determinants of the cost-effectiveness of intermittent preventive treatment for malaria in infants and children成本效益的决定因素在婴儿和儿童间歇性预防治疗疟疾.pdfVIP

Determinants of the Cost-Effectiveness of Intermittent Preventive Treatment for Malaria in Infants and Children Amanda Ross1,2*, Nicolas Maire1,2, Elisa Sicuri3,4, Thomas Smith1,2, Lesong Conteh5 1 Swiss Tropical and Public Health Institute, Basel, Switzerland, 2 University of Basel, Basel, Switzerland, 3 Barcelona Centre for International Health Research (CRESIB), ´ ´ ´ Hospital Clınic-Universitat de Barcelona, Barcelona, Spain, 4 CIBER Epidemiologıa y Salud Publica (CIBERESP), Barcelona, Spain, 5 Institute of Global Health Innovation, Imperial College London, London, United Kingdom Abstract Background: Trials of intermittent preventive treatment in infants (IPTi) and children (IPTc) have shown promising results in reducing malaria episodes but with varying efficacy and cost-effectiveness. The effects of different intervention and setting characteristics are not well known. We simulate the effects of the different target age groups and delivery channels, seasonal or year-round delivery, transmission intensity, seasonality, proportions of malaria fevers treated and drug characteristics. Methods: We use a dynamic, individual-based simulation model of Plasmodium falciparum malaria epidemiology, antimalarial drug action and case management to simulate DALYs averted and the cost per DALY averted by IPTi and IPTc. IPT cost components were estimated from economic studies alongside trials. Results: IPTi and IPTc were predicted to be cost-effective in most of the scenarios modelled. The cost-effectiveness is driven by the impact on DALYs, particularly for IPTc, and the low costs, particularly for IPTi which uses the existing delivery strategy, EPI. Cost-effectiveness was predicted to decrease with low tra