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