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Micro-costing for national-scale azithromycin mass drug administration to improve child survival in Niger

Bibliographic Data

ID22263871
AuthorsBrittany Peterson (0009-0008-8815-1642, University of California, San Francisco), William Nguyen (0009-0004-3594-6186, University of California, San Francisco), Laminou Maliki Haroun, Farissatou Oumarou, Ahmed M Arzika (0000-0001-7022-282X), Ramatou Maliki, Abdou Amza, Karamba Alio, Nasser Gallo, Bawa Aichatou, Ismael Issa Sara (0009-0005-7711-6938), Diallo Beidi, James G Kahn (0000-0002-1259-7233, Lee University), Stefano Bertozzi (0000-0002-1723-7085, University of Washington), Élodie Lebas (0000-0003-1617-143X, University of California, San Francisco), Benjamin F Arnold (0000-0001-6105-7295, University of California, San Francisco), Thomas M Lietman (0000-0001-8216-0240, University of California, San Francisco), Kieran S O’Brien (0000-0002-1962-5321, University of California, San Francisco), Meagan C Fitzpatrick (0000-0002-5248-2668, University of Maryland, Baltimore, corresponding author)
EditorsAbraham D Flaxman (0000-0001-6033-4713)
Year2026
Volume6
Issue6
Pagese0006039
Publication date2026-06-26
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0006039
PMID42361103
OpenAlexW7166090510
LanguageEN
References cited20

As programs for azithromycin mass drug administration (AZ-MDA) to reduce child mortality have begun in some parts of West Africa, it is imperative to understand their financial costs. We combined a micro-costing framework and observations from an implementation-focused sub-study within the AVENIR trials in 80 communities in the Dosso region of Niger to estimate the national health sector financial costs of a scaled-up programmatic approach for azithromycin biannual distribution to children aged 1–59 months of age living in nonurban areas, using the door-to-door modality. Our outcomes of interest were the annual budget at the regional and national levels for Niger and the cost per dose delivered. We found that the annual national budget required for AZ-MDA achieving 90% average coverage would be $12.5 million (M) (95% Uncertainty Interval (UI) $12.2M, $13.0M) translating to $1.59 (95% UI $1.40, $2.30) per dose delivered. Across regions, cost per dose would vary from $1.17 (95% UI $1.03, $1.69) to $3.61 (95% UI $3.20, $5.16), with higher cost per dose expected for more sparsely populated regions. Training costs represented a large fraction (16.4%) of total costs, and integration of training with that for existing health interventions may provide opportunities for efficiency

Azithromycin · Baseline (sea) · Confidence interval · Cost–benefit analysis · Drug administration · Food and drug administration · Mass drug administration · Psychological intervention · Total cost · Global Maternal and Child Health · Health Systems, Economic Evaluations, Quality of Life · Pneumonia and Respiratory Infections

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    Open Access•Ahmed M Arzika, Ramatou Maliki et al.•PLOS Global Public Health•2023

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    Open Access•Kieran S O’Brien, Ahmed M Arzika et al.•BMC Public Health•2021

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Citation velocityhistorical
Highly citedNo
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