PDF(Pubmed)
Abstract：
BACKGROUND: Malaria continues to be a public health problem in South Africa. While the disease is mainly confined to three of the nine provinces, most local transmissions occur because of importation of cases from neighbouring countries. The government of South Africa has reiterated its commitment to eliminate malaria within its borders. To support the achievement of this goal, this study presents a cost-benefit analysis of malaria elimination in South Africa through simulating different scenarios aimed at achieving malaria elimination within a 10-year period.
METHODS: A dynamic mathematical transmission model was developed to estimate the costs and benefits of malaria elimination in South Africa between 2018 and 2030. The model simulated a range of malaria interventions and estimated their impact on the transmission of Plasmodium falciparum malaria between 2018 and 2030 in the three endemic provinces of Limpopo, Mpumalanga and KwaZulu-Natal. Local financial, economic, and epidemiological data were used to calibrate the transmission model.
RESULTS: Based on the three primary simulated scenarios: Business as Usual, Accelerate and Source Reduction, the total economic burden was estimated as follows: for the Business as Usual scenario, the total economic burden of malaria in South Africa was R 3.69 billion (USD 223.3 million) over an 11-year period (2018-2029). The economic burden of malaria was estimated at R4.88 billion (USD 295.5 million) and R6.34 billion (~ USD 384 million) for the Accelerate and Source Reduction scenarios, respectively. Costs and benefits are presented in midyear 2020 values. Malaria elimination was predicted to occur in all three provinces if the Source Reduction strategy was adopted to help reduce malaria rates in southern Mozambique. This could be achieved by limiting annual local incidence in South Africa to less than 1 indigenous case with a prediction of this goal being achieved by the year 2026.
CONCLUSIONS: Malaria elimination in South Africa is feasible and economically worthwhile with a guaranteed positive return on investment (ROI). Findings of this study show that through securing funding for the proposed malaria interventions in the endemic areas of South Africa and neighbouring Mozambique, national elimination could be within reach in an 8-year period.
METHODS: A dynamic mathematical transmission model was developed to estimate the costs and benefits of malaria elimination in South Africa between 2018 and 2030. The model simulated a range of malaria interventions and estimated their impact on the transmission of Plasmodium falciparum malaria between 2018 and 2030 in the three endemic provinces of Limpopo, Mpumalanga and KwaZulu-Natal. Local financial, economic, and epidemiological data were used to calibrate the transmission model.
RESULTS: Based on the three primary simulated scenarios: Business as Usual, Accelerate and Source Reduction, the total economic burden was estimated as follows: for the Business as Usual scenario, the total economic burden of malaria in South Africa was R 3.69 billion (USD 223.3 million) over an 11-year period (2018-2029). The economic burden of malaria was estimated at R4.88 billion (USD 295.5 million) and R6.34 billion (~ USD 384 million) for the Accelerate and Source Reduction scenarios, respectively. Costs and benefits are presented in midyear 2020 values. Malaria elimination was predicted to occur in all three provinces if the Source Reduction strategy was adopted to help reduce malaria rates in southern Mozambique. This could be achieved by limiting annual local incidence in South Africa to less than 1 indigenous case with a prediction of this goal being achieved by the year 2026.
CONCLUSIONS: Malaria elimination in South Africa is feasible and economically worthwhile with a guaranteed positive return on investment (ROI). Findings of this study show that through securing funding for the proposed malaria interventions in the endemic areas of South Africa and neighbouring Mozambique, national elimination could be within reach in an 8-year period.
摘要：
背景：疟疾仍然是南非的公共卫生问题。虽然这种疾病主要局限于九个省份中的三个，大多数本地传播是由于从邻国输入病例而发生的。南非政府重申了在其境内消除疟疾的承诺。为了支持这一目标的实现，本研究通过模拟旨在在10年内实现消除疟疾的不同情景,对南非消除疟疾的成本效益进行了分析.
方法：开发了一种动态数学传递模型，以估算2018年至2030年南非消除疟疾的成本和收益。该模型模拟了一系列疟疾干预措施，并估计了它们对2018年至2030年在林波波三个流行省份传播恶性疟原虫疟疾的影响。姆普马兰加和夸祖鲁-纳塔尔。地方财政,经济,和流行病学数据用于校准传播模型。
结果：基于三个主要的模拟场景：加速和减少来源，总经济负担估计如下：对于正常情况下的业务，在11年期间(2018-2029年),南非疟疾的总经济负担为36.9亿雷亚尔(2.233亿美元).疟疾的经济负担估计为48.8亿兰特（2.955亿美元）和加速和源头减少情景的63.4亿兰特（约3.84亿美元），分别。成本和收益以2020年年中的值表示。如果采用减少来源战略来帮助降低莫桑比克南部的疟疾发病率，预计所有三个省都将消除疟疾。这可以通过将南非当地的年度发病率限制在不到1例土著病例来实现，并预测到2026年将实现这一目标。
结论：在南非消除疟疾是可行的，在经济上是值得的，并保证了积极的投资回报（ROI）。这项研究的结果表明，通过为南非和邻国莫桑比克的流行地区拟议的疟疾干预措施获得资金，全国淘汰可以在8年内实现。
方法：开发了一种动态数学传递模型，以估算2018年至2030年南非消除疟疾的成本和收益。该模型模拟了一系列疟疾干预措施，并估计了它们对2018年至2030年在林波波三个流行省份传播恶性疟原虫疟疾的影响。姆普马兰加和夸祖鲁-纳塔尔。地方财政,经济,和流行病学数据用于校准传播模型。
结果：基于三个主要的模拟场景：加速和减少来源，总经济负担估计如下：对于正常情况下的业务，在11年期间(2018-2029年),南非疟疾的总经济负担为36.9亿雷亚尔(2.233亿美元).疟疾的经济负担估计为48.8亿兰特（2.955亿美元）和加速和源头减少情景的63.4亿兰特（约3.84亿美元），分别。成本和收益以2020年年中的值表示。如果采用减少来源战略来帮助降低莫桑比克南部的疟疾发病率，预计所有三个省都将消除疟疾。这可以通过将南非当地的年度发病率限制在不到1例土著病例来实现，并预测到2026年将实现这一目标。
结论：在南非消除疟疾是可行的，在经济上是值得的，并保证了积极的投资回报（ROI）。这项研究的结果表明，通过为南非和邻国莫桑比克的流行地区拟议的疟疾干预措施获得资金，全国淘汰可以在8年内实现。
