Neglected tropical diseases (NTDs) remain a significant cause of morbidity and mortality in many low-income and middle-income countries. Several NTDs, namely lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH) and trachoma, are predominantly controlled by preventive chemotherapy (or mass drug administration), following recommendations set by the WHO. Over one billion people are now treated for NTDs with this strategy per year. However, further investment and increased domestic healthcare spending are urgently needed to continue these programmes. Consequently, it is vital that the cost-effectiveness of preventive chemotherapy is understood. We analyse the current estimates on the cost per disability-adjusted life year (DALY) of the preventive chemotherapy strategies predominantly used for these diseases and identify key evidence gaps that require further research. Overall, the reported estimates show that preventive chemotherapy is generally cost-effective, supporting WHO recommendations. More specifically, the cost per DALY averted estimates relating to community-wide preventive chemotherapy for lymphatic filariasis and onchocerciasis were particularly favourable when compared with other public health interventions. Cost per DALY averted estimates of school-based preventive chemotherapy for schistosomiasis and STH were also generally favourable but more variable. Notably, the broader socioeconomic benefits are likely not being fully captured by the DALYs averted metric. No estimates of cost per DALY averted relating to community-wide mass antibiotic treatment for trachoma were found, highlighting the need for further research. These findings are important for informing global health policy and support the need for continuing NTD control and elimination efforts. All data relevant to the study are included in the article.

中文翻译：

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目前用于控制和消除被忽视的热带病的预防性化疗策略是否具有成本效益？

被忽视的热带病 (NTD) 仍然是许多低收入和中等收入国家发病率和死亡率的重要原因。几种被忽视的热带病，即淋巴丝虫病、盘尾丝虫病、血吸虫病、土壤传播的蠕虫病 (STH) 和沙眼，主要通过预防性化疗（或大规模药物管理）根据 WHO 制定的建议进行控制。现在每年有超过 10 亿人接受 NTD 治疗。然而，迫切需要进一步投资和增加国内医疗保健支出以继续实施这些计划。因此，了解预防性化疗的成本效益至关重要。我们分析了目前对主要用于这些疾病的预防性化疗策略的每残疾调整生命年 (DALY) 成本的估计，并确定了需要进一步研究的关键证据缺口。总的来说，报告的估计表明，预防性化疗通常具有成本效益，支持世卫组织的建议。更具体地说，与其他公共卫生干预措施相比，与针对淋巴丝虫病和盘尾丝虫病的社区范围预防性化疗相关的每个 DALY 避免的估计成本特别有利。以学校为基础的血吸虫病和 STH 预防性化疗避免的每 DALY 成本估计也普遍有利，但变化更大。值得注意的是，DALYs 避免的指标可能没有充分体现更广泛的社会经济效益。没有发现与社区范围内沙眼大规模抗生素治疗相关的每个 DALY 成本的估计值，这突出表明需要进一步研究。这些发现对于为全球卫生政策提供信息和支持继续控制和消除 NTD 的必要性非常重要。与研究相关的所有数据都包含在文章中。