Abstract:
BACKGROUND:The intermittent administration of seasonal malaria chemoprevention (SMC) is recommended to prevent malaria among children aged 3-59 months in areas of the Sahel subregion in Africa. However, the cost-effectiveness and cost savings of SMC have not previously been evaluated in large-scale studies. METHODS:We did a cost-effectiveness and cost-savings analysis of a large-scale, multi-country SMC campaign with sulfadoxine-pyrimethamine plus amodiaquine for children younger than 5 years in seven countries in the Sahel subregion (Burkina Faso, Chad, Guinea, Mali, Niger, Nigeria, and The Gambia) in 2016. The financial and economic costs were analysed from the programmatic perspective and are reported in 2016 US$ for each country. The estimated numbers of averted malaria cases, deaths, and disability-adjusted life-years (DALYs) were based on numbers of SMC treatments administered and modelled malaria transmission. Cost savings were calculated from a programmatic perspective corresponding to the diagnostic and treatment costs for malaria cases averted. FINDINGS:The total cost of SMC for all seven countries was $22·8 million, and the weighted average economic cost of administering four monthly SMC cycles was $3·63 per child (ranging from $2·71 in Niger to $8·20 in The Gambia). Based on 80% modelled effectiveness of SMC, the incremental economic cost per malaria case averted ranged from $2·91 in Niger to $30·73 in The Gambia; the cost per severe case averted ranged from $119·63 in Niger to $506·00 in The Gambia; the cost per death averted ranged from $533·56 in Niger to $2256·92 in The Gambia; and the cost per DALY averted (discounted by 3%) ranged from $18·66 in Niger to $78·91 in The Gambia. The estimated total economic cost savings to the health systems in all seven countries were US$66·0 million and the total net economic cost savings were US$43·2 million. INTERPRETATION:SMC is a low-cost and highly cost-effective intervention that contributes to substantial cost savings by reducing malaria diagnostic and treatment costs among children. FUNDING:Unitaid.
journal_name
Lancet Glob Healthjournal_title
The Lancet. Global healthauthors
Gilmartin C,Nonvignon J,Cairns M,Milligan P,Bocoum F,Winskill P,Moroso D,Collins Ddoi
10.1016/S2214-109X(20)30475-7subject
Has Abstractpub_date
2021-02-01 00:00:00pages
e199-e208issue
2issn
2214-109Xpii
S2214-109X(20)30475-7journal_volume
9pub_type
杂志文章abstract:BACKGROUND:The way in which a government chooses to finance a health intervention can affect the uptake of health interventions and consequently the extent of health gains. In addition to health gains, some policies such as public finance can insure against catastrophic health expenditures. We aimed to evaluate the hea...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(14)70346-8
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Brazil ranks second worldwide in total number of COVID-19 cases and deaths. Understanding the possible socioeconomic and ethnic health inequities is particularly important given the diverse population and fragile political and economic situation. We aimed to characterise the COVID-19 pandemic in Brazil and a...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30285-0
更新日期:2020-08-01 00:00:00
abstract::Intervention coverage-the proportion of the population with a health-care need who receive care-does not account for intervention quality and potentially overestimates health benefits of services provided to populations. Effective coverage introduces the dimension of quality of care to the measurement of intervention ...
journal_title:The Lancet. Global health
pub_type: 杂志文章,评审
doi:10.1016/S2214-109X(20)30104-2
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Buruli ulcer can cause disfigurement and long-term loss of function. It is underdiagnosed and under-reported, and its current distribution is unclear. We aimed to synthesise and evaluate data on Buruli ulcer prevalence and distribution. METHODS:We did a systematic review of Buruli ulcer prevalence and used ...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30171-8
更新日期:2019-07-01 00:00:00
abstract::Child stunting is a global problem and is only modestly responsive to dietary interventions. Numerous observational studies have shown that water quality, sanitation, and handwashing (WASH) in a household are strongly associated with linear growth of children living in the same household. We have completed three rando...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30268-2
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:The average age at which people start smoking has been decreasing in many countries, but insufficient evidence exists on the adult hazards of having started smoking in childhood and, especially, in early childhood. We aimed to investigate the association between smoking habits (focusing on the age when smoke...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30221-7
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The rise in contraceptive use has largely been driven by short-acting methods of contraception, despite the high effectiveness of long-acting reversible contraceptives. Several countries in Latin America and the Caribbean have made important progress increasing the use of modern contraceptives, but important...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30481-9
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Improving access to reproductive health services and commodities is central to development. Efforts to assess progress on this front have been largely focused on national estimates, but such analyses can mask local disparities. We assessed progress in reproductive health services subnationally in India. MET...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(17)30033-5
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990-2020, an...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30425-3
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:The risk of severe COVID-19 if an individual becomes infected is known to be higher in older individuals and those with underlying health conditions. Understanding the number of individuals at increased risk of severe COVID-19 and how this varies between countries should inform the design of possible strateg...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30264-3
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The effects of political regimes on health are unclear because empirical evidence is neither strong nor robust. Traditional econometric tools do not allow the direction of causality to be established clearly. We used a new method to investigate whether political transition into democracy affected child morta...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(16)30104-8
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Few studies have reported long-term data on mortality rates for children admitted to hospital with pneumonia in Africa. We examined trends in case fatality rates for all-cause clinical pneumonia and its risk factors in Malawian children between 2001 and 2012. METHODS:Individual patient data for children (<5...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(15)00215-6
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Insufficient physical activity is a leading risk factor for non-communicable diseases, and has a negative effect on mental health and quality of life. We describe levels of insufficient physical activity across countries, and estimate global and regional trends. METHODS:We pooled data from population-based ...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30357-7
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:About 2·6 million third-trimester stillbirths occur annually worldwide, mostly in low-income and middle-income countries, where the causes of these deaths are rarely investigated. METHODS:We did a prospective, hospital-based, observational study in Soweto, South Africa, to investigate the causes of stillbir...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30541-2
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Children who are HIV-exposed uninfected (HEU) have higher morbidity and mortality than children who are HIV-unexposed and uninfected despite safer breastfeeding and improved maternal health with maternal antiretroviral therapy. We present the first global estimates of the population of children who are HEU (...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30448-6
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Low blood glucose concentrations are common in sick children who present to hospital in low-resource settings and are associated with increased mortality. The cutoff blood glucose concentration for the diagnosis and treatment of hypoglycaemia currently recommended by WHO (2·5 mmol/L) is not evidence-based. W...
