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Table 3 Economic evaluations of interventions to reduce mother to child transmission (MTCT) of HIV: estimates of effectiveness1

From: The cost-effectiveness of preventing mother-to-child transmission of HIV in low- and middle-income countries: systematic review

Study

Infant HIV cases averted

Reduction in forward transmission 2

Life years

QALYs 3 or DALYs 4

[32]

(0) 3764

(1) 4250

per 100,000 births5

n/a6

n/a

n/a

[33]

(1) 0.70

(2) 0.62

(3) 0.31

per 100 women

A 30% benefit was incorporated in the base case and varied from 10-50% in sensitivity analyses

n/a

(1) 13.2

(2) 11.6

(3) 5.8

DALYs per 100 women

[29]

(1) 99

(2) 272

(3) 307

n/a

n/a

n/a

[34]

(1) 476

(2) 603

(3) 315

(4) 229

(5) 309

per 20 000 women

A 30% benefit was considered in sensitivity analyses.

n/a

(1) 12572

(2) 15862

(3) 8326

(4) 6041

(5) 8163

DALYs per 20 000 women

[30]

(Total deaths averted)

(1) 26

(2) 25

(3) 5

(4) 37

(5) 200

(6) 124

(7) 160

(8) 188

(9) 200

n/a

(1) 461

(2) 449

(3) 98

(4) 661

(5) 3 655

(6) 2 260

(7) 2 926

(8) 3 434

(9) 3 654

n/a

[35]

(1) 137

(2) 160

(3) 89

(4) 142

n/a

n/a

n/a

[36]

23 181

n/a

 

n/a

[37]

n/a

n/a

n/a

n/a

[23]

(0) 4 & 3

(1) 91 & 64

(2) 46 & 32

(3) 91 & 64

(4) 102 & 72

All reported for ACTG 076 & HIVNET 012

30% external benefit considered in sensitivity analyses

n/a

n/a

[25]

(1)

Botswana: 243

Ivory Coast: 435

Kenya: 904

Rwanda: 1 380

Tanzania: 2 774

Uganda: 1 375

Zambia: 629 Zimbabwe: 1 013

n/a

n/a

(1) 7

BWA: 7571

CIV: 12 984

KEN: 27 784

RWA: 39 095

TZA: 82 806

UGA: 39 846

ZMB: 18 873

ZWE: 31 462 DALYs

[31]

Not given

n/a

 

(0) 446 208

(1) 445 922

(2) 447 391

(3) 451 250

(4) 446 869

(5) 446 187

QALYs

[27]

(0) 233

(1) 258

(2) 273

(3) 337

(4) 245

(5) 271

(6) 300

(7) 353

n/a

n/a

n/a

[22]

(1) 9880

(2) 4403

n/a

(1) 131 700

(2) 58 700 Potential years of life lost

n/a

[24]

(1) 33.1

(2) 32.5

n/a

n/a

n/a

[28]

(1) 3436

(2) 3436

(3) 3406

(4) 3406

(5) 5031

(6) 5031

For 2 VCT strategy

n/a

n/a

(1) 776.48

(2) 1158.74

(3) 1299.76

(4) 1939.63

(5) 1147.84

(6) 1712.92

QALYs for 2 VCT strategy

[26]

(1) 91

(2) 88

VCT may prevent HIV acquisition in discordant couples where the male is HIV+ve

n/a

n/a

[38]

(0) 241 596

(1) 71 945 (additional)

n/a

n/a

n/a

[40]

(1) 0.51

(2) 2.67

per 1000

n/a

n/a

(1) 12.9

(2) 67

per 1000

[39]

(1) 370

15% benefit incorporated in base case (0%-30% in sensitivity analyses)

n/a

(1) 10 449

  1. 1Numbers in round brackets correspond to the intervention strategies presented in Table 1.
  2. 2This is reduction in adult-to-adult transmission due to VCT (voluntary counseling and testing). All studies consider provider-initiated HIV testing (PIHT)).
  3. 3QALY = Quality-adjusted life years
  4. 4DALY = Disability-adjusted life years
  5. 5SOC = Societal (considers direct and indirect costs); PPHC = Public payer of healthcare costs (considers direct costs only); PRO = Provider (considers direct medical costs covered by the facility)
  6. 6n/a = not applicable
  7. 7 These are three-letter country codes published by the International Organization for Standardization (ISO)
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Cost Effectiveness and Resource Allocation

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