The cost of mapping trachoma: Data from the Global Trachoma Mapping Project

• Type of Material: Article
• Authors: Guillaume Trotignon, Haywards Heath; Ellen Jones, Haywards Heath; Thomas Engels, Haywards Heath; Elena Schmidt, Haywards Heath; Deborah McFarland, Emory University; Colin K. Macleod, London School of Hygiene & Tropical Medicine; Khaled Amer, Ministry of Health, Cairo; Amadou A. Bio, Ministère de la Santé; Ana Bakhtiari, Task Force for Global Health; Sarah Bovill, Haywards Heath; Amy H. Doherty, RTI International; Asad Aslam Khan, King Edward Medical University; Mariamo Mbofana, Ministerio da Saude; Siobhain McCullagh, Haywards Heath; Tom Millar, Haywards Heath; Consity Mwale, Provincial Health Office, Ndola; Lisa A. Rotondo, RTI International; Angela Weaver, United States Agency for International Development; Rebecca Willis, Task Force for Global Health; Anthony W. Solomon, London School of Hygiene & Tropical Medicine
• Language: English
• Date: 2017-10-18
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2017 World Health Organization.
• License: Creative Commons Attribution 3.0 IGO License
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pntd.0006023
• Title of Journal or Parent Work: PLoS Neglected Tropical Diseases
• ISSN: 1935-2727
• Volume: 11
• Issue: 10
• Start Page: e0006023
• End Page: e0006023
• Grant/Funding Information: A committee established in March 2012 to examine issues surrounding completion of global trachoma mapping was initially supported by a grant from Pfizer to the International Trachoma Initiative.; The Global Trachoma Mapping Project (GTMP) and this cost analysis were supported by a grant from the United Kingdom’s Department for International Development (URL: https://www.gov.uk/government/organisations/department-for-international-development; ARIES: 203145) to Sightsavers, which led a consortium of non-governmental organizations and academic institutions to support ministries of health to complete baseline trachoma mapping worldwide.; The GTMP was also supported by the United States Agency for International Development (URL: https://www.usaid.gov/), through the ENVISION project implemented by RTI International under cooperative agreement number AID-OAA-A-11-00048, and the END in Asia project implemented by FHI360 under cooperative agreement number OAA-A-10-00051.
• Keywords: Communicable Disease Control; Trachoma; Epidemiological Monitoring; Humans; Health Care Costs; Topography, Medical
• Research Categories: Health Sciences, General; Health Sciences, Public Health

Abstract

Background: The Global Trachoma Mapping Project (GTMP) was implemented with the aim of completing the baseline map of trachoma globally. Over 2.6 million people were examined in 1,546 districts across 29 countries between December 2012 and January 2016. The aim of the analysis was to estimate the unit cost and to identify the key cost drivers of trachoma prevalence surveys conducted as part of GTMP. Methodology and principal findings: In-country and global support costs were obtained using GTMP financial records. In-country expenditure was analysed for 1,164 districts across 17 countries. The mean survey cost was $13,113 per district [median: $11,675; IQR = $8,365-$14,618], $17,566 per evaluation unit [median: $15,839; IQR = $10,773-$19,915] , $692 per cluster [median: $625; IQR = $452-$847] and $6.0 per person screened [median: $4.9; IQR = $3.7-$7.9] . Survey unit costs varied substantially across settings, and were driven by parameters such as geographic location, demographic characteristics, seasonal effects, and local operational constraints. Analysis by activities showed that fieldwork constituted the largest share of in-country survey costs (74%), followed by training of survey teams (11%). The main drivers of in-country survey costs were personnel (49%) and transportation (44%). Global support expenditure for all surveyed districts amounted to $5.1m, which included grant management, epidemiological support, and data stewardship. Conclusion: This study provides the most extensive analysis of the cost of conducting trachoma prevalence surveys to date. The findings can aid planning and budgeting for future trachoma surveys required to measure the impact of trachoma elimination activities. Furthermore, the results of this study can also be used as a cost basis for other disease mapping programmes, where disease or context-specific survey cost data are not available.