Cost of school-based drug treatment in Tanzania

It has been argued that targeting delivery of anthelmintics to school-child ren by taking advantage of the existing education infrastructure and admini strative system can be one of the most cost-effective approaches in minimiz ing the intensity of infections with both schistosomiasis and major intesti nal nematodes in many developing countries. The study was conducted in January 1997, shortly after the completion of th e drug intervention programme. This paper provides an analysis of the costs of providing age-targeted treatment of schoolchildren for urinary schistos omiasis using praziquantel and for intestinal nematodes using albendazole a s an integral part of the School Health Programme in Tanga Region, Tanzania . The analysis shows that the total financial cost of the intervention progra mme in 1996 prices was US$54 252.28 (exchange rate: TSH 573 = US$1). Of thi s amount, the cost of drugs constitutes 80.6%, while the delivery cost appe ars relatively low, representing just below 20%. Even when the opportunity cost of unpaid days of labour input is included, the cost of drugs still re mains the highest cost component of the intervention (55.8%). In the curren t epidemiological and logistic setting of Tanzania, the financial cost per child treated using praziquantel, which involved prior screening at the sch ool level, was US$0.79, while treatment using albendazole was as low as US$ 0.23, of which US$0.20 was drug purchase cost. It is concluded that the base cost of delivering a universal, standard, sch ool-based health intervention such as albendazole can be as low as US$0.03 per child treated, but even a very slight increase in the complexity of del ivery can have a very significant impact on the cost of intervention.