Cost-effectiveness of zinc as adjunct therapy for acute childhood diarrhoea in developing countries
OBJECTIVE: To analyse the incremental costs, effects and cost-effectiveness of zinc used as adjunct therapy to standard treatment of acute childhood diarrhoea, including dysentery, and to reassess the cost-effectiveness of standard case management with oral rehydration salt (ORS). METHODS: A decisio...
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| Format: | Article |
| Language: | English |
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The World Health Organization
2004-07-01
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| Series: | Bulletin of the World Health Organization |
| Subjects: | |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000700010&lng=en&tlng=en |
| _version_ | 1797281853203283968 |
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| author | Bjarne Robberstad Tor Strand Robert E. Black Halvor Sommerfelt |
| author_facet | Bjarne Robberstad Tor Strand Robert E. Black Halvor Sommerfelt |
| author_sort | Bjarne Robberstad |
| collection | DOAJ |
| description | OBJECTIVE: To analyse the incremental costs, effects and cost-effectiveness of zinc used as adjunct therapy to standard treatment of acute childhood diarrhoea, including dysentery, and to reassess the cost-effectiveness of standard case management with oral rehydration salt (ORS). METHODS: A decision tree was used to model expected clinical outcomes and expected costs under four alternative treatment strategies. The best available epidemiological, clinical and economic evidence was used in the calculations, and the United Republic of Tanzania was the reference setting. Probabilistic cost-effectiveness analysis was performed using a Monte-Carlo simulation technique and the potential impacts of uncertainty in single parameters were explored in one-way sensitivity analyses. FINDINGS: ORS was found to be less cost-effective than previously thought. The use of zinc as adjunct therapy significantly improved the cost-effectiveness of standard management of diarrhoea for dysenteric as well as non-dysenteric illness. The results were particularly sensitive to mortality rates in non-dysenteric diarrhoea, but the alternative interventions can be defined as highly cost-effective even in pessimistic scenarios. CONCLUSION: There is sufficient evidence to recommend the inclusion of zinc into standard case management of both dysenteric and non-dysenteric acute diarrhoea. A direct transfer of our findings from the United Republic of Tanzania to other settings is not justified, but there are no indications of large geographical differences in the efficacy of zinc. It is therefore plausible that our findings are also applicable to other developing countries. |
| first_indexed | 2024-03-07T17:03:26Z |
| format | Article |
| id | doaj.art-fb9f00ba7cd04b598725065312fe6421 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T17:03:26Z |
| publishDate | 2004-07-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-fb9f00ba7cd04b598725065312fe64212024-03-03T03:04:43ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862004-07-01827523531S0042-96862004000700010Cost-effectiveness of zinc as adjunct therapy for acute childhood diarrhoea in developing countriesBjarne Robberstad0Tor Strand1Robert E. Black2Halvor Sommerfelt3University of BergenUniversity of BergenJohns Hopkins BloombergUniversity of BergenOBJECTIVE: To analyse the incremental costs, effects and cost-effectiveness of zinc used as adjunct therapy to standard treatment of acute childhood diarrhoea, including dysentery, and to reassess the cost-effectiveness of standard case management with oral rehydration salt (ORS). METHODS: A decision tree was used to model expected clinical outcomes and expected costs under four alternative treatment strategies. The best available epidemiological, clinical and economic evidence was used in the calculations, and the United Republic of Tanzania was the reference setting. Probabilistic cost-effectiveness analysis was performed using a Monte-Carlo simulation technique and the potential impacts of uncertainty in single parameters were explored in one-way sensitivity analyses. FINDINGS: ORS was found to be less cost-effective than previously thought. The use of zinc as adjunct therapy significantly improved the cost-effectiveness of standard management of diarrhoea for dysenteric as well as non-dysenteric illness. The results were particularly sensitive to mortality rates in non-dysenteric diarrhoea, but the alternative interventions can be defined as highly cost-effective even in pessimistic scenarios. CONCLUSION: There is sufficient evidence to recommend the inclusion of zinc into standard case management of both dysenteric and non-dysenteric acute diarrhoea. A direct transfer of our findings from the United Republic of Tanzania to other settings is not justified, but there are no indications of large geographical differences in the efficacy of zinc. It is therefore plausible that our findings are also applicable to other developing countries.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000700010&lng=en&tlng=enCincCincDiarreaDisenteríaSoluciones para rehidrataciónFluidoterapiaCostos y análisis de costoCosto de la enfermedadIncertidumbreSensibilidad y especificidadPaíses en desarrolloRepública Unida de Tanzanía |
| spellingShingle | Bjarne Robberstad Tor Strand Robert E. Black Halvor Sommerfelt Cost-effectiveness of zinc as adjunct therapy for acute childhood diarrhoea in developing countries Bulletin of the World Health Organization Cinc Cinc Diarrea Disentería Soluciones para rehidratación Fluidoterapia Costos y análisis de costo Costo de la enfermedad Incertidumbre Sensibilidad y especificidad Países en desarrollo República Unida de Tanzanía |
| title | Cost-effectiveness of zinc as adjunct therapy for acute childhood diarrhoea in developing countries |
| title_full | Cost-effectiveness of zinc as adjunct therapy for acute childhood diarrhoea in developing countries |
| title_fullStr | Cost-effectiveness of zinc as adjunct therapy for acute childhood diarrhoea in developing countries |
| title_full_unstemmed | Cost-effectiveness of zinc as adjunct therapy for acute childhood diarrhoea in developing countries |
| title_short | Cost-effectiveness of zinc as adjunct therapy for acute childhood diarrhoea in developing countries |
| title_sort | cost effectiveness of zinc as adjunct therapy for acute childhood diarrhoea in developing countries |
| topic | Cinc Cinc Diarrea Disentería Soluciones para rehidratación Fluidoterapia Costos y análisis de costo Costo de la enfermedad Incertidumbre Sensibilidad y especificidad Países en desarrollo República Unida de Tanzanía |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000700010&lng=en&tlng=en |
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