Document Detail


Malaria treatment and prophylaxis in endemic and nonendemic countries: evidence on strategies and their cost-effectiveness.
MedLine Citation:
PMID:  22122444     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Artemisinin combination treatment is currently the preferred treatment strategy to combat malaria. However, the drug costs are considerably higher than for previously used therapies. This review discusses the cost-effectiveness of current malaria treatment and prophylaxis in endemic and nonendemic countries. For endemic countries, a systematic search for economic evaluations (i.e., cost-effectiveness, cost-utility and cost-benefit analyses) was conducted, looking at the use of Artemisinin combination treatments in children, pregnant women and other adults. In total, 24 studies were identified investigating the cost-effectiveness of malaria treatments with the focus on uncomplicated malaria, severe or prereferral treatment, all in combination with adequate diagnosis, and malaria prevention by intermittent preventive treatment, respectively. In areas with both Plasmodium falciparum and Plasmodium vivax transmission, artemether-lumefantrine and dihydroartemisinin-piperaquine, respectively, are currently the most cost-effective treatment options. Treatment of severe malaria with artesunate is more cost effective compared with treatment with quinine. For patients that live more than 6 h away from an appropriate healthcare facility, prereferral treatment proved to be more cost-effective compared with no prereferral intervention. Cost-effectiveness of intermittent preventive treatment in pregnant women (IPTp) was dependent an clinical attendance. IPT in infants with sulphadoxine-pyrimethamine (SP) is cost effective in sites with high malaria transmission. IPT in children with artesunate (AS + SP), amodiaquine (AQ) + SPQ or SP alone is a cost effective and safe intervention for reducing the burden of malaria in children in areas with markedly seasonal malaria transmission. Although there is a need for it, little is known about the cost-effectiveness of current approaches to malaria therapy in nonendemic countries and the cost-effectiveness of antimalarial chemoprophylaxis.
Authors:
Michèle van Vugt; Anne van Beest; Elisa Sicuri; Maurits van Tulder; Martin P Grobusch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Future microbiology     Volume:  6     ISSN:  1746-0921     ISO Abbreviation:  Future Microbiol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101278120     Medline TA:  Future Microbiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1485-500     Citation Subset:  IM    
Affiliation:
Infectious Diseases, Center for Tropical Medicine & Travel Medicine, Division of Internal Medicine, AIGHD, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
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