High risk trachoma patients less likely to pay for treatment

February 26, 2003

Tanzanians who are at the greatest risk of contracting trachoma, a chronic infection that causes blindness, are the least willing to pay for azithromycin treatment, according to researchers from the Johns Hopkins Bloomberg School of Public Health. The researchers conclude that governments should continue to make antibiotics available free of charge in trachoma control programs. "Household willingness to pay for azithromycin treatment for trachoma control" will appear in the February 2003, issue of Bulletin, the magazine of the World Health Organization (WHO).

Kevin D. Frick, PhD, lead author of the study and associate professor of health policy and management in the School of Public Health, said, "Many individuals with symptoms suggested they would forgo treatment rather than pay for future antibiotic treatment. Therefore, if a government ever wanted to charge for the antibiotic in order to recover some of its costs, that plan might limit access for those who need the drug most and make it more difficult to eliminate the infection and the later complications, which include blindness."

In the Kongwa district of central Tanzania, close to 60 percent of preschool children have trachoma and eight percent of adults over the age of 55 have trichiasis, a complication of repeated trachoma infections in which the eyelashes turn in upon themselves and cause abrasions on the cornea. Previous estimates have suggested that at any one time, 5 to 7 million people are blinded as a result of trachoma infections and 300 to 500 million more have the disease.

Researchers looked at 394 households in six villages of central Tanzania to associate the willingness to pay for azithromycin treatments with measures of socioeconomic status, risk factors for active trachoma, and perceived benefit of initial treatment. After receiving an initial treatment, 38 percent of those studied indicated that they would not be willing to pay for future treatments, although they would be willing to receive the treatments.

Researchers found that patients were more willing to pay for treatments when they could use household items, such as the tin in their roofs, as payment. In addition, households that perceived a benefit from the initial treatment were also willing to pay a higher amount for future antibiotics. Since owning cattle was both an indicator of wealth and a risk factor for trachoma, the researchers expected to find that people with cattle would be more likely to pay a higher amount for treatment. Instead they found they were willing to pay less. In addition, members of a household headed by a female not in a polygamous marriage, which indicates a lower socioeconomic status, was associated with a lower willingness to pay for treatment.

The WHO recommends a four-pronged approach for controlling trachoma, called SAFE that includes surgery, antibiotic treatments, face washing and health education, and environmental changes. Traditionally, tetracycline was used to treat the disease, but it is more burdensome to administer than other trachoma-treatment antibiotics. Azithromycin treatments are in the form of a pill or liquid dosage and can be taken as little as once per year.

Frick explained, "Successful control efforts require resources much greater than the cost of antibiotics. The delivery of antibiotics and the provision of the other aspects of the SAFE plan are expensive and it takes years for trachoma control efforts to succeed. Learning who is willing to use personal resources as payment for follow-up treatment will help target the promotion of mass treatment programs for communities with endemic trachoma and thus maximize the response to the programs used to combat the infection."
-end-
Additional authors were Sheila West and Beatriz Munoz, with the Johns Hopkins School of Medicine, and Harran A. Mkocha, with the Kongwa Trachoma Project in the United Republic of Tanzania. Matthew Lynch also co-authored the report.

Research was supported by grants from the Edna McConnell Clark Foundation and the International Trachoma Initiative. Pfizer, Inc. provided the Zithromax® that was used in the mass treatment program in the villages.

Link to the Johns Hopkins Bloomberg School of Public Health at www.jhsph.edu.

Johns Hopkins University Bloomberg School of Public Health

Related Antibiotics Articles from Brightsurf:

Insights in the search for new antibiotics
A collaborative research team from the University of Oklahoma, the Memorial Sloan Kettering Cancer Center and Merck & Co. published an opinion article in the journal, Nature Chemical Biology, that addresses the gap in the discovery of new antibiotics.

New tricks for old antibiotics
The study published in the journal Immunity reveals that tetracyclines (broad spectre antibiotics), by partially inhibiting cell mitochondria activity, induce a compensatory response on the organism that decreases tissue damage caused during infection.

Benefits, risks seen with antibiotics-first for appendicitis
Antibiotics are a good choice for some patients with appendicitis but not all, according to study results published today in the New England Journal of Medicine.

How antibiotics interact
Understanding bottleneck effects in the translation of bacterial proteins can lead to a more effective combination of antibiotics / study in 'Nature Communications'

Are antivitamins the new antibiotics?
Antibiotics are among the most important discoveries of modern medicine and have saved millions of lives since the discovery of penicillin almost 100 years ago.

Hygiene reduces the need for antibiotics by up to 30%
A new paper published in the American Journal of Infection Control (AJIC), finds improved everyday hygiene practices, such as hand-washing, reduces the risk of common infections by up to 50%, reducing the need for antibiotics, by up to 30%.

Antibiotics: City dwellers and children take the most
City dwellers take more antibiotics than people in rural areas; children and the elderly use them more often than middle-aged people; the use of antibiotics decreases as education increases, but only in rich countries: These are three of the more striking trends identified by researchers of the NRW Forschungskolleg ''One Health and Urban Transformation'' at the University of Bonn.

Metals could be the link to new antibiotics
Compounds containing metals could hold the key to the next generation of antibiotics to combat the growing threat of global antibiotic resistance.

Antibiotics from the sea
The team led by Prof. Christian Jogler of Friedrich Schiller University, Jena, has succeeded in cultivating several dozen marine bacteria in the laboratory -- bacteria that had previously been paid little attention.

Antibiotics not necessary for most toothaches, according to new ADA guideline
The American Dental Association (ADA) announced today a new guideline indicating that in most cases, antibiotics are not recommended for toothaches.

Read More: Antibiotics News and Antibiotics Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.