Evidence map›Paper›PMID 28985732›Full record

ArticleMalaria journal2017

Cost-effectiveness of malaria preventive treatment for HIV-infected pregnant women in sub-Saharan Africa.

Sung Eun Choi, Margaret L Brandeau, Eran Bendavid

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Malaria journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Article
  6. Article
  7. Article
  8. Review
  9. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Sung Eun ChoiDepartment of Management Science and Engineering, Stanford University, Stanford, CA, USA. sungeunc@stanford.edu.ORCID 0000-0002-4001-7638
Margaret L BrandeauDepartment of Management Science and Engineering, Stanford University, Stanford, CA, USA.
Eran BendavidDivision of General Medical Disciplines, Stanford University, Stanford, CA, USA.
Stanford University · US

Funding

Trial of strategies to communicate genetic information to different ethnic and racial subpopulationsU54MD010724 · NIMHD · STANFORD UNIVERSITY · PI MALDONADO, YVONNE A. · 2016 to 2021
$16.3M
Making Better Decisions: Policy Modeling for AIDS and Drug AbuseR01DA015612 · NIDA · STANFORD UNIVERSITY · PI OWENS, DOUGLAS K · 2002 to 2017
$9.4M
Making Better Decisions: Policy Modeling for AIDS and Drug AbuseR37DA015612 · NIDA · STANFORD UNIVERSITY · PI DOUGLAS K OWENS · 2019 to 2026
$6.3M
NIDA NIH HHS R01 DA015612NIDA NIH HHS R37 DA015612NIMHD NIH HHS U54 MD010724
6 · The paper itself

Abstract

backgroundMalaria is a leading cause of morbidity and mortality among HIV-infected pregnant women in sub-Saharan Africa: at least 1 million pregnancies among HIV-infected women are complicated by co-infection with malaria annually, leading to increased risk of premature delivery, severe anaemia, delivery of low birth weight infants, and maternal death. Current guidelines recommend either daily cotrimoxazole (CTX) or intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) for HIV-infected pregnant women to prevent malaria and its complications. The cost-effectiveness of CTX compared to IPTp-SP among HIV-infected pregnant women was assessed.

methodsA microsimulation model of malaria and HIV among pregnant women in five malaria-endemic countries in sub-Saharan Africa was constructed. Four strategies were compared: (1) 2-dose IPTp-SP at current IPTp-SP coverage of the country ("2-IPT Low"); (2) 3-dose IPTp-SP at current coverage ("3-IPT Low"); (3) 3-dose IPTp-SP at the same coverage as antiretroviral therapy (ART) in the country ("3-IPT High"); and (4) daily CTX at ART coverage. Outcomes measured include maternal malaria, anaemia, low birth weight (LBW), and disability-adjusted life years (DALYs). Sensitivity analyses assessed the effect of adherence to CTX.

resultsCompared with the 2-IPT Low Strategy, women receiving CTX had 22.5% fewer LBW infants (95% CI 22.3-22.7), 13.5% fewer anaemia cases (95% CI 13.4-13.5), and 13.6% fewer maternal malaria cases (95% CI 13.6-13.7). In all simulated countries, CTX was the preferred strategy, with incremental cost-effectiveness ratios ranging from cost-saving to $3.9 per DALY averted from a societal perspective. CTX was less effective than the 3-IPT High Strategy when more than 18% of women stopped taking CTX during the pregnancy.

conclusionIn malarious regions of sub-Saharan Africa, daily CTX for HIV-infected pregnant women regardless of CD4 cell count is cost-effective compared with 3-dose IPTp-SP as long as more than 82% of women adhere to daily dosing.

Indexed as

Cost-Benefit AnalysisAfrica South of the SaharaAntimalarialsCoinfectionDrug CombinationsFemaleHIV InfectionsHumansMalariaModels, TheoreticalPregnancyPyrimethamineSulfadoxineTrimethoprim, Sulfamethoxazole Drug CombinationYoung AdultAntimalarialsDrug Combinationsfanasil, pyrimethamine drug combinationPyrimethamineSulfadoxineTrimethoprim, Sulfamethoxazole Drug Combination

Identifiers

PMID28985732
PMCPMC6389090
OpenAlexW2764201462

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.