@article{fdi:010078119,
  title = {{A} test-and-not-treat strategy for onchocerciasis elimination in {L}oa loa-coendemic areas : cost analysis of a pilot in the soa health district, {C}ameroon},
  author = {{L}enk, {E}. {J}. and {M}oungui, {H}. {C}. and {B}oussinesq, {M}ichel and {K}amgno, {J}. and {N}ana-{D}jeunga, {H}. {C}. and {F}itzpatrick, {C}. and {P}eultier, {A}cmm and {K}lion, {A}. {D}. and {F}letcher, {D}. {A}. and {N}utman, {T}. {B}. and {P}ion, {S}{\'e}bastien and {N}iamsi-{E}malio, {Y}. and {R}edekop, {W}. {K}. and {S}everens, {J}. {L}. and {S}tolk, {W}. {A}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {S}evere adverse events after treatment with ivermectin in individuals with high levels of {L}oa loa microfilariae in the blood preclude onchocerciasis elimination through community-directed treatment with ivermectin ({CDTI}) in {C}entral {A}frica. {W}e measured the cost of a community-based pilot using a test-and-not-treat ({T}a{NT}) strategy in the {S}oa health district in {C}ameroon. {M}ethods. {B}ased on actual expenditures, we empirically estimated the economic cost of the {S}oa {T}a{NT} campaign, including financial costs and opportunity costs that will likely be borne by control programs and stakeholders in the future. {I}n addition to the empirical analyses, we estimated base-case, less intensive, and more intensive resource use scenarios to explore how costs might differ if {T}a{NT} were implemented programmatically. {R}esults. {T}he total costs of {US}$283 938 divided by total population, people tested, and people treated with 42% coverage were {US}$4.0, {US}$9.2, and {US}$9.5, respectively. {I}n programmatic implementation, these costs (base-case estimates with less and more intensive scenarios) could be {US}$2.2 ($1.9-$3.6), {US}$5.2 ($4.5-$8.3), and {US}$5.4 ($4.6-$8.6), respectively. {C}onclusions. {T}a{NT} clearly provides a safe strategy for large-scale ivermectin treatment and overcomes a major obstacle to the elimination of onchocerciasis in areas coendemic for {L}oa loa. {A}lthough it is more expensive than standard {CDTI}, costs vary depending on the setting, the implementation choices made by the institutions involved, and the community participation rate. {R}esearch on the required duration of {T}a{NT} is needed to improve the affordability assessment, and more experience is needed to understand how to implement {T}a{NT} optimally.},
  keywords = {onchocerciasis ; {L}oa loa ; cost analysis ; point-of-care testing ; disease ; elimination ; {CAMEROUN}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {70},
  numero = {8},
  pages = {1628--1635},
  ISSN = {1058-4838},
  year = {2020},
  DOI = {10.1093/cid/ciz461},
  URL = {https://www.documentation.ird.fr/hor/fdi:010078119},
}