Cost-effectiveness of a reactive oral cholera immunization campaign using Shanchol™ in Malawi
Abstract Background Oral cholera vaccines (OCV) have been recommended as additional measures for the prevention of cholera. However, little is known about the cost-effectiveness of OCV use in sub-Saharan Africa, particularly in reactive outbreak contexts. This study aimed to investigate the cost-eff...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | Cost Effectiveness and Resource Allocation |
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| Online Access: | https://doi.org/10.1186/s12962-021-00270-y |
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| author | Patrick G. Ilboudo Martin A. Mengel Bradford D. Gessner Bagrey Ngwira Philippe Cavailler Jean-Bernard Le Gargasson |
| author_facet | Patrick G. Ilboudo Martin A. Mengel Bradford D. Gessner Bagrey Ngwira Philippe Cavailler Jean-Bernard Le Gargasson |
| author_sort | Patrick G. Ilboudo |
| collection | DOAJ |
| description | Abstract Background Oral cholera vaccines (OCV) have been recommended as additional measures for the prevention of cholera. However, little is known about the cost-effectiveness of OCV use in sub-Saharan Africa, particularly in reactive outbreak contexts. This study aimed to investigate the cost-effectiveness of the use of OCV Shanchol in response to a cholera outbreak in the Lake Chilwa area, Malawi. Methods The Excel-based Vaccine Introduction Cost-Effectiveness model was used to assess the cost-effectiveness ratios with and without indirect protection. Model input parameters were obtained from cost evaluations and epidemiological studies conducted in Malawi and published literature. One-way sensitivity and threshold analyses of cost-effectiveness ratios were performed. Results Compared with the reference scenario i.e. treatment of cholera cases, the immunization campaign would have prevented 636 and 1 020 cases of cholera without and with indirect protection, respectively. The cost-effectiveness ratios were US$19 212 per death, US$500 per case, and US$738 per DALY averted without indirect protection. They were US$10 165 per death, US$264 per case, and US$391 per DALY averted with indirect protection. The net cost per DALY averted was sensitive to four input parameters, including case fatality rate, duration of immunity (vaccine’s protective duration), discount rate and cholera incidence. Conclusion Relative to the Malawi gross domestic product per capita, the reactive OCV campaign represented a cost-effective intervention, particularly when considering indirect vaccine effects. Results will need to be assessed in other settings, e.g., during campaigns implemented directly by the Ministry of Health rather than by international partners. |
| first_indexed | 2024-12-13T23:23:30Z |
| format | Article |
| id | doaj.art-64433e52afdd49f39e6f7e5254ca3c63 |
| institution | Directory Open Access Journal |
| issn | 1478-7547 |
| language | English |
| last_indexed | 2024-12-13T23:23:30Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Cost Effectiveness and Resource Allocation |
| spelling | doaj.art-64433e52afdd49f39e6f7e5254ca3c632022-12-21T23:27:37ZengBMCCost Effectiveness and Resource Allocation1478-75472021-03-011911910.1186/s12962-021-00270-yCost-effectiveness of a reactive oral cholera immunization campaign using Shanchol™ in MalawiPatrick G. Ilboudo0Martin A. Mengel1Bradford D. Gessner2Bagrey Ngwira3Philippe Cavailler4Jean-Bernard Le Gargasson5Agence de Médecine PréventiveAgence de Médecine PréventiveAgence de Médecine PréventiveThe PolytechnicAgence de Médecine PréventiveAgence de Médecine PréventiveAbstract Background Oral cholera vaccines (OCV) have been recommended as additional measures for the prevention of cholera. However, little is known about the cost-effectiveness of OCV use in sub-Saharan Africa, particularly in reactive outbreak contexts. This study aimed to investigate the cost-effectiveness of the use of OCV Shanchol in response to a cholera outbreak in the Lake Chilwa area, Malawi. Methods The Excel-based Vaccine Introduction Cost-Effectiveness model was used to assess the cost-effectiveness ratios with and without indirect protection. Model input parameters were obtained from cost evaluations and epidemiological studies conducted in Malawi and published literature. One-way sensitivity and threshold analyses of cost-effectiveness ratios were performed. Results Compared with the reference scenario i.e. treatment of cholera cases, the immunization campaign would have prevented 636 and 1 020 cases of cholera without and with indirect protection, respectively. The cost-effectiveness ratios were US$19 212 per death, US$500 per case, and US$738 per DALY averted without indirect protection. They were US$10 165 per death, US$264 per case, and US$391 per DALY averted with indirect protection. The net cost per DALY averted was sensitive to four input parameters, including case fatality rate, duration of immunity (vaccine’s protective duration), discount rate and cholera incidence. Conclusion Relative to the Malawi gross domestic product per capita, the reactive OCV campaign represented a cost-effective intervention, particularly when considering indirect vaccine effects. Results will need to be assessed in other settings, e.g., during campaigns implemented directly by the Ministry of Health rather than by international partners.https://doi.org/10.1186/s12962-021-00270-yCost-effectivenessCholeraShancholModelMalawi |
| spellingShingle | Patrick G. Ilboudo Martin A. Mengel Bradford D. Gessner Bagrey Ngwira Philippe Cavailler Jean-Bernard Le Gargasson Cost-effectiveness of a reactive oral cholera immunization campaign using Shanchol™ in Malawi Cost Effectiveness and Resource Allocation Cost-effectiveness Cholera Shanchol Model Malawi |
| title | Cost-effectiveness of a reactive oral cholera immunization campaign using Shanchol™ in Malawi |
| title_full | Cost-effectiveness of a reactive oral cholera immunization campaign using Shanchol™ in Malawi |
| title_fullStr | Cost-effectiveness of a reactive oral cholera immunization campaign using Shanchol™ in Malawi |
| title_full_unstemmed | Cost-effectiveness of a reactive oral cholera immunization campaign using Shanchol™ in Malawi |
| title_short | Cost-effectiveness of a reactive oral cholera immunization campaign using Shanchol™ in Malawi |
| title_sort | cost effectiveness of a reactive oral cholera immunization campaign using shanchol™ in malawi |
| topic | Cost-effectiveness Cholera Shanchol Model Malawi |
| url | https://doi.org/10.1186/s12962-021-00270-y |
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