Cost effectiveness of option B plus for prevention of mother-to-child transmission of HIV in resource-limited countries: evidence from Kumasi, Ghana.
Identifieur interne : 000256 ( PubMed/Checkpoint ); précédent : 000255; suivant : 000257Cost effectiveness of option B plus for prevention of mother-to-child transmission of HIV in resource-limited countries: evidence from Kumasi, Ghana.
Auteurs : Adam Vandeusen [États-Unis] ; Elijah Paintsil [États-Unis] ; Thomas Agyarko-Poku [Ghana] ; Elisa F. Long [États-Unis]Source :
- BMC infectious diseases [ 1471-2334 ] ; 2015.
Descripteurs français
- KwdFr :
- Allaitement maternel (), Analyse coût-bénéfice, Années de vie ajustées sur la qualité, Antirétroviraux (usage thérapeutique), Antirétroviraux (économie), Chimioprévention (), Chimioprévention (économie), Complications de la grossesse et maladies infectieuses (traitement médicamenteux), Complications de la grossesse et maladies infectieuses (économie), Complications de la grossesse et maladies infectieuses (épidémiologie), Enfant, Enfant d'âge préscolaire, Femelle, Ghana (épidémiologie), Grossesse, Humains, Infections à VIH (), Infections à VIH (transmission), Infections à VIH (économie), Infections à VIH (épidémiologie), Modèles économétriques, Nouveau-né, Relations mère-enfant, Ressources en santé (économie), Transmission verticale de maladie infectieuse (), Transmission verticale de maladie infectieuse (économie), VIH-1 (Virus de l'Immunodéficience Humaine de type 1), Études rétrospectives.
- MESH :
- traitement médicamenteux : Complications de la grossesse et maladies infectieuses.
- usage thérapeutique : Antirétroviraux, Infections à VIH.
- économie : Antirétroviraux, Chimioprévention, Complications de la grossesse et maladies infectieuses, Infections à VIH, Ressources en santé, Transmission verticale de maladie infectieuse.
- épidémiologie : Complications de la grossesse et maladies infectieuses, Ghana, Infections à VIH.
- Allaitement maternel, Analyse coût-bénéfice, Années de vie ajustées sur la qualité, Chimioprévention, Enfant, Enfant d'âge préscolaire, Femelle, Grossesse, Humains, Infections à VIH, Modèles économétriques, Nouveau-né, Relations mère-enfant, Transmission verticale de maladie infectieuse, VIH-1 (Virus de l'Immunodéficience Humaine de type 1), Études rétrospectives.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Anti-Retroviral Agents (economics), Anti-Retroviral Agents (therapeutic use), Breast Feeding (statistics & numerical data), Chemoprevention (economics), Chemoprevention (statistics & numerical data), Child, Child, Preschool, Cost-Benefit Analysis, Female, Ghana (epidemiology), HIV Infections (economics), HIV Infections (epidemiology), HIV Infections (prevention & control), HIV Infections (transmission), HIV-1, Health Resources (economics), Humans, Infant, Newborn, Infectious Disease Transmission, Vertical (economics), Infectious Disease Transmission, Vertical (prevention & control), Infectious Disease Transmission, Vertical (statistics & numerical data), Models, Econometric, Mother-Child Relations, Pregnancy, Pregnancy Complications, Infectious (drug therapy), Pregnancy Complications, Infectious (economics), Pregnancy Complications, Infectious (epidemiology), Quality-Adjusted Life Years, Retrospective Studies.
- MESH :
- chemical , economics : Anti-Retroviral Agents.
- chemical , therapeutic use : Anti-Retroviral Agents.
- geographic , epidemiology : Ghana.
- drug therapy : Pregnancy Complications, Infectious.
- economics : Chemoprevention, HIV Infections, Health Resources, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious.
- epidemiology : HIV Infections, Pregnancy Complications, Infectious.
- prevention & control : HIV Infections, Infectious Disease Transmission, Vertical.
- statistics & numerical data : Breast Feeding, Chemoprevention, Infectious Disease Transmission, Vertical.
- transmission : HIV Infections.
- Child, Child, Preschool, Cost-Benefit Analysis, Female, HIV-1, Humans, Infant, Newborn, Models, Econometric, Mother-Child Relations, Pregnancy, Quality-Adjusted Life Years, Retrospective Studies.
Abstract
Achieving 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.
