Systematic review of microeconomic analysis of pregnancy-associated malaria

Deisy Cristina Restrepo-Posada; Jaime Carmona-Fonseca; Jaiberth Antonio Cardona-Arias

doi:10.1016/j.heliyon.2020.e04558

Systematic review of microeconomic analysis of pregnancy-associated malaria

Heliyon. 2020 Jul 30;6(7):e04558. doi: 10.1016/j.heliyon.2020.e04558. eCollection 2020 Jul.

Authors

Deisy Cristina Restrepo-Posada¹, Jaime Carmona-Fonseca², Jaiberth Antonio Cardona-Arias³

Affiliations

¹ Microbiology, University of Antioquia, Colombia.
² Microbiology, School of Medicine, Coordinator of the Research Group on Health and Community César Uribe Piedrahíta, University of Antioquia, Colombia.
³ Epidemiology, Applied Economics, Public Health, School of Microbiology of the University of Antioquia, Colombia.

Abstract

Introduction: Pregnancy-associated malaria (PAM) is a health problem with serious clinical, epidemiological and economic effects.

Purpose: To analyze the microeconomic evaluations of PAM reported in the world scientific literature.

Methods: Systematic review with 15 different search strategies in PubMed, ScienceDirect, Scielo, Google Scholar and Malaria in Pregnancy (MiP) Library. A search, selection and extraction protocol was applied, which guaranteed completeness and reproducibility in accordance with preferred reporting items for systematic reviews and meta-analysis guidelines. The methodological quality was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guide. The analysis were based on frequencies, costs and average and incremental cost-effectiveness ratios in 2018 US dollars adjusted for purchasing power parity.

Results: Twenty-two evaluations published between 1990 and 2018 were analyzed, of which 82% addressed cost-effectiveness in Africa. Twelve interventions were studied; of these, intermittent preventive treatment in pregnant women with sulfadoxine-pyrimethamine (IPTp-SP) was the most frequent strategy. The main outcomes were low birth weight, anaemia and DALYs avoided. The best average cost-effectiveness ratio was reported in IPTp-SP with a cost of US$ 2 per DALY avoided, followed by the administration of IPTp-SP in pregnant women with HIV (US$ 14.2).

Conclusions: The studies focus on Africa with a high heterogeneity in the interventions, outcomes, resources and populations studied. All the interventions were highly cost-effective, which demonstrates the importance of including prevention, care and control resources for PAM as a priority in health sector budgets. This is especially true considering the importance of its intervention for social progress and overcoming poverty in endemic areas.

Keywords: Cost-effectiveness; Costs; Economic evaluations; Economics; Evidence-based medicine; Infectious disease; Malaria; Pregnancy; Public health; Systematic review; Women's health.

Publication types

Review