Cost-effectiveness of intermittent preventive therapy and insecticide-treated bed nets for malaria prevention among pregnant women in Jos North, Plateau State, Nigeria
Notice bibliographique
Résumé
BACKGROUND: Malaria remains a major public health concern, particularly among pregnant women in endemic regions. Intermittent preventive therapy using sulfadoxine-pyrimethamine (IPTp-SP) and insecticide-treated nets (ITNs) is widely recommended for malaria prevention in pregnancy. However, the cost-effectiveness of these interventions, particularly in low-resource settings, needs further evaluation to inform policy and resource allocation. This study aimed to assess the cost-effectiveness of IPTp-SP and ITNs as malaria prevention strategies among pregnant women attending antenatal care (ANC) services in Jos North, Plateau State, Nigeria. METHODS: A cross-sectional study design was used to conduct a cost-effectiveness analysis (CEA) comparing IPTp-SP alone to a combined IPTp-SP/ITN intervention. A total of 1000 pregnant women accessing ANC services from 2019 to 2020 in five primary healthcare facilities were included. Cost data were collected from a provider's perspective using a cost valuation sheet adapted from the WHO CHOICE tool. Health outcomes were measured in disability-adjusted life years (DALYs) lost, with the primary outcomes being the prevalence of low birth weight (LBW) and maternal anaemia at 36-40 weeks of gestation. Data were analysed using STATA version 16, and an incremental cost-effectiveness ratio (ICER) was calculated. Probabilistic sensitivity analysis (PSA) was conducted using Monte Carlo simulations. RESULTS: The total DALYs lost were higher in the IPTp-SP-only group (101.53 DALYs) than in the IPTp-SP/ITN group (85.9 DALYs), yielding an incremental effect of 15.63 DALYs averted. The total cost of the intervention was higher for IPTp-SP/ITN (US$231.98) compared to IPTp-SP alone (US$131.79), with an incremental cost of US$100.19. The ICER was US$2.12 per DALY averted, indicating that IPTp-SP/ITN is a cost-effective intervention. The cost-effectiveness acceptability curve (CEAC) indicates that the probability of IPTp-SP/ITN being more cost-effective than IPTp-SP only at a WTP set at 150 US$/DALY is approximately 60%, suggesting that cost-effectiveness improves at higher WTP thresholds. CONCLUSION: This study demonstrates that IPTp-SP/ITN is a cost-effective intervention for preventing malaria during pregnancy. However, its cost-effectiveness is influenced by integration into ANC services, adherence to ITN use, and funding mechanisms. Policymakers should consider optimizing funding and service delivery models to improve intervention efficiency and sustainability. Further research incorporating household-level costs and long-term economic impacts is recommended.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».