Evidence map›Paper›PMID 39630851›Full record

Trial reportPLoS neglected tropical diseases2024

Cost-effectiveness of vector control for supplementing mass drug administration for eliminating lymphatic filariasis in India.

Donald S Shepard, Aung K Lwin, Sunish I Pulikkottil, Mariapillai Kalimuthu, Natarajan Arunachalam, Brij K Tyagi, Graham B White

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in PLoS neglected tropical diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Donald S ShepardHeller School for Social Policy and Management, MS035, Brandeis University, Waltham, Massachusetts, United States of America.ORCID 0000-0003-2187-0593
Aung K LwinHeller School for Social Policy and Management, MS035, Brandeis University, Waltham, Massachusetts, United States of America.
Sunish I PulikkottilIndian Council of Medical Research (ICMR) Centre for Research in Medical Entomology, Field Station, Chinna Chokkikulam, Madurai, Tamil Nadu, India.
Mariapillai KalimuthuIndian Council of Medical Research (ICMR) Centre for Research in Medical Entomology, Field Station, Chinna Chokkikulam, Madurai, Tamil Nadu, India.
Natarajan ArunachalamIndian Council of Medical Research (ICMR) Centre for Research in Medical Entomology, Field Station, Chinna Chokkikulam, Madurai, Tamil Nadu, India.
Brij K TyagiIndian Council of Medical Research (ICMR) Centre for Research in Medical Entomology, Field Station, Chinna Chokkikulam, Madurai, Tamil Nadu, India.
Graham B WhiteDepartment of Entomology and Nematology, University of Florida, Gainesville, Florida, United States of America.

Funding

Bill & Melinda Gates Foundation 43922
6 · The paper itself

Abstract

background/methodologyDespite progress using mass drug administration (MDA), lymphatic filariasis (LF) remains a major public health issue in India. Vector control could potentially augment MDA towards LF elimination. We conducted a cost-effectiveness analysis of MDA alone and MDA together with vector control single (VCS) modality or vector control integrated (VCI) modalities. Data came from historical controls and a three-arm cluster randomized trial of 36 villages at risk of LF transmission in Tamil Nadu, India. The arms were: MDA alone (the standard of care); MDA plus VCS (expanded polystyrene beads covering the water surface in wells and cesspits to suppress the filariasis vector mosquito Culex quinquefasciatus); and MDA plus VCI (VCS plus insecticidal pyrethroid-impregnated curtains [over windows, doors, and eaves). Economic costs in 2010 US$ combined government and community inputs from household to state levels. Outcomes were controlled microfilaria prevalence (MfP) and antigen prevalence (AgP) to conventional elimination targets (MfP<1% or AgP<2%) from 2010 to 2013, and modeled disability adjusted life years (DALYs) averted. PRINCIPAL

findingsThe estimated annual economic cost per resident was US$0.53 for MDA alone, US$1.02 for VCS, and US$1.83 for VCI. With MDA offered in all arms, all arms reduced LF prevalence substantially from 2010 to 2013. MDA proved highly cost effective at $112 per DALY averted, a very small (8%) share of India's then per capita Gross Domestic Product. Progress towards elimination was comparable across all three study arms.

conclusionsThe well-functioning MDA program proved effective and very cost-effective for eliminating LF, leaving little scope for further improvement. Supplementary vector control demonstrated no statistically significant additional benefit on MfP or AgP in this trial.

Indexed as

Cost-Benefit AnalysisCulexElephantiasis, FilarialFilaricidesMass Drug AdministrationMosquito ControlAnimalsFemaleHumansIndiaInsecticidesMaleMosquito VectorsFilaricidesInsecticides

Identifiers

PMID39630851
PMCPMC11649082

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.