Health intervention: Severity of disease a CEA (US$ per DALY averted) b Quality of evidence
for effectiveness
Catastrophic health expenditure Effect on productivity Socio-economic status Borda Rank
Weights (adds up to 1) 1/6 1/6 1/6 1/6 1/6 1/6  
Dengue (DF/DHF/DSS): Case management Medium



  ••
High.
Mean: 1172.
[3,32]

•••
Medium
[33-36]


  ••
Medium.
Thailand: On average US$61 annually per family.[51]

••
Medium.
US$ 118 million of productive work lost yearly.[15]
••
High



  •••
1
Trachoma: The SAFE strategy (surgery, antibiotics, face washing and environmental control) High



•••
High.
Mean: 3137.
 [3,32]

•••
Medium
[37-41]


••
Low.
Global. 1998 US$ 6.1 for trichiasis surgery. [52]

Medium.
Total potential productivity loss $ 5.3 billion (US$ 2003) [52]
••
High



•••
1
Visceral leishmaniasis: Case-detection and treatment, vector control High
     




•••
Medium.
Mean: 992.
[59]



  ••
Low
[42]
                                    


High.
Bangladesh: Median total expenditure 1.2 times per capita annually income. [53] India: 7 months of an individual’s income. [54]
•••
Medium.
Nearly all deaths occur at age 5-<30, before main productive age. [15]  


••
High    





•••
1
Lymphatic filariasis: Mass drug administration. Ivermectin and albendazole in Africa, and DEC and albendazole in onchoceriasis-free countries twice annually Low    





Low.
Mean: 9.5.
[3,26,32]



  •
Medium
[43]  




  ••
Low.
India: mean annual expenditure per person: US$ 2.1 [58] . 0.5 US$ per person per year (PCT, WHO)

Medium.
 India: infected individuals 27% less productive.[55] India: loss of >1 billion person-days per year.[56]
••
High    





•••
5
Onchoceriasis: Community-directed treatment with ivermectin annually Medium  



••
Low.
Mean: 22.45.
[ 3,26,32,]

Medium
 [44]  


••
Low.
0.5 US$ per person per year (PCT, WHO)

Medium.
School drop-out twice as high where head of house affected.[57]
••
High  



•••
4
Soil-transmitted helminthiasis: Mass shool-based treatment with albendazole or mebendazole annually Low  



 •
Low.
Mean: 6.5.
[3,32]

 •
High
[48]


 •••
Low.
0.5 US$ per person per year (PCT, WHO)

 •
Low.
No effect on school-performance. [45]

 •
High



  •••
5
Key
a Severity of disease. No of individual lifetime DALYs lost. Cut-offs: high = > 20, medium = > 10-20. Low = < 10.
bCost-effectiveness. Cut-offs: high = > 1000, medium = 100-1000, Low = < 100.
Table 2: Quantitative performance of selected criteria for some interventions targeting neglected tropical diseases.
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