Onchocerciasis control in Nigeria: will households be able to afford community-directed treatment with ivermectin?

Objectives: To determine the level of affordability of community-directed t reatment with ivermectin (CDTI) to households living in two onchocerciasis endemic Nigerian communities namely Toro in the north and Nike in the south . Methods: The proportion or the cost of treating people with ivermectin wi ll deplete in average monthly/projected annual household expenditure on foo d and health care, and on average monthly and projected annual household in come were respectively calculated and used to determine the level of afford ability of CDTI. Questionnaires administered to heads of households or thei r representatives were used to collect information on the household expendi tures and income. The suggested unit CDTI cost of $0.20 was used. However, as a test of sensitivity, we also used the unit cost of $0.056 which some c ommunity based distributors are charging per treatment. Result: Using $0.20 as the unit treatment cost. this will consume less than 0.05% of average a nnual household income in both communities. It will equally deplete 0.05% o f combined annual household expenditures on food and health care in both co mmunities. However, using $0.056 as the unit treatment cost, then 0.02% of average annual household expenditure on health care, 0.01% average annual e xpenditure on combined health care and food, and 0.01% of average annual ho usehold income will be depleted. Conclusion: The households living in both communities may be able to afford CDTI schemes. However, the final decision on levels of affordability lies with the households. They will decide whet her they can afford to trade-off some household income for ivermectin distr ibution. (C) 2001 Elsevier Science B.V. All rights reserved.