Cost-effectiveness of trachoma control measures: Comparing targeted household treatment and mass treatment of children

Kevin D. Frick, Thomas M. Lietman, Susan Osaki Holm, Hem C. Jha, J. S.P. Chaudhary, Ramesh C. Bhatta

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Objective The present study compares the cost-effectiveness of targeted household treatment and mass treatment of children in the most westerly part of Nepal. Methods Effectiveness was measured as the percentage point change in the prevalence of trachoma. Resource measures included personnel time required for treatment, transportation, the time that study subjects had to wait to receive treatment, and the quantity of azithromycin used. The costs of the programme were calculated from the perspectives of the public health programme sponsor, the study subjects, and the society as a whole. Findings Previous studies have indicated no statistically significant differences in effectiveness, and the present work showed no significant differences in total personnel and transportation costs per child aged 1-10 years, the total time that adults spent waiting, or the quantity of azithromycin per child. However, the mass treatment of children was slightly more effective and used less of each resource per child aged 1-10 years than the targeted treatment of households. Conclusion From all perspectives, the mass treatment of children is at least as effective and no more expensive than targeted household treatment, notwithstanding the absence of statistically significant differences. Less expensive targeting methods are required in order to make targeted household treatment more cost-effective.

Original languageEnglish (US)
Pages (from-to)201-207
Number of pages7
JournalBulletin of the World Health Organization
Issue number3
StatePublished - Apr 10 2001


  • Azithromycin/supply and distribution
  • Child
  • Comparative study
  • Cost-benefit analysis
  • Nepal (source: MeSH)
  • Trachoma/drug therapy

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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