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Cost Effectiveness of Seasonal Intermittent Preventive Treatment Using Amodiaquine & Artesunate or Sulphadoxine-Pyrimethamine in Ghanaian Children

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  • Lesong Conteh
  • Edith Patouillard
  • Margaret Kweku
  • Rosa Legood
  • Brian Greenwood
  • Daniel Chandramohan

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. Methods: 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. Results: 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

Suggested Citation

  • Lesong Conteh & Edith Patouillard & Margaret Kweku & Rosa Legood & Brian Greenwood & Daniel Chandramohan, 2010. "Cost Effectiveness of Seasonal Intermittent Preventive Treatment Using Amodiaquine & Artesunate or Sulphadoxine-Pyrimethamine in Ghanaian Children," PLOS ONE, Public Library of Science, vol. 5(8), pages 1-11, August.
    • Handle: RePEc:plo:pone00:0012223
    DOI: 10.1371/journal.pone.0012223
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    1. Milton C. Weinstein & Joanna E. Siegel & Alan M. Garber & Joseph Lipscomb & Bryan R. Luce & Willard G. Manning & George W. Torrance, 1997. "Productivity costs, time costs and health‐related quality of life: a response to the Erasmus Group," Health Economics, John Wiley & Sons, Ltd., vol. 6(5), pages 505-510, September.
    2. Asenso-Okyere, W. K. & Dzator, Janet A., 1997. "Household cost of seeking malaria care. A retrospective study of two districts in Ghana," Social Science & Medicine, Elsevier, vol. 45(5), pages 659-667, September.
    3. Robert W. Snow & Carlos A. Guerra & Abdisalan M. Noor & Hla Y. Myint & Simon I. Hay, 2005. "The global distribution of clinical episodes of Plasmodium falciparum malaria," Nature, Nature, vol. 434(7030), pages 214-217, March.
    4. Werner B.F. Brouwer & Marc A. Koopmanschap & Frans F.H. Rutten, 1997. "Productivity costs in cost‐effectiveness analysis: numerator or denominator: a further discussion," Health Economics, John Wiley & Sons, Ltd., vol. 6(5), pages 511-514, September.
    5. Morel, Chantal M. & Ngo Duc, Thang & Nguyen, Xuan Xa & Le Xuan, Hung & Le Khan, Thuan & Pham, Van Ky & Erhart, Annette & Mills, Anne J. & D'Alessandro, Umberto, 2008. "The economic burden of malaria on the household in south-central Vietnam," LSE Research Online Documents on Economics 28558, London School of Economics and Political Science, LSE Library.
    6. Koopmanschap, Marc A. & Rutten, Frans F. H. & van Ineveld, B. Martin & van Roijen, Leona, 1995. "The friction cost method for measuring indirect costs of disease," Journal of Health Economics, Elsevier, vol. 14(2), pages 171-189, June.
    7. Peter Doubilet & Colin B. Begg & Milton C. Weinstein & Peter Braun & Barbara J. McNeil, 1985. "Probabilistic Sensitivity Analysis Using Monte Carlo Simulation," Medical Decision Making, , vol. 5(2), pages 157-177, June.
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    1. Hamma Maiga & Jean Gaudart & Issaka Sagara & Modibo Diarra & Amadou Bamadio & Moussa Djimde & Samba Coumare & Boubou Sangare & Yeyia Dicko & Aly Tembely & Djibril Traore & Alassane Dicko & Estrella La, 2020. "Two-Year Scale-Up of Seasonal Malaria Chemoprevention Reduced Malaria Morbidity among Children in the Health District of Koutiala, Mali," IJERPH, MDPI, vol. 17(18), pages 1-10, September.
    2. Edith Patouillard & Lesong Conteh & Jayne Webster & Margaret Kweku & Daniel Chandramohan & Brian Greenwood, 2011. "Coverage, Adherence and Costs of Intermittent Preventive Treatment of Malaria in Children Employing Different Delivery Strategies in Jasikan, Ghana," PLOS ONE, Public Library of Science, vol. 6(11), pages 1-9, November.

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