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. 2021 Apr 29;21(1):826.
doi: 10.1186/s12889-021-10842-5.

Estimating the programmatic cost of targeted mass drug administration for malaria in Myanmar

Shwe Sin Kyaw  1   2 , Gilles Delmas  3 , Tom L Drake  4 , Olivier Celhay  5 , Wirichada Pan-Ngum  5   6 , Sasithon Pukrittayakamee  5   6 , Yoel Lubell  6   7 , Ricardo J Aguas  6   7 , Richard James Maude  6   7   8 , Lisa J White  9 , Francois Nosten  6   3   7
Affiliations

Estimating the programmatic cost of targeted mass drug administration for malaria in Myanmar

Shwe Sin Kyaw et al. BMC Public Health. .

Abstract

Background: Mass drug administration (MDA) has received growing interest to accelerate the elimination of multi-drug resistant malaria in the Greater Mekong Subregion. Targeted MDA, sometimes referred to as focal MDA, is the practice of delivering MDA to high incidence subpopulations only, rather than the entire population. The potential effectiveness of delivering targeted MDA was demonstrated in a recent intervention in Kayin State, Myanmar. Policymakers and funders need to know what resources are required if MDA, targeted or otherwise, is to be included in elimination packages beyond existing malaria interventions. This study aims to estimate the programmatic cost and the unit cost of targeted MDA in Kayin State, Myanmar.

Methods: We used financial data from a malaria elimination initiative, conducted in Kayin State, to estimate the programmatic costs of the targeted MDA component using a micro-costing approach. Three activities (community engagement, identification of villages for targeted MDA, and conducting mass treatment in target villages) were evaluated. We then estimated the programmatic costs of implementing targeted MDA to support P. falciparum malaria elimination in Kayin State. A costing tool was developed to aid future analyses.

Results: The cost of delivering targeted MDA within an integrated malaria elimination initiative in eastern Kayin State was approximately US$ 910,000. The cost per person reached, distributed among those in targeted and non-targeted villages, for the MDA component was US$ 2.5.

Conclusion: This cost analysis can assist policymakers in determining the resources required to clear malaria parasite reservoirs. The analysis demonstrated the value of using financial data from research activities to predict programmatic implementation costs of targeting MDA to different numbers of target villages.

Keywords: Costs; MDA; Malaria elimination; Myanmar; P. falciparum.

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Conflict of interest statement

None of the authors declare any competing interests.

Figures

Fig. 1
Fig. 1
The total cost of targeted mass drug administration in Kayin State, Myanmar, based on financial data provided by the Malaria Elimination Task Force. MDA, mass drug administration
Fig. 2
Fig. 2
The variation in the cost of community engagement due to changes in a range of model parameters. CE, Community Engagement
Fig. 3
Fig. 3
The variation in the cost of identification of villages for MDA due to changes in a range of model parameters. uPCR, ultrasensitive polymerase chain reaction
Fig. 4
Fig. 4
The variation in the cost of targeted mass treatment due to changes in a range of model parameters. MDA, mass drug administration; ACT, Artemisinin Combination Therapy
See this image and copyright information in PMC

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