A cost-effectiveness analysis of anthelminthic intervention for community control of ascariasis: Traditional vs. pharmaceutical therapy

A Cost-Effectiveness Analysis of a targeted intervention for community control of Ascariasis was carried out in three rural communities near Quito, Ecuador. Targeted treatment with Paico (Chenopodium ambrosioides) and Albendazole (ABZ) was applied to children aged 5 to 15 years attending primary local schools in Aglla, Checa and Iguinaro. Prevalence and intensity of ascariasis and prevalence of other intestinal parasitic diseases were determined immediately before and after one month of the intervention to assess the effectiveness of treatment regimes. A written informed consent and a parasitic survey were applied before the screening test of stool samples. All registered students were assigned at random to three different treatment regimes: Andean-traditional (Paico), modern-Western (ABZ) and control group (doing nothing). Treatment was provided within the schools with the assistance of the school teachers. Significant differences in prevalence before and after treatment were recorded for both types of treatment. Information on social and cultural patterns of the three communities, as well as information on resource use was also collected for cost analysis. Logit logistic regression analysis was used for categorical data interpretation. The final model included three predictive variables related to environmental and social conditions present in the villages. Reduction in the prevalence of parasitism approached statistical significance in both treatments. Paico demonstrate to be four times more effective than control (doing nothing) group, while ABZ was two times more effective than Paico. The results were expressed in terms of the cost per child treated. The results showed Paico to be more cost-effective than the other two procedures.