journal_title:The Lancet. Global health
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2214-109X(20)30388-0
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Understanding the effects of socioeconomic disparities in health outcomes is important to implement specific preventive actions. We assessed socioeconomic disparities in mortality indicators in a rural South African population over the period 2001-13. METHODS:We used data from 21 villages of the Agincourt H...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(17)30297-8
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Tuberculosis is recognised as a major cause of morbidity and mortality in children, with most cases in children going undiagnosed and resulting in poor outcomes. Household contact management, which aims to identify children with active tuberculosis and to provide preventive therapy for those with HIV or thos...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30401-7
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Global efforts to increase births at health-care facilities might not reduce maternal or newborn mortality if quality of care is insufficient. However, little systematic evidence exists for the quality at health facilities caring for women and newborn babies in low-income countries. We analysed the quality o...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(16)30180-2
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:In 2007, WHO launched a global initiative for the elimination of mother-to-child transmission of syphilis (congenital syphilis). An important aspect of the initiative is strengthening surveillance to monitor progress towards elimination. In 2008, using a health systems model with country data inputs, WHO est...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(16)30135-8
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:More timely estimates of malaria prevalence are needed to inform optimal control strategies and measure progress. Since 2014, Tanzania has implemented nationwide malaria screening for all pregnant women within the antenatal care system. We aimed to compare malaria test results during antenatal care to two po...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30405-X
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Attainment of universal health coverage is a global health priority. The Myanmar Government has committed to attainment of universal health coverage by 2030, but progress so far has not been assessed. We aimed to estimate national and subnational health service coverage and financial risk protection. METHOD...
journal_title:The Lancet. Global health
pub_type: 评论,杂志文章
doi:10.1016/S2214-109X(18)30318-8
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Global rollout of dolutegravir-based antiretroviral therapy (ART) has been hampered in part by insufficient safety data in pregnancy. We compared birth outcomes among women initiating dolutegravir-based ART with those among women initiating efavirenz-based ART in pregnancy in Botswana. METHODS:In this obser...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30218-3
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:As the incomes of many AIDS-burdened countries grow and donors' budgets for helping to fight the disease tighten, national governments and external funding partners increasingly face the following question: what is the capacity of countries that are highly affected by AIDS to finance their responses from dom...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(14)70342-0
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:In accordance with the age parameters specified in Sustainable Development Goal target 3.4, current policy and monitoring of non-communicable disease (NCD) mortality trends focus on people aged 30-69 years. This approach excludes the majority of NCD deaths, which occur at older ages. We aimed to compare card...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30069-5
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Scrub typhus (caused by Orientia tsutsugamushi), murine typhus (caused by Rickettsia typhi), and leptospirosis are common causes of febrile illness in Asia; meningitis and meningoencephalitis are severe complications. However, scarce data exist for the burden of these pathogens in patients with CNS disease i...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(14)70289-X
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Low birthweight (LBW) of less than 2500 g is an important marker of maternal and fetal health, predicting mortality, stunting, and adult-onset chronic conditions. Global nutrition targets set at the World Health Assembly in 2012 include an ambitious 30% reduction in LBW prevalence between 2012 and 2025. Esti...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30565-5
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lympha...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30286-2
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Total domestic and international funding for malaria is inadequate to achieve WHO global targets in burden reduction by 2030. We describe the trends of investments in malaria-related research in sub-Saharan Africa and compare investment with national disease burden to identify areas of funding strength and p...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(17)30245-0
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:The population exposed to potentially hazardous substances through inappropriate and unsafe management practices related to disposal and recycling of end-of-life electrical and electronic equipment, collectively known as e-waste, is increasing. We aimed to summarise the evidence for the association between s...
journal_title:The Lancet. Global health
pub_type: 杂志文章,评审
doi:10.1016/S2214-109X(13)70101-3
更新日期:2013-12-01 00:00:00