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PLoS Neglected Tropical DiseasesVolume 7, Issue 1, January 2013, Article number e2032

African Programme for Onchocerciasis Control 1995-2015: Model-Estimated Health Impact and Cost(Article)(Open Access)

  • Coffeng, L.E.,
  • Stolk, W.A.,
  • Zouré, H.G.M.,
  • Veerman, J.L.,
  • Agblewonu, K.B.,
  • Murdoch, M.E.,
  • Noma, M.,
  • Fobi, G.,
  • Richardus, J.H.,
  • Bundy, D.A.P.,
  • Habbema, D.,
  • de Vlas, S.J.,
  • Amazigo, U.V.
  • View Correspondence (jump link)
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  • aDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  • bAfrican Programme for Onchocerciasis Control, Ouagadougou, Burkina Faso
  • cSchool of Population Health, The University of Queensland, Brisbane, Australia
  • dDepartment of Dermatology, Watford General Hospital, Watford, United Kingdom
  • eHuman Development Network, The World Bank, Washington, D.C., United States
  • fIndependent Consultant, Enugu, Nigeria

Abstract

Background: Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015. Methods and Findings: With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million. Conclusions: Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future. © 2013 Coffeng et al.

Indexed keywords

EMTREE drug terms:ivermectin
EMTREE medical terms:Africaafrican programme for onchocerciasis controlarticleblindnesscost effectiveness analysisendemic diseasehealth care costhealth impact assessmenthealth programhumaninfectionmodelmorbidityonchocerciasisparasite controlprevalencepruritusquality adjusted life yearsensitivity analysisvisual impairment

Chemicals and CAS Registry Numbers:

ivermectin, 70288-86-7

Funding details

Funding sponsor Funding number Acronym
World Bank Group
See opportunities by WBG		WBG

  • 1

    Ivermectin kills microfilariae and permanently reduces the production of microfilariae by adult female worms, slowing down transmission and preventing morbidity , . Annual mass treatment with ivermectin is implemented through a community-directed treatment approach, empowering communities to take responsibility for ivermectin delivery and to decide how, when, and by whom ivermectin treatment is administered. Mass treatment with ivermectin is enabled by donation of the drug by the pharmaceutical company Merck through the Mectizan Donation Program. Furthermore, coordination of the program is funded by donor countries (through the World Bank) and national onchocerciasis task forces (including beneficiary governments and non-governmental development organizations). To demonstrate APOC's importance, validate the efforts of endemic communities and national task forces, and maintain commitment of all stakeholders, it is essential to establish the health impact and cost of APOC.

  • ISSN: 19352727
  • Source Type: Journal
  • Original language: English
  • DOI: 10.1371/journal.pntd.0002032
  • Document Type: Article
  • Publisher: Public Library of Science

  Coffeng, L. E.; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Netherlands;
© Copyright 2017 Elsevier B.V., All rights reserved.

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