Cost-effectiveness analysis of malaria interventions using disability adjusted life years: a systematic review.
Cost-effectiveness analysis of malaria interventions using disability adjusted life years: a systematic review.
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DOI：
10.1186/s12962-017-0072-9
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Chimbari MJ
中科院分区：
文献类型：
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作者：
Gunda R;Chimbari MJ
尽管过去和现在都在努力控制疟疾，但疟疾仍然是一个公共卫生问题。为了维持控制工作以实现消除疟疾的目标，重要的是采用最具成本效益的干预措施。本文综述了使用残疾调整生命年对疟疾干预的成本效益的研究。通过检索国际同行评议期刊和灰色文献进行文献综述。通过Medline （PubMed）、EMBASE和谷歌Scholar搜索引擎进行搜索。这些搜索包括1996年至2016年期间用英文发表的文章。该研究的纳入标准是疟疾干预的类型、发表年份和按避免的每个DALY成本计算的成本-效果比。我们纳入了40项专门在疟疾干预措施的成本效益分析（CEA）中使用DALY指标的研究。大多数审查的研究（75%）使用来自非洲环境的数据完成，大多数干预措施（60.0%）针对所有年龄组。干预措施包括病例治疗、预防、病媒控制、经杀虫剂处理的蚊帐、早期发现、环境管理、诊断和教育规划。磺胺多辛-乙胺嘧啶是疟疾预防中最常见的选择药物，而以青蒿素为基础的联合疗法是病例治疗中最常见的药物。根据CEA指南，就每个干预措施避免的每个DALYs成本而言，大多数干预措施被证明具有成本效益。DALY指标是确定疟疾干预措施成本效益的有用工具。本文论证了CEA在为决策者提供决策信息方面的重要性。
Malaria continues to be a public health problem despite past and on-going control efforts. For sustenance of control efforts to achieve the malaria elimination goal, it is important that the most cost-effective interventions are employed. This paper reviews studies on cost-effectiveness of malaria interventions using disability-adjusted life years. A review of literature was conducted through a literature search of international peer-reviewed journals as well as grey literature. Searches were conducted through Medline (PubMed), EMBASE and Google Scholar search engines. The searches included articles published in English for the period from 1996 to 2016. The inclusion criteria for the study were type of malaria intervention, year of publication and cost-effectiveness ratio in terms of cost per DALY averted. We included 40 studies which specifically used the DALY metric in cost-effectiveness analysis (CEA) of malaria interventions. The majority of the reviewed studies (75%) were done using data from African settings with the majority of the interventions (60.0%) targeting all age categories. Interventions included case treatment, prophylaxis, vector control, insecticide treated nets, early detection, environmental management, diagnosis and educational programmes. Sulfadoxine–pyrimethamine was the most common drug of choice in malaria prophylaxis, while artemisinin-based combination therapies were the most common drugs for case treatment. Based on guidelines for CEA, most interventions proved cost-effective in terms of cost per DALYs averted for each intervention. The DALY metric is a useful tool for determining the cost-effectiveness of malaria interventions. This paper demonstrates the importance of CEA in informing decisions made by policy makers.