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The public health benefit and burden of mass drug administration programs in Vietnamese schoolchildren: Impact of mebendazole

BACKGROUND: Mass anthelmintic drug administration is recommended in developing countries to address infection by soil-transmitted helminthiases (STH). We quantified the public health benefit of treatment with mebendazole in eight million Vietnamese children aged 5–14 years from 2006 to 2011. This wa...

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Autores principales: Debaveye, Sam, Gonzalez Torres, Claudia Virginia, De Smedt, Delphine, Heirman, Bert, Kavanagh, Shane, Dewulf, Jo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258429/
https://www.ncbi.nlm.nih.gov/pubmed/30419030
http://dx.doi.org/10.1371/journal.pntd.0006954
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author Debaveye, Sam
Gonzalez Torres, Claudia Virginia
De Smedt, Delphine
Heirman, Bert
Kavanagh, Shane
Dewulf, Jo
author_facet Debaveye, Sam
Gonzalez Torres, Claudia Virginia
De Smedt, Delphine
Heirman, Bert
Kavanagh, Shane
Dewulf, Jo
author_sort Debaveye, Sam
collection PubMed
description BACKGROUND: Mass anthelmintic drug administration is recommended in developing countries to address infection by soil-transmitted helminthiases (STH). We quantified the public health benefit of treatment with mebendazole in eight million Vietnamese children aged 5–14 years from 2006 to 2011. This was compared to the environmental impact of the pharmaceutical supply chain of mebendazole, as the resource use and emissions associated with pharmaceutical production can be associated with a public health burden, e.g. through emissions of fine particulate matter. METHODOLOGY: Through Markov modelling the disability due to STH was quantified for hookworm, Ascaris lumbricoides and Trichuris trichiura. For each worm type, four levels of intensity of infection were included: none, light, medium and heavy. The treatment effect on patients was quantified in Disability-Adjusted Life Years (DALYs). The public health burden induced by the pharmaceutical supply chain of mebendazole was quantified in DALYs through Life Cycle Assessment. PRINCIPAL FINDINGS: Compared to ‘no treatment’, the modelled results of five-year treatment averted 116,587 DALYs (68% reduction) for the three worms combined and largely driven by A. lumbricoides. The main change in DALYs occurred in the first year of treatment, after which the results stabilized. The public health burden associated with the pharmaceutical supply chain was 6 DALYs. CONCLUSIONS: The public health benefit of the Mass Drug Administration (MDA) averted substantially more DALYs than those induced by the pharmaceutical supply chain. These results were verified in a sensitivity analysis. The starting prevalence for each worm was the most sensitive model parameter. This methodology is useful for policymakers interested in a holistic approach towards the public health performance of MDA programs, enveloping both the treatment benefit received by the patient and the public health burden associated with the resource consumption and environmental emissions of the pharmaceutical production and supply chain.
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spelling pubmed-62584292018-12-06 The public health benefit and burden of mass drug administration programs in Vietnamese schoolchildren: Impact of mebendazole Debaveye, Sam Gonzalez Torres, Claudia Virginia De Smedt, Delphine Heirman, Bert Kavanagh, Shane Dewulf, Jo PLoS Negl Trop Dis Research Article BACKGROUND: Mass anthelmintic drug administration is recommended in developing countries to address infection by soil-transmitted helminthiases (STH). We quantified the public health benefit of treatment with mebendazole in eight million Vietnamese children aged 5–14 years from 2006 to 2011. This was compared to the environmental impact of the pharmaceutical supply chain of mebendazole, as the resource use and emissions associated with pharmaceutical production can be associated with a public health burden, e.g. through emissions of fine particulate matter. METHODOLOGY: Through Markov modelling the disability due to STH was quantified for hookworm, Ascaris lumbricoides and Trichuris trichiura. For each worm type, four levels of intensity of infection were included: none, light, medium and heavy. The treatment effect on patients was quantified in Disability-Adjusted Life Years (DALYs). The public health burden induced by the pharmaceutical supply chain of mebendazole was quantified in DALYs through Life Cycle Assessment. PRINCIPAL FINDINGS: Compared to ‘no treatment’, the modelled results of five-year treatment averted 116,587 DALYs (68% reduction) for the three worms combined and largely driven by A. lumbricoides. The main change in DALYs occurred in the first year of treatment, after which the results stabilized. The public health burden associated with the pharmaceutical supply chain was 6 DALYs. CONCLUSIONS: The public health benefit of the Mass Drug Administration (MDA) averted substantially more DALYs than those induced by the pharmaceutical supply chain. These results were verified in a sensitivity analysis. The starting prevalence for each worm was the most sensitive model parameter. This methodology is useful for policymakers interested in a holistic approach towards the public health performance of MDA programs, enveloping both the treatment benefit received by the patient and the public health burden associated with the resource consumption and environmental emissions of the pharmaceutical production and supply chain. Public Library of Science 2018-11-12 /pmc/articles/PMC6258429/ /pubmed/30419030 http://dx.doi.org/10.1371/journal.pntd.0006954 Text en © 2018 Debaveye et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Debaveye, Sam
Gonzalez Torres, Claudia Virginia
De Smedt, Delphine
Heirman, Bert
Kavanagh, Shane
Dewulf, Jo
The public health benefit and burden of mass drug administration programs in Vietnamese schoolchildren: Impact of mebendazole
title The public health benefit and burden of mass drug administration programs in Vietnamese schoolchildren: Impact of mebendazole
title_full The public health benefit and burden of mass drug administration programs in Vietnamese schoolchildren: Impact of mebendazole
title_fullStr The public health benefit and burden of mass drug administration programs in Vietnamese schoolchildren: Impact of mebendazole
title_full_unstemmed The public health benefit and burden of mass drug administration programs in Vietnamese schoolchildren: Impact of mebendazole
title_short The public health benefit and burden of mass drug administration programs in Vietnamese schoolchildren: Impact of mebendazole
title_sort public health benefit and burden of mass drug administration programs in vietnamese schoolchildren: impact of mebendazole
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258429/
https://www.ncbi.nlm.nih.gov/pubmed/30419030
http://dx.doi.org/10.1371/journal.pntd.0006954
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