The economics of schistosomiasis chemotherapy

The optimal choice o f chemotherapy regime arises in the design o f every schistosomiasis control programme. This choice is o f particular contemporary interest for two reasons. At one extreme the development of effective single-dose oral drugs such as praziquantel and oxamniquine makes mass chemotherapy a practical option. At the other extreme there has been a revival o f advocacy for some form o f selective treatment. But all developing countries that contemplate schistosomiasis control face severe budget constraints, requiring careful analysis o f the economics o f chemotherapy. In this article, Nick Prescott presents a generalized framework For resource allocation in schistosomiasis chemotherapy, demonstrating that the optimal choice o f chemotherapy regime depends critically on the level of budget constraint, the unit costs o f screening and treatment, and rates o f compliance with screening and chemotherapy-all factors which are usually neglected in the choice o f control strategy.