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Related Experiment Videos

Antimalarials during pregnancy: a cost-effectiveness analysis

L J Schultz1, R W Steketee, L Chitsulo

  • 1Division of Parasitic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA.

Bulletin of the World Health Organization
|January 1, 1995
PubMed
Summary

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This summary is machine-generated.

A two-dose sulfadoxine-pyrimethamine (SP) regimen during pregnancy is a cost-effective strategy to prevent low birth weight (LBW) in malaria-endemic areas. This intervention significantly reduces LBW cases compared to other antimalarial treatments.

Area of Science:

  • * Maternal and reproductive health
  • * Infectious disease epidemiology
  • * Health economics

Background:

  • * Pregnancy malaria, particularly Plasmodium falciparum, is a major cause of low birth weight (LBW), a leading risk factor for neonatal mortality.
  • * Chloroquine (CQ)-resistant malaria is prevalent in many endemic regions, necessitating effective alternative treatment strategies.
  • * Antenatal clinics (ANC) are crucial points for implementing interventions to improve maternal and infant outcomes.

Purpose of the Study:

  • * To evaluate the cost-effectiveness of three different antimalarial regimens for preventing LBW in pregnant women in Malawi.
  • * To compare the number of LBW cases prevented and the associated costs per case prevented for each regimen.
  • * To determine the optimal antimalarial strategy for inclusion in antenatal care packages in areas with CQ-resistant malaria.
Keywords:
AfricaAfrica South Of The SaharaBiologyBirth WeightBody WeightCost EffectivenessDelivery Of Health CareDeveloping CountriesDiseasesDrugs--therapeutic useEastern AfricaEnglish Speaking AfricaEvaluationEvaluation IndexesHealthHealth ServicesLow Birth WeightMalaria--prevention and controlMalawiMaternal Health ServicesMaternal-child Health ServicesModels, TheoreticalOrganization And AdministrationParasitic DiseasesPhysiologyPrenatal CarePrimary Health CareProgram EvaluationProgramsQuantitative EvaluationResearch MethodologyTheoretical StudiesTreatment

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Main Methods:

  • * A decision-analysis model was developed using current data and costs from Malawi.
  • * The model predicted LBW cases prevented by sulfadoxine-pyrimethamine (SP) and chloroquine (CQ) regimens.
  • * Factors analyzed included antimalarial costs, ANC visit compliance, placental malaria prevalence, and LBW incidence.

Main Results:

  • * A two-dose SP regimen (second and third trimesters) prevented 205 LBW cases per 10,000 women at $9.66 per case.
  • * An SP treatment followed by weekly CQ regimen prevented 59 LBW cases at $62 per case.
  • * An initial CQ treatment followed by weekly CQ regimen prevented only 30 LBW cases at $113 per case.

Conclusions:

  • * The two-dose SP regimen is a highly cost-effective intervention for reducing LBW incidence in areas with CQ-resistant P. falciparum.
  • * This regimen should be integrated into standard antenatal care services.
  • * Implementing effective malaria prevention during pregnancy significantly improves neonatal health outcomes.