Reducing Malaria Mortality at the Lowest Budget: An Optimization Tool for Selecting Malaria Preventative Interventions Applied to Ghana

MDM Policy & Practice
Christophe SauboinBaudouin Standaert

Abstract

Background. Preventative malaria interventions include long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), and seasonal malaria chemoprevention (SMC). The RTS,S vaccine candidate is now also approved for pilot introduction. This analysis estimates the optimal approach when combining current interventions with the vaccine to reduce under-five malaria mortality in Ghana at the lowest cost. Methods. A vector model was combined with a static human cohort model, using country-specific unit costs. Current coverage of each intervention was used as baseline. The base-case vaccine price was US$5/dose, with US$2 or US$10 tested in sensitivity analysis. Model simulations used a goal for extra mortality reduction in children aged <5 years, and identified the optimal combination of interventions to reach that goal at the lowest cost. The time horizon was 5 years. Results. The optimal sequence of investments would be the following: (1) introduce RTS,S; (2) introduce SMC; (3) increase LLINs and IRS concurrently. RTS,S introduction was associated with mortality reduction of 16% for a budget increase of US$15.6 million. Adding SMC with a partial coverage of 4% further reduced mortality by 1% at an additional budget of US$1.4...Continue Reading

References

Aug 5, 2010·The American Journal of Tropical Medicine and Hygiene·Nakul ChitnisRichard Steketee
Jul 18, 2016·Malaria Journal·Justice NonvignonMoses Aikins
Mar 16, 2017·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·William CrownKalyan S Pasupathy
Oct 11, 2017·The American Journal of Tropical Medicine and Hygiene·Erin EckertCorine Karema
Oct 14, 2018·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Josephine MauskopfJohan L Severens

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Citations

Mar 5, 2020·Journal of Market Access & Health Policy·Baudouin StandaertSharon Zhang

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