Estimated global resources needed to attain international malaria control goals

Kiszewski, Anthony E.; Johns, Benjamin; Schapira, Allan; Delacollette, Charles; Crowell, Valerie; Tan-Torres, Tessa; Ameneshewa, Birkinesh; Teklehaimanot, Awash; Nafo-Traoré, Fatoumata

doi:10.2471/blt.06.039529

Cited by 54 publications

(68 citation statements)

References 10 publications

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“…Besides acquired immune deficiency syndrome (AIDS) and tuberculosis, malaria is one of the world's biggest public health problems. A total of US$38-45 billion will be spent from 2006 to 2015 for the diagnosis and treatment of malaria [2], mainly in underdeveloped countries, which are the most affected by this disease [3].…”

Section: Introductionmentioning

confidence: 99%

Nanoencapsulation increases quinine antimalarial efficacy against Plasmodium berghei in vivo

Haas

Bettoni

Oliveira

et al. 2009

International Journal of Antimicrobial Agents

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The aims of this work were to develop quinine (QN)-loaded nanocapsules, to evaluate their efficacy in vivo and to determine their pharmacokinetics and erythrocyte partition coefficient. Plasmodium berghei-infected Wistar rats were used to evaluate the efficacy of QN-loaded nanocapsules using different dosing regimens. Pharmacokinetics was evaluated after intravenous administration of free or nanoencapsulated QN (25 mg/kg) to infected rats. The QN partition coefficient into P. berghei-infected erythrocytes was evaluated. QN-loaded nanocapsules presented an adequate particle size (176 nm), narrow particle distribution (0.19), negative zeta potential (-18 mV) and high drug content and encapsulation efficiency. Intravenous administration of QN-loaded nanocapsules at 75 mg/kg/day to infected rats resulted in 100% survival, representing an almost 30% reduction compared with the free QN effective dose (105 mg/kg/day). The pharmacokinetic parameters of nanoencapsulated QN were not significantly different from those determined for free drug (alpha=0.05). The QN partition coefficient into infected erythrocytes doubled (6.25+/-0.25) when the drug was nanoencapsulated compared with the free drug (3.03+/-0.07). Therefore, nanoencapsulation increased the interaction between QN and the erythrocyte and this mechanism is responsible for the drug's increased efficacy when nanoencapsulated.

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Section: Introductionmentioning

confidence: 99%

Nanoencapsulation increases quinine antimalarial efficacy against Plasmodium berghei in vivo

Haas

Bettoni

Oliveira

et al. 2009

International Journal of Antimicrobial Agents

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“…In addition to its impact on the health of individuals, malaria places considerable costs on households [2]–[4], communities [5] and nations [6], [7].…”

Section: Introductionmentioning

confidence: 99%

Determinants of the Cost-Effectiveness of Intermittent Preventive Treatment for Malaria in Infants and Children

et al. 2011

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BackgroundTrials of intermittent preventive treatment in infants (IPTi) and children (IPTc) have shown promising results in reducing malaria episodes but with varying efficacy and cost-effectiveness. The effects of different intervention and setting characteristics are not well known. We simulate the effects of the different target age groups and delivery channels, seasonal or year-round delivery, transmission intensity, seasonality, proportions of malaria fevers treated and drug characteristics.MethodsWe use a dynamic, individual-based simulation model of Plasmodium falciparum malaria epidemiology, antimalarial drug action and case management to simulate DALYs averted and the cost per DALY averted by IPTi and IPTc. IPT cost components were estimated from economic studies alongside trials.ResultsIPTi and IPTc were predicted to be cost-effective in most of the scenarios modelled. The cost-effectiveness is driven by the impact on DALYs, particularly for IPTc, and the low costs, particularly for IPTi which uses the existing delivery strategy, EPI. Cost-effectiveness was predicted to decrease with low transmission, badly timed seasonal delivery in a seasonal setting, short-acting and more expensive drugs, high frequencies of drug resistance and high levels of treatment of malaria fevers. Seasonal delivery was more cost-effective in seasonal settings, and year-round in constant transmission settings. The difference was more pronounced for IPTc than IPTi due to the different proportions of fixed costs and also different assumed drug spacing during the transmission season. The number of DALYs averted was predicted to decrease as a target five-year age-band for IPTc was shifted from children under 5 years into older ages, except at low transmission intensities.ConclusionsModelling can extend the information available by predicting impact and cost-effectiveness for scenarios, for outcomes and for multiple strategies where, for practical reasons, trials cannot be carried out. Both IPTi and IPTc are generally cost-effective but could be rendered cost-ineffective by characteristics of the setting, drug or implementation.

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“…Also available now are updated estimates on the prevalence of malnutrition; new intervention coverage estimates made available by Countdown-to-2015 2 ; updated price estimates from the WHO-CHOICE project 3 and updated estimates of the resources needed to scale up immunization, 4 malaria 5 and prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) programmes. 6 Although global price estimates for the scale-up of packages of selected child health interventions are regularly published, 7,8 to our knowledge none has been empirically validated against existing country data.…”

Section: Introductionmentioning

confidence: 99%