ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2013
Cost-effectiveness of World Health Organization 2010 guidelines for prevention of mother-to-child HIV transmission in Zimbabwe.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed.
- Validation and calibration of a computer simulation model of pediatric HIV infection.PloS one · 2013Trial
- Modelling the potential clinical and economic impact of universal antenatal hepatitis C (HCV) screening and providing treatment for pregnant women with HCV and their infants in Egypt: a cost-effectiveness study.BMJ public health · 2024Article
- The Cost of Maternal Complications and Its Associated Factors Among Mothers Attending Public Hospitals in Harari Region and Dire Dawa City Administration, Eastern Ethiopia: An Institution-Based Cross-Sectional Study.ClinicoEconomics and outcomes research : CEOR · 2023Article
- Costs and Cost Drivers of Providing Option B+ Services to Mother-Baby Pairs for PMTCT of HIV in Health Centre IV Facilities in Jinja District, Uganda.BioMed research international · 2020Article
- Cost-effectiveness of option B+ in prevention of mother-to-child transmission of HIV in Yunnan Province, China.BMC infectious diseases · 2019Article
- Protocol for the evaluation of the population-level impact of Zimbabwe's prevention of mother-to-child HIV transmission program option B+: a community based serial cross-sectional study.BMC pregnancy and childbirth · 2019Article
- Prevention of mother-to-child transmission (PMTCT) of HIV: a review of the achievements and challenges in Burkina-Faso.HIV/AIDS (Auckland, N.Z.) · 2019Article
- UNICEF's contribution to the adoption and implementation of option B+ for preventing mother-to-child transmission of HIV: a policy analysis.Globalization and health · 2018Article
- Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study.Health policy and planning · 2017Article
- Bibliometric trends of health economic evaluation in Sub-Saharan Africa.Globalization and health · 2016Review
- A risk score to identify HIV-infected women most likely to become lost to follow-up in the postpartum period.AIDS care · 2016Article
- Optimizing Antiretroviral Therapy (ART) for Maternal and Child Health (MCH): Rationale and Design of the MCH-ART Study.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- HIV-Infected Ugandan Women on Antiretroviral Therapy Maintain HIV-1 RNA Suppression Across Periconception, Pregnancy, and Postpartum Periods.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Comparative cost-effectiveness of Option B+ for prevention of mother-to-child transmission of HIV in Malawi.AIDS (London, England) · 2016Article
- Should HIV testing for all pregnant women continue? Cost-effectiveness of universal antenatal testing compared to focused approaches across high to very low HIV prevalence settings.Journal of the International AIDS Society · 2016Article
- Prenatal Transmission of Syphilis and Human Immunodeficiency Virus in Brazil: Achieving Regional Targets for Elimination.Open forum infectious diseases · 2015Article
- Cost effectiveness of option B plus for prevention of mother-to-child transmission of HIV in resource-limited countries: evidence from Kumasi, Ghana.BMC infectious diseases · 2015Article
- Estimating PMTCT's Impact on Heterosexual HIV Transmission: A Mathematical Modeling Analysis.PloS one · 2015Article
- Article
- Individualizing the WHO HIV and infant feeding guidelines: optimal breastfeeding duration to maximize infant HIV-free survival.AIDS (London, England) · 2014Article
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13 authors.
Funding
Abstract
backgroundIn 2010, the World Health Organization (WHO) released revised guidelines for prevention of mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT). We projected clinical impacts, costs, and cost-effectiveness of WHO-recommended PMTCT strategies in Zimbabwe.
methodsWe used Zimbabwean data in a validated computer model to simulate a cohort of pregnant, HIV-infected women (mean age, 24 years; mean CD4 count, 451 cells/µL; subsequent 18 months of breastfeeding). We simulated guideline-concordant care for 4 PMTCT regimens: single-dose nevirapine (sdNVP); WHO-recommended Option A, WHO-recommended Option B, and Option B+ (lifelong maternal 3-drug antiretroviral therapy regardless of CD4). Outcomes included maternal and infant life expectancy (LE) and lifetime healthcare costs (2008 US dollars [USD]). Incremental cost-effectiveness ratios (ICERs, in USD per year of life saved [YLS]) were calculated from combined (maternal + infant) discounted costs and LE.
resultsReplacing sdNVP with Option A increased combined maternal and infant LE from 36.97 to 37.89 years and would reduce lifetime costs from $5760 to $5710 per mother-infant pair. Compared with Option A, Option B further improved LE (38.32 years), and saved money within 4 years after delivery ($5630 per mother-infant pair). Option B+ (LE, 39.04 years; lifetime cost, $6620 per mother-infant pair) improved maternal and infant health, with an ICER of $1370 per YLS compared with Option B.
conclusionsReplacing sdNVP with Option A or Option B will improve maternal and infant outcomes and save money; Option B increases health benefits and decreases costs compared with Option A. Option B+ further improves maternal outcomes, with an ICER (compared with Option B) similar to many current HIV-related healthcare interventions.
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