ArticleBMC infectious diseases2015
Cost effectiveness of option B plus for prevention of mother-to-child transmission of HIV in resource-limited countries: evidence from Kumasi, Ghana.
Article in BMC infectious diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review of Methods and Practice for Integrating Maternal, Fetal, and Child Health Outcomes, and Family Spillover Effects into Cost-Utility Analyses.PharmacoEconomics · 2024Pooled it
- Economic costs and cost-effectiveness of conditional cash transfers for the uptake of services for the prevention of vertical HIV transmissions in a resource-limited setting.Social science & medicine (1982) · 2023Trial
- Political prioritization of prevention of mother-to-child transmission of HIV and syphilis: a qualitative comparative policy analysis in Ghana, Mozambique, and Sudan.Frontiers in public health · 2026Article
- Screening for Resistant Bacteria, Antimicrobial Resistance Genes, Sexually Transmitted Infections andPathogens (Basel, Switzerland) · 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
- Associations between health systems capacity and mother-to-child HIV prevention program outcomes in Zambia.PloS one · 2018Article
- Job satisfaction and turnover intentions among health care staff providing services for prevention of mother-to-child transmission of HIV in Dar es Salaam, Tanzania.Human resources for health · 2017Article
- The History of the HIV/AIDS Epidemic in Africa.Current HIV/AIDS reports · 2016Review
- Infectious Diseases of Poverty in Children: A Tale of Two Worlds.Pediatric clinics of North America · 2016Review
- Modeling and Cost-Effectiveness in HIV Prevention.Current HIV/AIDS reports · 2016Review
- 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
- Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundAchieving the goal of eliminating mother-to-child HIV transmission (MTCT) necessitates increased access to antiretroviral therapy (ART) for HIV-infected pregnant women. Option B provides ART through pregnancy and breastfeeding, whereas Option B+ recommends continuous ART regardless of CD4 count, thus potentially reducing MTCT during future pregnancies. Our objective was to compare maternal and pediatric health outcomes and cost-effectiveness of Option B+ versus Option B in Ghana.
methodsA decision-analytic model was developed to simulate HIV progression in mothers and transmission (in utero, during birth, or through breastfeeding) to current and all future children. Clinical parameters, including antenatal care access and fertility rates, were estimated from a retrospective review of 817 medical records at two hospitals in Ghana. Additional parameters were obtained from published literature. Modeled outcomes include HIV infections averted among newborn children, quality-adjusted life-years (QALYs), and cost-effectiveness ratios.
resultsHIV-infected women in Ghana have a lifetime average of 2.3 children (SD 1.3). Projected maternal life expectancy under Option B+ is 16.1 years, versus 16.0 years with Option B, yielding a gain of 0.1 maternal QALYs and 3.2 additional QALYs per child. Despite higher initial ART costs, Option B+ costs $785/QALY gained, a value considered very cost-effective by World Health Organization benchmarks. Widespread implementation of Option B+ in Ghana could theoretically prevent up to 668 HIV infections among children annually. Cost-effectiveness estimates remained favorable over robust sensitivity analyses.
conclusionsAlthough more expensive than Option B, Option B+ substantially reduces MTCT in future pregnancies, increases both maternal and pediatric QALYs, and is a cost-effective use of limited resources in Ghana.
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