epidemiol 23: 373380.
    [Google Scholar]
  37. Harding-Esch E et al., 2015. Costs of testing for ocular Chlamydia trachomatis infection compared to mass drug administration for trachoma in the Gambia: application of results from the PRET study. PLoS Negl Trop Dis 9: e0003670.
    [Google Scholar]
  38. Kolaczinski JH, Robinson E, Finn TP, 2011. The cost of antibiotic mass drug administration for trachoma control in a remote area of South Sudan. PLoS Negl Trop Dis 5: e1362.
    [Google Scholar]
  39. Schemann JF, Guinot C, Traore L, Zefack G, Dembele M, Diallo I, Traore A, Vinard P, Malvy D, 2007. Longitudinal evaluation of three azithromycin distribution strategies for treatment of trachoma in a sub-Saharan African country, Mali. Acta Trop 101: 4053.
    [Google Scholar]
  40. Courtright P et al., 2018. Strengthening the links between mapping, planning and global engagement for disease elimination: lessons learnt from trachoma. Br J Ophthalmol 102: 13241327.
    [Google Scholar]
  41. O’Brien KS, Emerson P, Hooper PJ, Reingold AL, Dennis EG, Keenan JD, Lietman TM, Oldenburg CE, 2018. Antimicrobial resistance following mass azithromycin distribution for trachoma: a systematic review. Lancet Infect Dis 19: e14e25.
    [Google Scholar]
  42. Doan T et al., MORDOR Study Group, 2019. Macrolide resistance in MORDOR I - a cluster-randomized trial in Niger. N Engl J Med 380: 22712273.
    [Google Scholar]
  43. Chidambaram JD et al., 2006. Effect of a single mass antibiotic distribution on the prevalence of infectious trachoma. JAMA 295: 11421146.
    [Google Scholar]
  44. House JI et al., 2009. Assessment of herd protection against trachoma due to repeated mass antibiotic distributions: a cluster-randomised trial. Lancet 373: 11111118.
    [Google Scholar]
  45. Solomon AW et al., 2008. Two doses of azithromycin to eliminate trachoma in a Tanzanian community. N Engl J Med 358: 18701871.
    [Google Scholar]
  46. Marks M, Bottomley C, Tome H, Pitakaka R, Butcher R, Sokana O, Kako H, Solomon AW, Mabey DC, 2016. Mass drug administration of azithromycin for trachoma reduces the prevalence of genital Chlamydia trachomatis infection in the Solomon Islands. Sex Transm Infect 92: 261265.
    [Google Scholar]
  47. Keenan JD et al., 2018. Azithromycin to reduce childhood mortality in sub-Saharan Africa. N Engl J Med 378: 15831592.
    [Google Scholar]
  48. Porco TC et al., 2009. Effect of mass distribution of azithromycin for trachoma control on overall mortality in Ethiopian children: a randomized trial. JAMA 302: 962968.
    [Google Scholar]
  49. Mitja O et al., 2015. Mass treatment with single-dose azithromycin for yaws. N Engl J Med 372: 703710.
    [Google Scholar]
  50. Marks M, Mitja O, Fitzpatrick C, Asiedu K, Solomon AW, Mabey DC, Funk S, 2017. Mathematical modeling of programmatic requirements for yaws eradication. Emerg Infect Dis 23: 2228.
    [Google Scholar]
  51. Ghinai R et al., 2015. A cross-sectional study of ‘yaws’ in districts of Ghana which have previously undertaken azithromycin mass drug administration for trachoma control. PLoS Negl Trop Dis 9: e0003496.
    [Google Scholar]
  52. Taleo F et al., Global Trachoma Mapping Project, 2017. Integrated mapping of yaws and trachoma in the five northern-most provinces of Vanuatu. PLoS Negl Trop Dis 11: e0005267.
    [Google Scholar]
  53. Mwingira UJ, Means AR, Chikawe M, Kilembe B, Lyimo D, Crowley K, Rusibamayila N, Nshala A, Mphuru A, 2016. Integrating neglected tropical disease and immunization programs: the experiences of the Tanzanian Ministry of Health. Am J Trop Med Hyg 95: 505507.
    [Google Scholar]
  54. Pinsent A, Burton MJ, Gambhir M, 2016. Enhanced antibiotic distribution strategies and the potential impact of facial cleanliness and environmental improvements for the sustained control of trachoma: a modelling study. BMC Med 14: 71.
    [Google Scholar]
  55. Amza A et al., 2017. Effectiveness of expanding annual mass azithromycin distribution treatment coverage for trachoma in Niger: a cluster randomised trial. Br J Ophthalmol 102: 680686.
    [Google Scholar]
  56. Oldenburg CE et al., 2018. Comparison of mass azithromycin coverage targets of children in Niger: a cluster-randomized trachoma trial. Am J Trop Med Hyg 98: 389395.
    [Google Scholar]
  57. Levine MM, Simon R, 2018. The gathering storm: is untreatable typhoid fever on the way? mBio 9: e00482-18.
    [Google Scholar]
  58. Brady MA, Stelmach R, Davide-Smith M, Johnson J, Pou B, Koroma J, Frimpong K, Weaver A, 2017. Costs of transmission assessment surveys to provide evidence for the elimination of lymphatic filariasis. PLoS Negl Trop Dis 11: e0005097.
    [Google Scholar]
  59. Bangert M, Molyneux DH, Lindsay SW, Fitzpatrick C, Engels D, 2017. The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals. Infect Dis Poverty 6: 73.
    [Google Scholar]
  60. Malecela MN, 2019. Reflections on the decade of the neglected tropical diseases. Int Health 11: 338340.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.20-0686
Loading
/content/journals/10.4269/ajtmh.20-0686
Loading

Data & Media loading...

  • Received : 16 Jun 2020
  • Accepted : 12 Jul 2020
  • Published online : 05 Oct 2020
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error