Cost Effectiveness of Seasonal Intermittent Preventive Treatment Using Amodiaquine & Artesunate or Sulphadoxine-Pyrimethamine in Ghanaian Children
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{"title"=>"Cost effectiveness of seasonal intermittent preventive treatment using amodiaquine & artesunate or sulphadoxine-pyrimethamine in Ghanaian children", "type"=>"journal", "authors"=>[{"first_name"=>"Lesong", "last_name"=>"Conteh", "scopus_author_id"=>"6506168921"}, {"first_name"=>"Edith", "last_name"=>"Patouillard", "scopus_author_id"=>"14621712500"}, {"first_name"=>"Margaret", "last_name"=>"Kweku", "scopus_author_id"=>"16550392200"}, {"first_name"=>"Rosa", "last_name"=>"Legood", "scopus_author_id"=>"6506429707"}, {"first_name"=>"Brian", "last_name"=>"Greenwood", "scopus_author_id"=>"36040863900"}, {"first_name"=>"Daniel", "last_name"=>"Chandramohan", "scopus_author_id"=>"7003426215"}], "year"=>2010, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"77957881268", "doi"=>"10.1371/journal.pone.0012223", "pui"=>"359754152", "pmid"=>"20808923", "scopus"=>"2-s2.0-77957881268", "issn"=>"19326203", "isbn"=>"1932-6203 (Electronic)\\n1932-6203 (Linking)"}, "id"=>"d41e05de-4484-39cf-8709-e05b90d37d84", "abstract"=>"BACKGROUND: Intermittent preventive treatment for malaria in children (IPTc) involves the administration of a full course of an anti-malarial treatment to children under 5 years old at specified time points regardless of whether or not they are known to be infected, in areas where malaria transmission is seasonal. It is important to determine the costs associated with IPTc delivery via community based volunteers and also the potential savings to health care providers and caretakers due to malaria episodes averted as a consequence of IPTc.\\n\\nMETHODS: Two thousand four hundred and fifty-one children aged 3-59 months were randomly allocated to four groups to receive: three days of artesunate plus amodiaquine (AS+AQ) monthly, three days of AS+AQ bimonthly, one dose of sulphadoxine-pyrimethamine (SP) bi-monthly or placebo. This paper focuses on incremental cost effectiveness ratios (ICERs) of the three IPTc drug regimens as delivered by community based volunteers (CBV) in Hohoe, Ghana compared to current practice, i.e. case management in the absence of IPTc. Financial and economic costs from the publicly funded health system perspective are presented. Treatment costs borne by patients and their caretakers are also estimated to present societal costs. The costs and effects of IPTc during the intervention period were considered with and without a one year follow up. Probabilistic sensitivity analysis was undertaken to account for uncertainty.\\n\\nRESULTS: Economic costs per child receiving at least the first dose of each course of IPTc show SP bimonthly, at US$8.19, is the cheapest to deliver, followed by AS+AQ bimonthly at US$10.67 and then by AS+AQ monthly at US$14.79. Training, drug delivery and supervision accounted for approximately 20-30% each of total unit costs. During the intervention period AS & AQ monthly was the most cost effective IPTc drug regimen at US$67.77 (61.71-74.75, CI 95%) per malaria case averted based on intervention costs only, US$64.93 (58.92-71.92, CI 95%) per malaria case averted once the provider cost savings are included and US$61.00 (54.98, 67.99, CI 95%) when direct household cost savings are also taken into account. SP bimonthly was US$105.35 (75.01-157.31, CI 95%) and AS & AQ bimonthly US$211.80 (127.05-399.14, CI 95%) per malaria case averted based on intervention costs only. The incidence of malaria in the post intervention period was higher in children who were <1 year old when they received AS+AQ monthly compared to the placebo group leading to higher cost effectiveness ratios when one year follow up is included. The cost per child enrolled fell considerably when modelled to district level as compared to those encountered under trial conditions.\\n\\nCONCLUSIONS: We demonstrate how cost-effective IPTc is using three different drug regimens and the possibilities for reducing costs further if the intervention was to be scaled up to the district level. The need for effective training, drug delivery channels and supervision to support a strong network of community based volunteers is emphasised.", "link"=>"http://www.mendeley.com/research/cost-effectiveness-seasonal-intermittent-preventive-treatment-using-amodiaquine-artesunate-sulphadox", "reader_count"=>64, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>4, "Librarian"=>2, "Researcher"=>14, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>11, "Student > Postgraduate"=>4, "Student > Master"=>11, "Other"=>4, "Student > Bachelor"=>3, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>4, "Librarian"=>2, "Researcher"=>14, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>11, "Student > Postgraduate"=>4, "Student > Master"=>11, "Other"=>4, "Student > Bachelor"=>3, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_subject_area"=>{"Unspecified"=>6, "Agricultural