Programmatic implications of the TUMIKIA trial on community-wide treatment for soil-transmitted helminths: further health economic analyses needed before a change in policy
File(s)
Published version
Author(s)
Turner, Hugo C
Bundy, Donald AP
Type
Journal Article
Abstract
School-based deworming programmes are currently the main approach used to control the soil-transmitted helminths (STHs). A key unanswered policy question is whether mass drug administration (MDA) should be targeted to
the whole community instead, and several trials in this area have been conducted or are currently on-going. A recent
well-conducted trial demonstrated that successful community-wide treatment is a feasible strategy for STH control
and can be more efective than school-based treatment in reducing prevalence and intensity of hookworm infection. However, we would argue that it is vital that these fndings are not taken out of context or over generalised, as
the additional health benefts gained from switching to community-wide treatment will vary depending on the STH
species and baseline endemicity. Moreover, community-wide treatment will typically be more expensive than schoolbased treatment. The epidemiological evidence for an additional beneft from a switch to community-wide treatment
has yet to be proven to represent “good value for money” across diferent settings. Further work is needed before
changes in policy are made regarding the use of community-wide treatment for STH control, including comprehensive assessments of its additional public health benefts and costs across a range of scenarios, accounting for the
presence of alternative treatment delivery platforms.
the whole community instead, and several trials in this area have been conducted or are currently on-going. A recent
well-conducted trial demonstrated that successful community-wide treatment is a feasible strategy for STH control
and can be more efective than school-based treatment in reducing prevalence and intensity of hookworm infection. However, we would argue that it is vital that these fndings are not taken out of context or over generalised, as
the additional health benefts gained from switching to community-wide treatment will vary depending on the STH
species and baseline endemicity. Moreover, community-wide treatment will typically be more expensive than schoolbased treatment. The epidemiological evidence for an additional beneft from a switch to community-wide treatment
has yet to be proven to represent “good value for money” across diferent settings. Further work is needed before
changes in policy are made regarding the use of community-wide treatment for STH control, including comprehensive assessments of its additional public health benefts and costs across a range of scenarios, accounting for the
presence of alternative treatment delivery platforms.
Date Issued
2020-02-27
Date Acceptance
2020-02-17
Citation
Parasites and Vectors, 2020, 13 (1)
ISSN
1756-3305
Publisher
BioMed Central
Journal / Book Title
Parasites and Vectors
Volume
13
Issue
1
Copyright Statement
© 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing,
adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and
the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material
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is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds
the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and
the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material
in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material
is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds
the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Identifier
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Subjects
Science & Technology
Life Sciences & Biomedicine
Parasitology
Tropical Medicine
Soil-transmitted helminths
Policy
Deworming
Community-wide treatment
School-based treatment
Cost
MATHEMATICAL-MODELS
EQUITY
COST
Publication Status
Published
Article Number
102