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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)