and Biological Sciences"=>6, "Arts and Humanities"=>1, "Philosophy"=>1, "Business, Management and Accounting"=>2, "Chemistry"=>1, "Economics, Econometrics and Finance"=>6, "Environmental Science"=>2, "Nursing and Health Professions"=>2, "Biochemistry, Genetics and Molecular Biology"=>1, "Mathematics"=>1, "Medicine and Dentistry"=>25, "Pharmacology, Toxicology and Pharmaceutical Science"=>2, "Psychology"=>2, "Social Sciences"=>6}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>25}, "Social Sciences"=>{"Social Sciences"=>6}, "Psychology"=>{"Psychology"=>2}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>6}, "Environmental Science"=>{"Environmental Science"=>2}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>2}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Chemistry"=>{"Chemistry"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>6}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>6}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"Pakistan"=>1, "Brazil"=>1, "United Kingdom"=>2, "Kenya"=>1}, "group_count"=>9}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/835335"], "description"=>"<p>*Lost productivity.</p><p>**Care has been taken to avoid double counting certain provider and household costs.</p>", "links"=>[], "tags"=>["costs", "inpatient", "outpatient", "malaria", "anaemia"], "article_id"=>505703, "categories"=>["Medicine", "Information And Computing Sciences"], "users"=>["Lesong Conteh", "Edith Patouillard", "Margaret Kweku", "Rosa Legood", "Brian Greenwood", "Daniel Chandramohan"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0012223.t003", "stats"=>{"downloads"=>1, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Unit_Costs_of_Inpatient_and_Outpatient_Treatment_of_Malaria_with_and_without_Anaemia_US_2008_/505703", "title"=>"Unit Costs of Inpatient and Outpatient Treatment of Malaria with and without Anaemia (US$ 2008).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 23:56:24"}
  • {"files"=>["https://ndownloader.figshare.com/files/835301"], "description"=>"<p>*A dose reflects the act of the child taking each daily IPTc tablet (one day for SP and three days for AQ& AS), a course reflects the monthly taking of all doses of IPTc.</p><p>**The slight differences in training costs reflect the different number of children assigned to each trial arm.</p>", "links"=>[], "tags"=>["costs", "receiving", "iptc"], "article_id"=>505671, "categories"=>["Medicine", "Information And Computing Sciences"], "users"=>["Lesong Conteh", "Edith Patouillard", "Margaret Kweku", "Rosa Legood", "Brian Greenwood", "Daniel Chandramohan"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0012223.t002", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Unit_Costs_of_receiving_IPTc_cost_per_child_receiving_at_least_the_first_dose_of_each_course_US_2008_/505671", "title"=>"Unit Costs of receiving IPTc (cost per child receiving at least the first dose of each course<sup>*</sup>) (US$2008).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 23:56:13"}
  • {"files"=>["https://ndownloader.figshare.com/files/835462"], "description"=>"<p>Unit Costs of Delivering IPTc after scaling up district wide (under five population 33,000) (US$ 2008).</p>", "links"=>[], "tags"=>["costs", "delivering", "iptc", "scaling"], "article_id"=>505835, "categories"=>["Medicine", "Information And Computing Sciences"], "users"=>["Lesong Conteh", "Edith Patouillard", "Margaret Kweku", "Rosa Legood", "Brian Greenwood", "Daniel Chandramohan"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0012223.t007", "stats"=>{"downloads"=>1, "page_views"=>46, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Unit_Costs_of_Delivering_IPTc_after_scaling_up_district_wide_under_five_population_33_000_US_2008_/505835", "title"=>"Unit Costs of Delivering IPTc after scaling up district wide (under five population 33,000) (US$ 2008).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 23:57:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/835096"], "description"=>"<p>Cost-Effectiveness Acceptability Curve: Probability that IPTc is cost-effective given willingness to pay to avert a case of malaria.</p>", "links"=>[], "tags"=>["acceptability", "probability", "iptc", "cost-effective", "avert"], "article_id"=>505457, "categories"=>["Medicine", "Information And Computing Sciences"], "users"=>["Lesong Conteh", "Edith Patouillard", "Margaret Kweku", "Rosa Legood", "Brian Greenwood", "Daniel Chandramohan"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0012223.g001", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cost_Effectiveness_Acceptability_Curve_Probability_that_IPTc_is_cost_effective_given_willingness_to_pay_to_avert_a_case_of_malaria_/505457", "title"=>"Cost-Effectiveness Acceptability Curve: Probability that IPTc is cost-effective given willingness to pay to avert a case of malaria.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-20 23:55:05"}
