02124nas a2200217   4500000000100000008004100001260001200042653003700054653001000091653002700101653002900128653001100157100001300168700001200181245017800193856008600371300000800457490000700465520142000472022001401892       2020                            d  c02/202010aSoil-transmitted helminths (STH)10aCosts10aSchool-based deworming10aCommunity-wide treatment10aPolicy1 aTurner H1 aBundy D00aProgrammatic implications of the TUMIKIA trial on community-wide treatment for soil-transmitted helminths: further health economic analyses needed before a change in policy.  uhttps://parasitesandvectors.biomedcentral.com/track/pdf/10.1186/s13071-020-3977-7  a1020 v133 a<p>School-based deworming programmes are currently the main approach used to control the soil-transmitted helminths (STHs). A key unanswered policy question is whether mass drug administration (MDA) should be targeted to the whole community instead, and several trials in this area have been conducted or are currently on-going. A recent well-conducted trial demonstrated that successful community-wide treatment is a feasible strategy for STH control and can be more effective than school-based treatment in reducing prevalence and intensity of hookworm infection. However, we would argue that it is vital that these findings are not taken out of context or over generalised, as the additional health benefits gained from switching to community-wide treatment will vary depending on the STH species and baseline endemicity. Moreover, community-wide treatment will typically be more expensive than school-based treatment. The epidemiological evidence for an additional benefit from a switch to community-wide treatment has yet to be proven to represent "good value for money" across different settings. Further work is needed before changes in policy are made regarding the use of community-wide treatment for STH control, including comprehensive assessments of its additional public health benefits and costs across a range of scenarios, accounting for the presence of alternative treatment delivery platforms.</p>  a1756-3305