Resources Repository
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ArticlePublication 2014Rise and Fall of HIV in High-Prevalence Countries: A Challenge for Mathematical Modeling
Several countries with generalized, high-prevalence HIV epidemics, mostly in sub-Saharan Africa, have experienced rapid declines …
Several countries with generalized, high-prevalence HIV epidemics, mostly in sub-Saharan Africa, have experienced rapid declines in transmission. These HIV epidemics, often with rapid onsets, have generally been attributed to a combination of factors related to high-risk sexual behavior. The subsequent declines in these countries began prior to widespread therapy or implementation of any other major biomedical prevention. This change has been construed as evidence of behavior change, often on the basis of mathematical models, but…
Mathematical Models | Health Outcomes | Sub-Saharan Africa | Infectious Diseases | Health/Medicine -
ArticlePublication 2013Validation and Calibration of a Simulation Model of Pediatric HIV Infection
The authors developed a microsimulation model of pediatric HIV disease progression using the Cost-Effectiveness of …
The authors developed a microsimulation model of pediatric HIV disease progression using the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model framework. This CEPAC-Pediatric model was then validated by varying CD4 data and comparing the corresponding model-generated survival curves to empirical survival curves obtained from the International Epidemiologic Database to Evaluate AIDS (IeDEA). The model was calibrated to other African countries by systematically varying immunologic and HIV mortality-related input parameters. In the calibration analyses, the model-generated…
Microsimulation | Calibration/Validation | Sub-Saharan Africa | Infectious Diseases | Child/Nutrition | Health/Medicine -
ArticlePublication 2013Public Finance of Rotavirus Vaccination in India and Ethiopia: Extended CEA
This study uses extended cost-effectiveness analysis (ECEA) to evaluate a hypothetical publicly financed program for …
This study uses extended cost-effectiveness analysis (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. The authors measured program impact on: (1) averted rotavirus deaths; (2) reduction in household expenditures; (3) financial risk protection; and (4) distributional consequences across the country’s wealth strata. In India and Ethiopia, the program was predicted to decrease rotavirus deaths substantially, and effectively provide financial risk protection among the poor, while also reducing household…
Cost-Effectiveness Analysis | Health Outcomes | Sub-Saharan Africa | Priority Setting/Ethics | Infectious Diseases | Child/Nutrition | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | Asia & Pacific -
GuidelinesPublication 2013Economic Analyses to Support Decisions about HPV Vaccination in Low- and Middle-Income Countries: Consensus Report and Guide
Low- and middle-income countries need to consider economic issues such as cost-effectiveness, affordability and sustainability …
Low- and middle-income countries need to consider economic issues such as cost-effectiveness, affordability and sustainability before introducing a program for human papillomavirus (HPV) vaccination. However, many such countries lack the technical capacity and data to conduct their own analyses. This report describes the consensus of an expert group convened by the World Health Organization, prioritizing key issues to be addressed when considering economic analyses to support HPV vaccine introduction in these countries. The expert group…
Cost-Effectiveness Analysis | Health Outcomes | Sub-Saharan Africa | Costing Methods | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2010Cost-Effectiveness of Alternative Pregnancy Termination Strategies in Nigeria and Ghana
To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, …
To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, the authors developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women. The model was used to compare the costs and benefits of unsafe abortion and three first-trimester abortion modalities: hospital-based dilatation and curettage, hospital- and clinic-based manual vacuum aspiration (MVA), and medical abortion using misoprostol (MA). The results showed that…
Cost-Effectiveness Analysis | State-Transition | Sub-Saharan Africa | Maternal/Reproductive Health | Culture/Society | Economics/Finance | Health/Medicine -
ArticlePublication 2024Hepatitis C Elimination in Rwanda: Progress, Feasibility, Economic Evaluation
This study evaluates the impact of Rwanda's national program launched in 2018 to eliminate hepatitis …
This study evaluates the impact of Rwanda's national program launched in 2018 to eliminate hepatitis C virus (HCV) and identifies strategies to achieve World Health Organization (WHO) elimination goals by 2030. Employing a microsimulation model spanning 2015 to 2050, the analysis assesses HCV epidemic trends, prevalence, mortality, and total care costs under various scenarios. Results show that between 2018 and 2022, over 7 million people were screened and 60,000 treated, projecting Rwanda's potential achievement of…
Microsimulation | Sub-Saharan Africa | Infectious Diseases | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2022Modeling the Relative Risk of Incidence and Mortality of Select Vaccine-Preventable Diseases
Immunization is one of the most effective public health interventions, saving millions of lives every …
Immunization is one of the most effective public health interventions, saving millions of lives every year. Ethiopia has seen gradual improvements in immunization coverage and access to child health care services; however, inequalities in child mortality across wealth quintiles and regions remain persistent. This paper models the relative distributional incidence and mortality of four vaccine-preventable diseases (VPDs) (rotavirus diarrhea, human papillomavirus, measles, and pneumonia) by wealth quintile and geographic region in Ethiopia. The authors approach…
Evidence Synthesis | Sub-Saharan Africa | Priority Setting/Ethics | Infectious Diseases | Social Determinants | Health/Medicine -
ArticlePublication 2021Health Gains and Financial Protection from HPV Vaccination
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical …
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical impoverishment in many low-resource settings. This article uses a static cohort model that captures the main features of HPV vaccines and population demographics to project health and economic outcomes associated with routine HPV vaccination in Ethiopia. The findings show that, assuming 100% vaccine efficacy against HPV-16/18 and 50% vaccination coverage, routine HPV vaccination could avert up to 970 000 cases…
Microsimulation | Sub-Saharan Africa | Priority Setting/Ethics | Infectious Diseases -
ArticlePublication 2020Integrating Non-Communicable Disease and HIV Treatment in Uganda
Despite growing enthusiasm for integrating treatment of non-communicable diseases into human immunodeficiency virus (HIV) care …
Despite growing enthusiasm for integrating treatment of non-communicable diseases into human immunodeficiency virus (HIV) care and treatment services in sub-Saharan Africa, there is little evidence on the potential health and financial consequences of such integration. This article aims to study the cost-effectiveness of basic non-communicable disease-HIV integration in a Ugandan setting. The article presents an epidemiologic-cost model to analyze, from the provider perspective, the cost-effectiveness of integrating hypertension, diabetes mellitus and high cholesterol screening and…
Cost-Effectiveness Analysis | Sub-Saharan Africa | Infectious Diseases