  • {"files"=>["https://ndownloader.figshare.com/files/835408"], "description"=>"<p>Numbers in parenthesis are cost savings.</p><p>*This is based on the savings of averting treatment compared to the placebo (See <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0012223#pone-0012223-t003\" target=\"_blank\">Table 3</a>).</p><p>**Net costs are calculated by subtracting resource savings from intervention costs.</p><p>***Net costs effectiveness is calculated by dividing costs by the protective efficacy against clinical malaria.</p>", "links"=>[], "tags"=>["pediatrics and child health", "public health and epidemiology/health policy", "public health and epidemiology/health services research and economics", "public health and epidemiology/preventive medicine"], "article_id"=>505776, "categories"=>["Medicine", "Information And Computing Sciences"], "users"=>["Lesong Conteh", "Edith Patouillard", "Margaret Kweku", "Rosa Legood", "Brian Greenwood", "Daniel Chandramohan"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0012223.t005", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cost_Effectiveness_of_IPTc_/505776", "title"=>"Cost Effectiveness of IPTc.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 23:56:46"}
  • {"files"=>["https://ndownloader.figshare.com/files/835372"], "description"=>"<p>Effectiveness of different IPTc regimens.</p>", "links"=>[], "tags"=>["iptc"], "article_id"=>505739, "categories"=>["Medicine", "Information And Computing Sciences"], "users"=>["Lesong Conteh", "Edith Patouillard", "Margaret Kweku", "Rosa Legood", "Brian Greenwood", "Daniel Chandramohan"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0012223.t004", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Effectiveness_of_different_IPTc_regimens_/505739", "title"=>"Effectiveness of different IPTc regimens.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 23:56:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/835432"], "description"=>"<p>Resource use when scaling up from Pilot Study to District Wide delivery.</p>", "links"=>[], "tags"=>["scaling"], "article_id"=>505797, "categories"=>["Medicine", "Information And Computing Sciences"], "users"=>["Lesong Conteh", "Edith Patouillard", "Margaret Kweku", "Rosa Legood", "Brian Greenwood", "Daniel Chandramohan"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0012223.t006", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Resource_use_when_scaling_up_from_Pilot_Study_to_District_Wide_delivery_/505797", "title"=>"Resource use when scaling up from Pilot Study to District Wide delivery.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 23:56:58"}
  • {"files"=>["https://ndownloader.figshare.com/files/835179"], "description"=>"<p>Cost-Effectiveness Plane: Incremental costs and cases of malaria averted per 1000 children receiving IPTc compared to no IPTc.</p>", "links"=>[], "tags"=>["incremental", "costs", "cases", "malaria", "averted", "1000", "children", "receiving", "iptc", "compared"], "article_id"=>505540, "categories"=>["Medicine", "Information And Computing Sciences"], "users"=>["Lesong Conteh", "Edith Patouillard", "Margaret Kweku", "Rosa Legood", "Brian Greenwood", "Daniel Chandramohan"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0012223.g002", "stats"=>{"downloads"=>4, "page_views"=>23, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cost_Effectiveness_Plane_Incremental_costs_and_cases_of_malaria_averted_per_1000_children_receiving_IPTc_compared_to_no_IPTc_/505540", "title"=>"Cost-Effectiveness Plane: Incremental costs and cases of malaria averted per 1000 children receiving IPTc compared to no IPTc.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-20 23:55:29"}
  • {"files"=>["https://ndownloader.figshare.com/files/835262"], "description"=>"a<p>There was an imbalance in the number of children allocated to one study group. All possible reasons as to why this might have occurred were explored and chance was the most likely explanation <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0012223#pone.0012223-Kweku1\" target=\"_blank\">[14]</a>.</p>b<p>Drug delivery refers to the supply channel from the central medical stores to the community based volunteer.</p>", "links"=>[], "tags"=>["costs", "delivering", "iptc"], "article_id"=>505633, "categories"=>["Medicine", "Information And Computing Sciences"], "users"=>["Lesong Conteh", "Edith Patouillard", "Margaret Kweku", "Rosa Legood", "Brian Greenwood", "Daniel Chandramohan"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0012223.t001", "stats"=>{"downloads"=>1, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Total_Costs_of_Delivering_different_IPTc_regimens_US_2008_a_/505633", "title"=>"Total Costs of Delivering different IPTc regimens(US$ 2008).<sup>a</sup>", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 23:56:02"}

PMC Usage Stats | Further Information

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Relative Metric

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