| Autor: |
Charfudin Sacoor, Martin Meremikwu, Laia Cirera, Clara Pons-Duran, Máximo Ramírez, Elaine Roman, Franco Pagnoni, Clara Menendez, Raquel González, Christina Maly, Elisa Sicuri, Dachi Arikpo, Manu F Manun’Ebo, Antía Figueroa-Romero, Louise Ranaivo, Francesco Ramponi |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
BMJ Global Health, Vol 8, Iss 7 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2059-7908 |
| DOI: |
10.1136/bmjgh-2022-010238 |
| Popis: |
Introduction Malaria in pregnancy is a major driver of maternal and infant mortality in sub-Saharan Africa. The WHO recommends the administration of intermittent preventive treatment with sulfadoxine pyrimethamine (IPTp-SP) at antenatal care (ANC) visits. Despite being a highly cost-effective strategy, IPTp-SP coverage and uptake remains low. A pilot project was conducted to assess the cost-effectiveness (CE) of community-based delivery of IPTp (C-IPTp) in addition to ANC delivery to increase IPTp uptake in the Democratic Republic of Congo (DRC), Madagascar (MDG), Mozambique (MOZ) and Nigeria (NGA).Methods Costs and CE estimates of C-IPTp were calculated according to two scenarios: (1) costs in ‘programmatic mode’ (ie, costs if C-IPTp was to be implemented by national health systems) and (2) costs from the pilot project. The effectiveness of C-IPTp was obtained through estimates of the averted disability-adjusted life-years (DALYs) associated with maternal clinical malaria and anaemia, low birth weight and neonatal mortality.Results Net incremental costs of C-IPTp ranged between US$6138–US$47 177 (DRC), US$5552–US$31 552 (MDG), US$10 202–US$53 221 (MOZ) and US$667–US$28 645 (NGA) per 1000 pregnant women, under scenarios (1) and (2), respectively. Incremental cost-effectiveness ratios (ICERs) ranged between US$15–US$119 in DRC, US$9–US$53 in MDG, US$104–US$543 in MOZ and US$2–US$66 in NGA per DALY averted, under scenarios (1) and (2), respectively. ICERs fall below the WHO recommended CE threshold based on the gross domestic product per capita.Conclusion Findings suggest that C-IPTp is a highly cost-effective intervention. Results can inform policy decisions on adopting and optimising effective interventions for preventing malaria in pregnancy. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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