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DC Field | Value | Language |
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dc.contributor.author | Sicuri, Elisa | - |
dc.contributor.author | Fernandes, Silke | - |
dc.contributor.author | Macete, Eusebio Víctor | - |
dc.contributor.author | González, Raquel | - |
dc.contributor.author | Mombo-Ngoma, Ghyslain | - |
dc.contributor.author | Massougbodji, Achille | - |
dc.contributor.author | Abdulla, Salim | - |
dc.contributor.author | Kuwawenaruwa, August | - |
dc.contributor.author | Katana, Abraham | - |
dc.contributor.author | Desai, Meghna | - |
dc.contributor.author | Cot, Michel | - |
dc.contributor.author | Ramharter, Michael | - |
dc.contributor.author | Kremsner, Peter G. | - |
dc.contributor.author | Slutsker, Laurence | - |
dc.contributor.author | Aponte, John J. | - |
dc.contributor.author | Hanson, Kara | - |
dc.contributor.author | Menéndez, Clara | - |
dc.date.accessioned | 2016-02-03T13:41:59Z | - |
dc.date.available | 2016-02-03T13:41:59Z | - |
dc.date.issued | 2015-04-27 | - |
dc.identifier.issn | 1932-6203 | - |
dc.identifier.uri | http://hdl.handle.net/2445/69197 | - |
dc.description.abstract | Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended in HIV-negative women to avert malaria, while this relies on cotrimoxazole prophylaxis (CTXp) in HIV-positive women. Alternative antimalarials are required in areas where parasite resistance to antifolate drugs is high. The cost-effectiveness of IPTp with alternative drugs is needed to inform policy. METHODS: The cost-effectiveness of 2-dose IPTp-mefloquine (MQ) was compared with IPTp-SP in HIV-negative women (Benin, Gabon, Mozambique and Tanzania). In HIV-positive women the cost-effectiveness of 3-dose IPTp-MQ added to CTXp was compared with CTXp alone (Kenya, Mozambique and Tanzania). The outcomes used were maternal clinical malaria, anaemia at delivery and non-obstetric hospital admissions. The poor tolerability to MQ was included as the value of women's loss of working days. Incremental cost-effectiveness ratios (ICERs) were calculated and threshold analysis undertaken. RESULTS: For HIV-negative women, the ICER for IPTp-MQ versus IPTp-SP was 136.30 US$ (2012 US$) (95%CI 131.41; 141.18) per disability-adjusted life-year (DALY) averted, or 237.78 US$ (95%CI 230.99; 244.57), depending on whether estimates from Gabon were included or not. For HIV-positive women, the ICER per DALY averted for IPTp-MQ added to CTXp, versus CTXp alone was 6.96 US$ (95%CI 4.22; 9.70). In HIV-negative women, moderate shifts of variables such as malaria incidence, drug cost, and IPTp efficacy increased the ICERs above the cost-effectiveness threshold. In HIV-positive women the intervention remained cost-effective for a substantial (up to 21 times) increase in cost per tablet. CONCLUSIONS: Addition of IPTp with an effective antimalarial to CTXp was very cost-effective in HIV-positive women. IPTp with an efficacious antimalarial was more cost-effective than IPTp-SP in HIV-negative women. However, the poor tolerability of MQ does not favour its use as IPTp. Regardless of HIV status, prevention of malaria in pregnancy with a highly efficacious, well tolerated antimalarial would be cost-effective despite its high price. TRIALS REGISTRATION: ClinicalTrials.gov NCT 00811421; Pan African Trials Registry PACTR2010020001429343 and PACTR2010020001813440. | - |
dc.format.extent | 23 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Public Library of Science (PLoS) | - |
dc.relation.isformatof | Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0125072 | - |
dc.relation.ispartof | PLoS One, 2015, vol. 10, num. 4, p. e0125072 | - |
dc.relation.uri | http://dx.doi.org/10.1371/journal.pone.0125072 | - |
dc.rights | CC0 (c) Sicuri et al., 2015 | - |
dc.rights.uri | http://creativecommons.org/publicdomain/zero/1.0/ | - |
dc.source | Articles publicats en revistes (ISGlobal) | - |
dc.subject.classification | Malària | - |
dc.subject.classification | Persones seropositives | - |
dc.subject.classification | Embaràs | - |
dc.subject.classification | Assaigs clínics | - |
dc.subject.other | Malaria | - |
dc.subject.other | HIV-positive persons | - |
dc.subject.other | Pregnancy | - |
dc.subject.other | Clinical trials | - |
dc.title | Economic Evaluation of an Alternative Drug to Sulfadoxine-Pyrimethamine as Intermittent Preventive Treatment of Malaria in Pregnancy | eng |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.date.updated | 2016-02-02T15:33:49Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 25915616 | - |
Appears in Collections: | Articles publicats en revistes (ISGlobal) |
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sicuri2015_1870.pdf | 2.51 MB | Adobe PDF | View/Open |
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