IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0215972.html
   My bibliography  Save this article

Evaluating the costs of cholera illness and cost-effectiveness of a single dose oral vaccination campaign in Lusaka, Zambia

Author

Listed:
  • Tannia Tembo
  • Michelo Simuyandi
  • Kanema Chiyenu
  • Anjali Sharma
  • Obvious N Chilyabanyama
  • Clara Mbwili-Muleya
  • Mazyanga Lucy Mazaba
  • Roma Chilengi

Abstract

Introduction: In 2016, for the very first time, the Ministry of Health in Zambia implemented a reactive outbreak response to control the spread of cholera and vaccinated at-risk populations with a single dose of Shancol—an oral cholera vaccine (OCV). This study aimed to assess the costs of cholera illness and determine the cost-effectiveness of the 2016 vaccination campaign. Methodology: From April to June 2017, we conducted a retrospective cost and cost-effectiveness analysis in three peri-urban areas of Lusaka. To estimate costs of illness from a household perspective, a systematic random sample of 189 in-patients confirmed with V. cholera were identified from Cholera Treatment Centre registers and interviewed for out-of-pocket costs. Vaccine delivery and health systems costs were extracted from financial records at the District Health Office and health facilities. The cost of cholera treatment was derived by multiplying the subsidized cost of drugs by the quantity administered to patients during hospitalisation. The cost-effectiveness analysis measured incremental cost-effectiveness ratio—cost per case averted, cost per life saved and cost per DALY averted—for a single dose OCV. Results: The mean cost per administered vaccine was US$1.72. Treatment costs per hospitalized episode were US$14.49–US$18.03 for patients ≤15 years old and US$17.66–US$35.16 for older patients. Whereas households incurred costs on non-medical items such as communication, beverages, food and transport during illness, a large proportion of medical costs were borne by the health system. Assuming vaccine effectiveness of 88.9% and 63%, a life expectancy of 62 years and Gross Domestic Product (GDP) per capita of US$1,500, the costs per case averted were estimated US$369–US$532. Costs per life year saved ranged from US$18,515–US$27,976. The total cost per DALY averted was estimated between US$698–US$1,006 for patients ≤15 years old and US$666–US$1,000 for older patients. Conclusion: Our study determined that reactive vaccination campaign with a single dose of Shancol for cholera control in densely populated areas of Lusaka was cost-effective.

Suggested Citation

  • Tannia Tembo & Michelo Simuyandi & Kanema Chiyenu & Anjali Sharma & Obvious N Chilyabanyama & Clara Mbwili-Muleya & Mazyanga Lucy Mazaba & Roma Chilengi, 2019. "Evaluating the costs of cholera illness and cost-effectiveness of a single dose oral vaccination campaign in Lusaka, Zambia," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-16, May.
  • Handle: RePEc:plo:pone00:0215972
    DOI: 10.1371/journal.pone.0215972
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215972
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0215972&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0215972?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Vittal Mogasale & Enusa Ramani & Hyeseung Wee & Jerome H Kim, 2016. "Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 10(12), pages 1-15, December.
    2. Dziedzom Kwesi Awalime & Bernard Bright K. Davies-Teye & Linda A. Vanotoo & Nkechi S. Owoo & Edward Nketiah-Amponsah, 2017. "Economic evaluation of 2014 cholera outbreak in Ghana: a household cost analysis," Health Economics Review, Springer, vol. 7(1), pages 1-8, December.
    3. Patrick G Ilboudo & Xiao Xian Huang & Bagrey Ngwira & Abel Mwanyungwe & Vittal Mogasale & Martin A Mengel & Philippe Cavailler & Bradford D Gessner & Jean-Bernard Le Gargasson, 2017. "Cost-of-illness of cholera to households and health facilities in rural Malawi," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-12, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Patrick G Ilboudo & Xiao Xian Huang & Bagrey Ngwira & Abel Mwanyungwe & Vittal Mogasale & Martin A Mengel & Philippe Cavailler & Bradford D Gessner & Jean-Bernard Le Gargasson, 2017. "Cost-of-illness of cholera to households and health facilities in rural Malawi," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-12, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0215972. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.