Antiretroviral drugs as a public health intervention for pregnant HIV-infected women in rural South Africa : an issue of cost-effectiveness and capacity.
To estimate cost-effectiveness and capacity requirements for providing antiretroviral drugs to pregnant HIV-infected women in rural South Africa.
Hlabisa health district, where HIV prevalence among pregnant women was 26.0% in 1997.
Calculation of the number of paediatric HIV infections averted under three scenarios, and their cost.
No intervention was compared with scenario A (zidovudine delivered within current infrastructure), scenario B (zidovudine delivered through enhanced infrastructure), and scenario C (short-course zidovudine plus lamivudine delivered through enhanced infrastructure).
Cost-effectiveness was defined as cost per infection averted and cost per potential life-year gained.
Capacity was determined in terms of staff and infrastructure required to effectively implement the scenarios.
With no intervention, 657 paediatric HIV infections were projected for 1997.
In scenario A this could be reduced by 15% at a cost of USS 574 825, in scenario B by 42% at US$ 1 520 770, and in scenario C by 47% at US$ 764 901.
In scenario C, drugs accounted for 76% of costs, whereas additional staff accounted for 18%. Cost per infection averted was US$ 2492 and cost per potential life-year gained (discounted at 3%) was US$ 88.
Cost of scenario C was equivalent to 14% of the 1997 district health budget. (...)
Mots-clés Pascal : SIDA, Virose, Infection, Transmission mère enfant, Chimiothérapie, Zidovudine, Lamivudine, Chimioprophylaxie, Gestation, Prévention, Traitement, Analyse coût efficacité, Programme sanitaire, Femelle, Homme, République Sud Africaine, Afrique, Zone rurale, Antiviral, Pyrimidine nucléoside, Didésoxynucléoside, Immunopathologie, Immunodéficit, Economie santé, Transmission verticale
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Mother to child transmission, Chemotherapy, Zidovudine, Lamivudine, Chemoprophylaxis, Pregnancy, Prevention, Treatment, Cost efficiency analysis, Sanitary program, Female, Human, South Africa, Africa, Rural area, Antiviral, Pyrimidine nucleoside, Dideoxynucleoside, Immunopathology, Immune deficiency, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0434147
Code Inist : 002B02S05. Création : 25/01/1999.