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Several NTDs, namely lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH) and trachoma, are predominantly controlled by preventive chemotherapy (or mass drug administration), following recommendations set by the WHO. Over one billion people are now treated for NTDs with this strategy per year. However, further investment and increased domestic healthcare spending are urgently needed to continue these programmes. Consequently, it is vital that the cost-effectiveness of preventive chemotherapy is understood. We analyse the current estimates on the cost per disability-adjusted life year (DALY) of the preventive chemotherapy strategies predominantly used for these diseases and identify key evidence gaps that require further research. Overall, the reported estimates show that preventive chemotherapy is generally cost-effective, supporting WHO recommendations. More specifically, the cost per DALY averted estimates relating to community-wide preventive chemotherapy for lymphatic filariasis and onchocerciasis were particularly favourable when compared with other public health interventions. Cost per DALY averted estimates of school-based preventive chemotherapy for schistosomiasis and STH were also generally favourable but more variable. Notably, the broader socioeconomic benefits are likely not being fully captured by the DALYs averted metric. No estimates of cost per DALY averted relating to community-wide mass antibiotic treatment for trachoma were found, highlighting the need for further research. These findings are important for informing global health policy and support the need for continuing NTD control and elimination efforts.<\/jats:p>","DOI":"10.1136\/bmjgh-2021-005456","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T12:30:02Z","timestamp":1641558602000},"page":"e005456","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Are current preventive chemotherapy strategies for controlling and eliminating neglected tropical diseases cost-effective?"],"prefix":"10.1136","volume":"6","author":[{"given":"Hugo C","family":"Turner","sequence":"first","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK"},{"name":"Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, Ho Chi Minh City, Vietnam"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilma A","family":"Stolk","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony W","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D","family":"King","sequence":"additional","affiliation":[{"name":"Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Montresor","sequence":"additional","affiliation":[{"name":"Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H","family":"Molyneux","sequence":"additional","affiliation":[{"name":"Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaspreet","family":"Toor","sequence":"additional","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK"},{"name":"Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"2025072914244905000_6.8.e005456.1","unstructured":"World Health Organization . 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