DOI: 10.1186/s12879-015-0859-2
PubMed: 25887574
Affiliations:
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pubmed:25887574Le document en format XML
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Elijah.paintsil@yale.edu.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Departments of Pediatrics & Pharmacology, Yale School of Medicine, Yale Child Health Research Center, 464 Congress Ave, New Haven, CT</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Agyarko Poku, Thomas" sort="Agyarko Poku, Thomas" uniqKey="Agyarko Poku T" first="Thomas" last="Agyarko-Poku">Thomas Agyarko-Poku</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pharmacy, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. tagyarkopoku@gmail.com.</nlm:affiliation><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Pharmacy, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Long, Elisa F" sort="Long, Elisa F" uniqKey="Long E" first="Elisa F" last="Long">Elisa F. 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mère-enfant</term><term>Ressources en santé (économie)</term><term>Transmission verticale de maladie infectieuse ()</term><term>Transmission verticale de maladie infectieuse (économie)</term><term>VIH-1 (Virus de l'Immunodéficience Humaine de type 1)</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en"><term>Anti-Retroviral Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Retroviral Agents</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Pregnancy Complications, Infectious</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Chemoprevention</term><term>HIV Infections</term><term>Health Resources</term><term>Infectious Disease Transmission, Vertical</term><term>Pregnancy 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xml:lang="fr"><term>Antirétroviraux</term><term>Chimioprévention</term><term>Complications de la grossesse et maladies infectieuses</term><term>Infections à VIH</term><term>Ressources en santé</term><term>Transmission verticale de maladie infectieuse</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Complications de la grossesse et maladies infectieuses</term><term>Ghana</term><term>Infections à VIH</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Child</term><term>Child, Preschool</term><term>Cost-Benefit Analysis</term><term>Female</term><term>HIV-1</term><term>Humans</term><term>Infant, Newborn</term><term>Models, Econometric</term><term>Mother-Child Relations</term><term>Pregnancy</term><term>Quality-Adjusted Life Years</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Allaitement maternel</term><term>Analyse coût-bénéfice</term><term>Années de vie ajustées sur la qualité</term><term>Chimioprévention</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Infections à VIH</term><term>Modèles économétriques</term><term>Nouveau-né</term><term>Relations mère-enfant</term><term>Transmission verticale de maladie infectieuse</term><term>VIH-1 (Virus de l'Immunodéficience Humaine de type 1)</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Achieving 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.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25887574</PMID><DateCreated><Year>2015</Year><Month>04</Month><Day>18</Day></DateCreated><DateCompleted><Year>2015</Year><Month>12</Month><Day>08</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2334</ISSN><JournalIssue CitedMedium="Internet"><Volume>15</Volume><PubDate><Year>2015</Year><Month>Mar</Month><Day>18</Day></PubDate></JournalIssue><Title>BMC infectious diseases</Title><ISOAbbreviation>BMC Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Cost effectiveness of option B plus for prevention of mother-to-child transmission of HIV in resource-limited countries: evidence from Kumasi, Ghana.</ArticleTitle><Pagination><MedlinePgn>130</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12879-015-0859-2</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Achieving 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.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A 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.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">HIV-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.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Although 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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>VanDeusen</LastName><ForeName>Adam</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA. avandeusen@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paintsil</LastName><ForeName>Elijah</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Departments of Pediatrics & Pharmacology, Yale School of Medicine, Yale Child Health Research Center, 464 Congress Ave, New Haven, CT, USA. Elijah.paintsil@yale.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Agyarko-Poku</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Pharmacy, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. tagyarkopoku@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Long</LastName><ForeName>Elisa F</ForeName><Initials>EF</Initials><AffiliationInfo><Affiliation>University of California Los Angeles, Anderson School of Management, Los Angeles, CA, USA. elisa.long@anderson.ucla.edu.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>K08 AI074404</GrantID><Acronym>AI</Acronym><Agency>NIAID NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01-DA15612</GrantID><Acronym>DA</Acronym><Agency>NIDA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>P30 MH062294</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01-HD074253</GrantID><Acronym>HD</Acronym><Agency>NICHD NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 HD074253</GrantID><Acronym>HD</Acronym><Agency>NICHD NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>K08AI074404</GrantID><Acronym>AI</Acronym><Agency>NIAID NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 DA015612</GrantID><Acronym>DA</Acronym><Agency>NIDA NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>03</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Infect Dis</MedlineTA><NlmUniqueID>100968551</NlmUniqueID><ISSNLinking>1471-2334</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D044966">Anti-Retroviral Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>J Gen Intern Med. 2013 Oct;28(10):1294-301</RefSource><PMID Version="1">23588668</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>JAMA. 1996 Oct 16;276(15):1253-8</RefSource><PMID Version="1">8849754</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>BMJ. 2005 Dec 17;331(7530):1431-7</RefSource><PMID Version="1">16282380</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune 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Health Sex. 2010 Jun;12(5):569-81</RefSource><PMID Version="1">20432081</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D044966" MajorTopicYN="N">Anti-Retroviral Agents</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001942" MajorTopicYN="N">Breast Feeding</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018890" MajorTopicYN="N">Chemoprevention</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" 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MajorTopicYN="N">Pregnancy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011251" MajorTopicYN="Y">Pregnancy Complications, Infectious</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019057" MajorTopicYN="N">Quality-Adjusted Life Years</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">PMC4374181</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2014</Year><Month>10</Month><Day>31</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>02</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>4</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>4</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>12</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">25887574</ArticleId><ArticleId IdType="doi">10.1186/s12879-015-0859-2</ArticleId><ArticleId IdType="pii">10.1186/s12879-015-0859-2</ArticleId><ArticleId IdType="pmc">PMC4374181</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Ghana</li><li>États-Unis</li></country><region><li>Californie</li><li>Connecticut</li></region></list><tree><country name="États-Unis"><region name="Connecticut"><name sortKey="Vandeusen, Adam" sort="Vandeusen, Adam" uniqKey="Vandeusen A" first="Adam" last="Vandeusen">Adam Vandeusen</name></region><name sortKey="Long, Elisa F" sort="Long, Elisa F" uniqKey="Long E" first="Elisa F" last="Long">Elisa F. Long</name><name sortKey="Paintsil, Elijah" sort="Paintsil, Elijah" uniqKey="Paintsil E" first="Elijah" last="Paintsil">Elijah Paintsil</name></country><country name="Ghana"><noRegion><name sortKey="Agyarko Poku, Thomas" sort="Agyarko Poku, Thomas" uniqKey="Agyarko Poku T" first="Thomas" last="Agyarko-Poku">Thomas Agyarko-Poku</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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