Modelling the cost-effectiveness of mass screening and treatment for reducing Plasmodium falciparum malaria burden
Abstract Background Past experience and modelling suggest that, in most cases, mass treatment strategies are not likely to succeed in interrupting Plasmodium falciparum malaria transmission. However, this does not preclude their use to reduce disease burden. Mass screening and treatment (MSAT) is pr...
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ftdoajarticles:oai:doaj.org/article:f025525ac151437abc4fd70ce7cd3c33 2023-05-15T15:17:33+02:00 Modelling the cost-effectiveness of mass screening and treatment for reducing Plasmodium falciparum malaria burden Crowell Valerie Briët Olivier JT Hardy Diggory Chitnis Nakul Maire Nicolas Pasquale Aurelio Smith Thomas A 2013-01-01T00:00:00Z https://doi.org/10.1186/1475-2875-12-4 https://doaj.org/article/f025525ac151437abc4fd70ce7cd3c33 EN eng BMC http://www.malariajournal.com/content/12/1/4 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-12-4 1475-2875 https://doaj.org/article/f025525ac151437abc4fd70ce7cd3c33 Malaria Journal, Vol 12, Iss 1, p 4 (2013) Mass Screening Treatment Malaria falciparum Incremental Cost Effectiveness Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2013 ftdoajarticles https://doi.org/10.1186/1475-2875-12-4 2022-12-31T04:25:46Z Abstract Background Past experience and modelling suggest that, in most cases, mass treatment strategies are not likely to succeed in interrupting Plasmodium falciparum malaria transmission. However, this does not preclude their use to reduce disease burden. Mass screening and treatment (MSAT) is preferred to mass drug administration (MDA), as the latter involves massive over-use of drugs. This paper reports simulations of the incremental cost-effectiveness of well-conducted MSAT campaigns as a strategy for P. falciparum malaria disease-burden reduction in settings with varying receptivity (ability of the combined vector population in a setting to transmit disease) and access to case management. Methods MSAT incremental cost-effectiveness ratios (ICERs) were estimated in different sub-Saharan African settings using simulation models of the dynamics of malaria and a literature-based MSAT cost estimate. Imported infections were simulated at a rate of two per 1,000 population per annum. These estimates were compared to the ICERs of scaling up case management or insecticide-treated net (ITN) coverage in each baseline health system, in the absence of MSAT. Results MSAT averted most episodes, and resulted in the lowest ICERs, in settings with a moderate level of disease burden. At a low pre-intervention entomological inoculation rate (EIR) of two infectious bites per adult per annum (IBPAPA) MSAT was never more cost-effective than scaling up ITNs or case management coverage. However, at pre-intervention entomological inoculation rates (EIRs) of 20 and 50 IBPAPA and ITN coverage levels of 40 or 60%, respectively, the ICER of MSAT was similar to that of scaling up ITN coverage further. Conclusions In all the transmission settings considered, achieving a minimal level of ITN coverage is a “best buy”. At low transmission, MSAT probably is not worth considering. Instead, MSAT may be suitable at medium to high levels of transmission and at moderate ITN coverage. If undertaken as a burden-reducing intervention, MSAT should ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 12 1 |
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Mass Screening Treatment Malaria falciparum Incremental Cost Effectiveness Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Mass Screening Treatment Malaria falciparum Incremental Cost Effectiveness Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Crowell Valerie Briët Olivier JT Hardy Diggory Chitnis Nakul Maire Nicolas Pasquale Aurelio Smith Thomas A Modelling the cost-effectiveness of mass screening and treatment for reducing Plasmodium falciparum malaria burden |
topic_facet |
Mass Screening Treatment Malaria falciparum Incremental Cost Effectiveness Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Past experience and modelling suggest that, in most cases, mass treatment strategies are not likely to succeed in interrupting Plasmodium falciparum malaria transmission. However, this does not preclude their use to reduce disease burden. Mass screening and treatment (MSAT) is preferred to mass drug administration (MDA), as the latter involves massive over-use of drugs. This paper reports simulations of the incremental cost-effectiveness of well-conducted MSAT campaigns as a strategy for P. falciparum malaria disease-burden reduction in settings with varying receptivity (ability of the combined vector population in a setting to transmit disease) and access to case management. Methods MSAT incremental cost-effectiveness ratios (ICERs) were estimated in different sub-Saharan African settings using simulation models of the dynamics of malaria and a literature-based MSAT cost estimate. Imported infections were simulated at a rate of two per 1,000 population per annum. These estimates were compared to the ICERs of scaling up case management or insecticide-treated net (ITN) coverage in each baseline health system, in the absence of MSAT. Results MSAT averted most episodes, and resulted in the lowest ICERs, in settings with a moderate level of disease burden. At a low pre-intervention entomological inoculation rate (EIR) of two infectious bites per adult per annum (IBPAPA) MSAT was never more cost-effective than scaling up ITNs or case management coverage. However, at pre-intervention entomological inoculation rates (EIRs) of 20 and 50 IBPAPA and ITN coverage levels of 40 or 60%, respectively, the ICER of MSAT was similar to that of scaling up ITN coverage further. Conclusions In all the transmission settings considered, achieving a minimal level of ITN coverage is a “best buy”. At low transmission, MSAT probably is not worth considering. Instead, MSAT may be suitable at medium to high levels of transmission and at moderate ITN coverage. If undertaken as a burden-reducing intervention, MSAT should ... |
format |
Article in Journal/Newspaper |
author |
Crowell Valerie Briët Olivier JT Hardy Diggory Chitnis Nakul Maire Nicolas Pasquale Aurelio Smith Thomas A |
author_facet |
Crowell Valerie Briët Olivier JT Hardy Diggory Chitnis Nakul Maire Nicolas Pasquale Aurelio Smith Thomas A |
author_sort |
Crowell Valerie |
title |
Modelling the cost-effectiveness of mass screening and treatment for reducing Plasmodium falciparum malaria burden |
title_short |
Modelling the cost-effectiveness of mass screening and treatment for reducing Plasmodium falciparum malaria burden |
title_full |
Modelling the cost-effectiveness of mass screening and treatment for reducing Plasmodium falciparum malaria burden |
title_fullStr |
Modelling the cost-effectiveness of mass screening and treatment for reducing Plasmodium falciparum malaria burden |
title_full_unstemmed |
Modelling the cost-effectiveness of mass screening and treatment for reducing Plasmodium falciparum malaria burden |
title_sort |
modelling the cost-effectiveness of mass screening and treatment for reducing plasmodium falciparum malaria burden |
publisher |
BMC |
publishDate |
2013 |
url |
https://doi.org/10.1186/1475-2875-12-4 https://doaj.org/article/f025525ac151437abc4fd70ce7cd3c33 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 12, Iss 1, p 4 (2013) |
op_relation |
http://www.malariajournal.com/content/12/1/4 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-12-4 1475-2875 https://doaj.org/article/f025525ac151437abc4fd70ce7cd3c33 |
op_doi |
https://doi.org/10.1186/1475-2875-12-4 |
container_title |
Malaria Journal |
container_volume |
12 |
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1 |
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1766347800772083712 |