Optimizing Age Structured Mass Drug Administration Against Soil-transmitted Helminthiasis in Ghana Using Cost-Benefit Analysis

Soil-transmitted helminthiasis (STH), a neglected tropical disease (NTD) remains a major health problem all over the world especially in developing countries such as, Cameroon with a prevalence of 30.8%, Nigeria and Ghana with a prevalence of 25.4% (Pullan et. al, 2014). This study touches on transmission patterns and investigates the effectiveness of policies on mass drug administration as a means to control STH in Ghana. The government of Ghana currently focuses mass drug administration efforts on school aged children (SAC) that are children between the ages of 5-14 years. This paper develops and evaluates a different mass drug administration strategy by hypothesizing that it would be more cost-effective to target some percentage of vulnerable adults in MDA efforts as opposed to only targeting SAC between ages 5-14 years in Ghana. This we hypothesize would lead to a faster reduction in prevalence over time, would be cost-effective and would hopefully lead to an eventual reduction in morbidity caused by this disease to a level of no public health significance in Ghana. We conduct three cost-effectiveness analyses based on three different case setups. Given the parameter values from literature, our results suggest that it is most cost-effective to cover 20% of adults while covering at least 24% of children in mass drug administration assuming that the number of individuals covered is equal to 80% a figure which is the current total coverage of school-aged children.