African Programme for Onchocerciasis Control 1995-2015: Model-Estimated Health Impact and Cost

Coffeng, Luc E., Stolk, Wilma A., Zoure, Honorat G. M., Veerman, J. Lennert, Agblewonu, Koffi B., Murdoch, Michele E., Noma, Mounkaila, Fobi, Grace, Richardus, Jan Hendrik, Bundy, Donald A. P., Habbema, Dik, de Vlas, Sake J. and Amazigo, Uche V. (2013) African Programme for Onchocerciasis Control 1995-2015: Model-Estimated Health Impact and Cost. PLoS Neglected Tropical Diseases, 7 1: e2032.1-e2032.9. doi:10.1371/journal.pntd.0002032

Author Coffeng, Luc E.
Stolk, Wilma A.
Zoure, Honorat G. M.
Veerman, J. Lennert
Agblewonu, Koffi B.
Murdoch, Michele E.
Noma, Mounkaila
Fobi, Grace
Richardus, Jan Hendrik
Bundy, Donald A. P.
Habbema, Dik
de Vlas, Sake J.
Amazigo, Uche V.
Title African Programme for Onchocerciasis Control 1995-2015: Model-Estimated Health Impact and Cost
Journal name PLoS Neglected Tropical Diseases   Check publisher's open access policy
ISSN 1935-2735
Publication date 2013-01
Year available 2013
Sub-type Article (original research)
DOI 10.1371/journal.pntd.0002032
Open Access Status DOI
Volume 7
Issue 1
Start page e2032.1
End page e2032.9
Total pages 9
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Collection year 2014
Language eng
Formatted abstract
Background: Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in
16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015.

Methods and Findings: With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM,
and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million.

Conclusions: Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015.  APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future.
Keyword Annual Ivermectin Treatment
West Africa
Microfilarial Load
Excess Mortality
Dose Ivermectin
Vector Control
Skin disease
Human Host
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
Available Versions of this Record
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 38 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 37 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Sun, 03 Mar 2013, 00:09:00 EST by System User on behalf of School of Public Health