Health, financial, and education gains of investing in preventive chemotherapy for schistosomiasis, soil-transmitted helminthiases, and lymphatic filariasis in Madagascar: A modeling study

摘要

Author summary Neglected tropical diseases (NTDs) cause ill health and disability among the poorest people with extensive economic and social effects. Existing cost-effectiveness analyses, however, have typically focused on the health gains associated with the scale up of preventive chemotherapy. This misses the key fact that health investments can contribute to gains in other sectors leading to broader benefits of NTD control. This study determines the value for money of national NTD control across multiple sectors. We assess the potential health, financial, and education gains of NTD control in a setting where NTDs are highly endemic. We build on extended cost-effectiveness analysis methods to examine five interventions which governments aim to scale up nationally. We find that, per dollar spent, preventive chemotherapy could avert a substantial number of infections, disability-adjusted life years or DALYs, and cases of school absenteeism. Our analysis incorporates broader wealth and education gains into the economic evaluation of health interventions and therefore provides information about the efficiency of attainment of three Sustainable Development Goals. This study highlights the potentially large societal benefits of investing in NTD control.