ArticleAIDS (London, England)2016
Comparative cost-effectiveness of Option B+ for prevention of mother-to-child transmission of HIV in Malawi.
Article in AIDS (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Approaches to improving the efficiency of HIV programme investments.BMJ global health · 2022Article
- Level of quality of option BBMC health services research · 2020Article
- Development and Implementation of a Mobile Phone-Based Prevention of Mother-To-Child Transmission of HIV Cascade Analysis Tool: Usability and Feasibility Testing in Kenya and Mozambique.JMIR mHealth and uHealth · 2019Article
- Cost-effectiveness of HIV Prevention Interventions in Sub-Saharan Africa: A Systematic Review.EClinicalMedicine · 2019Article
- Toward Improving Accessibility of Point-of-Care Diagnostic Services for Maternal and Child Health in Low- and Middle-Income Countries.Point of care · 2019Article
- The History of the HIV/AIDS Epidemic in Africa.Current HIV/AIDS reports · 2016Review
- "I Was Not Told That I Still Have The Virus": Perceptions of Utilization of Option B+ Services at a Health Center in Malawi.Journal of the International Association of Providers of AIDS CareArticle
- Article
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo estimate the cost-effectiveness of prevention of mother-to-child transmission (MTCT) of HIV with lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') compared with ART during pregnancy or breastfeeding only unless clinically indicated ('Option B').
designMathematical modelling study of first and second pregnancy, informed by data from the Malawi Option B+ programme.
methodsIndividual-based simulation model. We simulated cohorts of 10 000 women and their infants during two subsequent pregnancies, including the breastfeeding period, with either Option B+ or B. We parameterized the model with data from the literature and by analysing programmatic data. We compared total costs of antenatal and postnatal care, and lifetime costs and disability-adjusted life-years of the infected infants between Option B+ and Option B.
resultsDuring the first pregnancy, 15% of the infants born to HIV-infected mothers acquired the infection. With Option B+, 39% of the women were on ART at the beginning of the second pregnancy, compared with 18% with Option B. For second pregnancies, the rates MTCT were 11.3% with Option B+ and 12.3% with Option B. The incremental cost-effectiveness ratio comparing the two options ranged between about US$ 500 and US$ 1300 per DALY averted.
conclusionOption B+ prevents more vertical transmissions of HIV than Option B, mainly because more women are already on ART at the beginning of the next pregnancy. Option B+ is a cost-effective strategy for PMTCT if the total future costs and lost lifetime of the infected infants are taken into account.
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