Health intervention: Severity of disease (in lifetime DALYs lost) a CEA (US$ per DALY averted) Evidence for intervention Catastropic health expenditure Effect on productivity Socio-economic status
Dengue (DF/DHF/DSS): Case management DHF case fatality rate 3.8%, DSS CFR 5-10%.[15]
12.8
587 [2] or 716-1757[3] One Cochrane review and three RCTs.[33-36] Thailand: On average US$61 annually per family.[51] Southeast Asia: US$ 118 million lost yearly due to loss of productive work [15]. Poor [2, 3]
Trachoma: The SAFE strategy (surgery, antibiotics, face washing and environmental control) 22.4 39-6,269
 [32] or 5-100 [3]
One clinical evidence systematic reviewand four Cochrane reviews. [37-41] Global. 1998 US$ 6.1 for trichiasis surgery. [52] Total potential productivity loss $ 5.3 billion (US$ 2003) [52]. Poor [2, 3]
Visceral leishmaniasis: Case-detection and treatment, vector control VL case fatality rate 10%[30], 0.23%-13.2%[31]
23.5
9 [32] or 11-22 [3] (cutaneous and visceral leish) or 362-1622 per death averted (visceral only).[59] One review [42] . No Cochrane review available. Bangladesh: Median total expenditure 1.2 times per capita annually income. [53] India: 7 months of an individual’s income [54]. Nearly all deaths occur at age 5-<30, before main productive age [15]. Poor [2, 3]
Lymphatic filariasis: Mass drug administration. Ivermectin and albendazole in Africa, and DEC and albendazole in onchoceriasis-free countries twice annually  7.1 15 [32] or 5-10 [3] or 4-8 [26] One Cochrane review [43]. Brown 2000 evaluated effect of ivermectin. India: mean annual expenditure per person: US$ 2.1 [58] . 0.5 US$ per person per year (PCT, WHO) India: infected individuals 27% less productive [55]. India: loss of >1 billion person-days per year [56]. Poor [2, 3]
Onchoceriasis: Community-directed treatment with ivermectin annually  16.2 7, 9 or 37 [32,3,26] One Cochrane review: only savannah strain evaluated [44]. Boatin 1998 evaluate effect of ivermectin. 0.5 US$ per person per year (PCT, WHO) School drop-out twice as high where head of house affected [57]. Poor [2, 3]
Soil-transmitted helminthiases (STH): Mass shool-based treatment with albendazole or mebendazole annually 4.6 3 [32] or 2-11 [3] One systematic review [48]. Cochrane reviews restricted to STH in pregnancy, in HIV-positive and effect on school performance. Benton: US $ more per annum on health than uninfected individuals. 0.5 US$ per person per year (PCT, WHO) No effect on school-performance according to Cochrane [45]. Poor [2, 3]
Key a Severity of disease. Estimates of individual lifetime DALYs lost are made by using a DALY calculator (see appendix).
Table 1: Performance on selected criteria of some interventions targeting neglected tropical diseases.