文章基本信息

标题：Are long-lasting insecticide-treated bednets and water filters cost-effective tools for delaying HIV disease progression in Kenya?
本地全文：下载
作者：Stéphane Verguet ; James G. Kahn ; Global Health Sciences, University of California, San Francisco, CA, USA 等
期刊名称：Global Health Action
印刷版ISSN：1654-9716
电子版ISSN：1654-9880
出版年度：2015
卷号：8
期号：0
DOI：10.3402/gha.v8.27695
语种：English
出版社：Taylor & Francis
摘要：Background: Co-infection with malaria and other infectious diseases has been shown to increase viral load and accelerate HIV disease progression. A recent study in Kenya demonstrated that providing long-lasting insecticide-treated bednets (LLIN) and water filters (WF) to HIV-positive adults with CD4 >350 cells/mm3significantly reduced HIV progression.Design: We conducted a cost analysis to estimate the potential net financial savings gained by delaying HIV progression and increasing the time to antiretroviral therapy (ART) eligibility through delivering LLIN and WF to 10% of HIV-positive adults with CD4 >350 cells/mm3 in Kenya.Results: Given a 3-year duration of intervention benefit, intervention unit cost of US$32 and patient-year ART cost of US$757 (2011 US$), over the lifetime of ART patients, in Kenya, we estimated the intervention could yield a return on investment (ROI) of 11 (95% uncertainty range [UR]: 5–23), based on a cost of about US$2 million and savings in ART costs of about US$26 million (95% UR: 8–50) (discounted at 3%). Our findings were subjected to a number of sensitivity analyses. Of note, deferral of time to ART eligibility could potentially result in 3,000 new HIV infections not averted by ART and thus decrease ART cost savings to US$14 million, decreasing the ROI to 6.Conclusions: Provision of LLIN and WF could be a cost-saving and practical method to defer time to ART eligibility in the context of highly resource-constrained environments experiencing donor fatigue for HIV/AIDS programs.Keywords: cost savings; insecticide-treated bednets; water filtration; HIV disease progression; antiretroviral therapy; malaria; diarrhea; Kenya; sub-Saharan Africa(Published: 10 June 2015)Citation: Glob Health Action 2015, 8: 27695 - http://dx.doi.org/10.3402/gha.v8.27695Supplementary Material: To access the supplementary material for this article, please see Supplementary files under ‘Article Tools’
关键词：Global Health; Health Economics;cost savings; insecticide-treated bednets; water filtration; HIV disease progression; antiretroviral therapy; malaria; diarrhea; Kenya; sub-Saharan Africa