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Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa

OBJECTIVES: To evaluate the relative cost-effectiveness of introducing the RTS,S malaria vaccine in sub-Saharan Africa compared with further scale-up of existing interventions. DESIGN: A mathematical modelling and cost-effectiveness study. SETTING: Sub-Saharan Africa. PARTICIPANTS: People of all age...

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Autores principales: Winskill, Peter, Walker, Patrick GT, Griffin, Jamie T, Ghani, Azra C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321383/
https://www.ncbi.nlm.nih.gov/pubmed/28588994
http://dx.doi.org/10.1136/bmjgh-2016-000090
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author Winskill, Peter
Walker, Patrick GT
Griffin, Jamie T
Ghani, Azra C
author_facet Winskill, Peter
Walker, Patrick GT
Griffin, Jamie T
Ghani, Azra C
author_sort Winskill, Peter
collection PubMed
description OBJECTIVES: To evaluate the relative cost-effectiveness of introducing the RTS,S malaria vaccine in sub-Saharan Africa compared with further scale-up of existing interventions. DESIGN: A mathematical modelling and cost-effectiveness study. SETTING: Sub-Saharan Africa. PARTICIPANTS: People of all ages. INTERVENTIONS: The analysis considers the introduction and scale-up of the RTS,S malaria vaccine and the scale-up of long-lasting insecticide-treated bed nets (LLINs), indoor residual spraying (IRS) and seasonal malaria chemoprevention (SMC). MAIN OUTCOME MEASURE: The number of Plasmodium falciparum cases averted in all age groups over a 10-year period. RESULTS: Assuming access to treatment remains constant, increasing coverage of LLINs was consistently the most cost-effective intervention across a range of transmission settings and was found to occur early in the cost-effectiveness scale-up pathway. IRS, RTS,S and SMC entered the cost-effective pathway once LLIN coverage had been maximised. If non-linear production functions are included to capture the cost of reaching very high coverage, the resulting pathways become more complex and result in selection of multiple interventions. CONCLUSIONS: RTS,S was consistently implemented later in the cost-effectiveness pathway than the LLINs, IRS and SMC but was still of value as a fourth intervention in many settings to reduce burden to the levels set out in the international goals.
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spelling pubmed-53213832017-06-06 Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa Winskill, Peter Walker, Patrick GT Griffin, Jamie T Ghani, Azra C BMJ Glob Health Research OBJECTIVES: To evaluate the relative cost-effectiveness of introducing the RTS,S malaria vaccine in sub-Saharan Africa compared with further scale-up of existing interventions. DESIGN: A mathematical modelling and cost-effectiveness study. SETTING: Sub-Saharan Africa. PARTICIPANTS: People of all ages. INTERVENTIONS: The analysis considers the introduction and scale-up of the RTS,S malaria vaccine and the scale-up of long-lasting insecticide-treated bed nets (LLINs), indoor residual spraying (IRS) and seasonal malaria chemoprevention (SMC). MAIN OUTCOME MEASURE: The number of Plasmodium falciparum cases averted in all age groups over a 10-year period. RESULTS: Assuming access to treatment remains constant, increasing coverage of LLINs was consistently the most cost-effective intervention across a range of transmission settings and was found to occur early in the cost-effectiveness scale-up pathway. IRS, RTS,S and SMC entered the cost-effective pathway once LLIN coverage had been maximised. If non-linear production functions are included to capture the cost of reaching very high coverage, the resulting pathways become more complex and result in selection of multiple interventions. CONCLUSIONS: RTS,S was consistently implemented later in the cost-effectiveness pathway than the LLINs, IRS and SMC but was still of value as a fourth intervention in many settings to reduce burden to the levels set out in the international goals. BMJ Publishing Group 2017-01-24 /pmc/articles/PMC5321383/ /pubmed/28588994 http://dx.doi.org/10.1136/bmjgh-2016-000090 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle Research
Winskill, Peter
Walker, Patrick GT
Griffin, Jamie T
Ghani, Azra C
Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa
title Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa
title_full Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa
title_fullStr Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa
title_full_unstemmed Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa
title_short Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa
title_sort modelling the cost-effectiveness of introducing the rts,s malaria vaccine relative to scaling up other malaria interventions in sub-saharan africa
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321383/
https://www.ncbi.nlm.nih.gov/pubmed/28588994
http://dx.doi.org/10.1136/bmjgh-2016-000090
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