The 1,7-malaria reactive community-based testing and response(1,7-mRCTR)approach in Tanzania:a cost-effectiveness analysis  

作　　者：Radhika Pradip Tampi Duoquan Wang Salim Abdulla Muhidin Kassim Mahende Tegemeo Gavana Hajirani M.Msuya Augustine Kuwawenaruwa Michael Mihayo Felix Brown Honorati Masanja Wilbald Anthony Katia Bruxvoort Fadhila Kihwele Godlove Chila Wei Chang Marcia Castro Xiao Ning Prosper P.Chaki Yeromin P.Mlacha Jessica Cohen Nicolas A.Menzies 

机构地区：[1]Program in Health Policy,Harvard University,Cambridge,MA,USA [2]National Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention(Chinese Center for Tropical Diseases Research),NHC Key Laboratory of Parasite and Vector Biology,WHO Collaborating Center for Tropical Diseases,National Center for International Research On Tropical Diseases,Shanghai,China [3]School of Global Health,Chinese Center for Tropical Diseases Research,Shanghai Jiao Tong University School of Medicine,Shanghai,China [4]Ifakara Health Institute,#5 Ifakara Street,Plot 463 Mikocheni,P.O.Box 78373,Dar es Salaam,Tanzania [5]Africa Academy for Public Health,Dar-es-Salaam,Tanzania [6]School of Public Health,University of Alabama at Birmingham,Birmingham,AL,USA [7]World Bank Group,Washington,DC,USA [8].8 Department of Global Health and Population,Harvard T.H.Chan School of Public Health,Boston,MA,USA

出　　处：《Infectious Diseases of Poverty》2024年第6期40-49,共10页贫困所致传染病(英文)

基　　金：supported by Bill&Melinda Gates Foundation(OPP1198779 and OPP1213975);The funder did not participate in the study design,data collection,analysis,or writing of the manuscript.

摘　　要：Background Reactive case detection(RACD)for malaria control has been found effective in low transmission set-tings,but its impact and cost-effectiveness in moderate-to-high transmission settings are unknown.We conducted an economic evaluation alongside an empirical trial of a modified RACD strategy(1,7-mRCTR)in three moderate-to-high malaria transmission districts in Tanzania.Methods The costs and cost savings associated with the intervention relative to passive case detection alone were estimated in the study sites of Kilwa,Kibiti,and Rufiji districts in Tanzania from 2019-2021.Empirical cost data were collected using household surveys.The incremental costs of the intervention were calculated from under a societal perspective.Costs are reported in 2022 US dollars.Trial data and malaria registers from health facilities were used to calculate the number of malaria cases detected.We simulated unobserved and distal health effects of the intervention to assess cost-effectiveness in terms of incremental cost-effectiveness ratios(ICERs).Propagated uncertainty was assessed via second-order Monte Carlo simulation,including bootstrapping of empirical data distributions.Incremental costs per disability-adjusted life year(DALY)averted were compared to a willingness-to-pay threshold based on estimated opportunity costs of healthcare spending in Tanzania.Results The programmatic cost of the 1,7-mRCTR intervention was 5327 United States Dollars(USD)per 1000 popu-lation.The combination of reactive and passive case detection in the intervention arm resulted in an additional 445 malaria cases detected per 1000 compared to passive detection alone,yielding an incremental cost per additional case detected of 12.0 USD.Based on modelling results,for every percentage point decline in malaria prevalence,the intervention averted 95.2 cases and 0.04 deaths per 1000 population.On average,the 1,7-mRCTR intervention averted 19.1 DALYs per 1000 population.Compared to passive malaria detection,the ICERs for the 1,7-mRCTR inter-vention were 7.3

关 键 词：Cost-efectiveness analysis MALARIA Reactive case detection 1 7-mRCTR Tanzania 

分 类 号：R53[医药卫生—内科学]