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Mother-to-child transmission of HIV: a simulation-based approach for the evaluation of intervention strategies

Author

Listed:
  • I T Vieira

    (University of Southampton)

  • P R Harper

    (University of Southampton)

  • A K Shahani

    (University of Southampton)

  • V De Senna

    (Fundação Visconde de Cairu, Faculdade de Ciências Contábeis)

Abstract

Mother-to-child transmission (MTCT) of HIV is the most significant source of HIV infection in children below the age of 15 years. In 2000 alone, about 600 000 new infections occurred, the vast majority from mothers living in developing countries who were not aware of their HIV-positive status. To date, at least 4.3 million children have died from AIDS. In this paper, we discuss the development of an operational model that can be used to evaluate intervention options for the prevention of MTCT of HIV. The problem was approached by defining suitable pregnancy risk groups, prevention options and the required model outputs to evaluate different intervention strategies. The method chosen to approach the problem was a discrete-event, three-phase simulation, built in Visual Basic, with a stochastic semi-Markov structure. The developed model takes individual pregnant women through each stage of their pregnancy, labour and birth. Different intervention strategies may be modelled at any time, including short-course antiretroviral drugs and cessation of breastfeeding. The model is demonstrated with data from Botswana, which has one of the highest HIV-infection rates in the world.

Suggested Citation

  • I T Vieira & P R Harper & A K Shahani & V De Senna, 2003. "Mother-to-child transmission of HIV: a simulation-based approach for the evaluation of intervention strategies," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 54(7), pages 713-722, July.
    • Handle: RePEc:pal:jorsoc:v:54:y:2003:i:7:d:10.1057_palgrave.jors.2601566
    DOI: 10.1057/palgrave.jors.2601566
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    Citations

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    Cited by:

    1. M S Rauner & S C Brailsford & S Flessa, 2005. "Use of discrete-event simulation to evaluate strategies for the prevention of mother-to-child transmission of HIV in developing countries," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(2), pages 222-233, February.
    2. White, Leroy & Smith, Honora & Currie, Christine, 2011. "OR in developing countries: A review," European Journal of Operational Research, Elsevier, vol. 208(1), pages 1-11, January.
    3. Filipa Aragão & José Vera & Inês Vaz Pinto, 2012. "Cost-Effectiveness of the Third-Agent Class in Treatment-Naive Human Immunodeficiency Virus-Infected Patients in Portugal," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-11, September.

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