@article{Okell:2014:10.1038/ncomms6606,
author = {Okell, LC and Cairns, M and Griffin, JT and Ferguson, NM and Tarning, J and Jagoe, G and Hugo, P and Baker, M and D'Alessandro, U and Bousema, T and Ubben, D and Ghani, AC},
doi = {10.1038/ncomms6606},
journal = {Nature Communications},
title = {Contrasting benefits of different artemisinin combination therapies as first-line malaria treatments using model-based cost-effectiveness analysis},
url = {http://dx.doi.org/10.1038/ncomms6606},
volume = {5},
year = {2014}
}

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TY  - JOUR
AB  - There are currently several recommended drug regimens for uncomplicated falciparummalaria in Africa. Each has different properties that determine its impact on diseaseburden. Two major antimalarial policy options are artemether–lumefantrine (AL) anddihydroartemisinin–piperaquine (DHA–PQP). Clinical trial data show that DHA–PQP provideslonger protection against reinfection, while AL is better at reducing patient infectiousness.Here we incorporate pharmacokinetic-pharmacodynamic factors, transmission-reducingeffects and cost into a mathematical model and simulate malaria transmission and treatmentin Africa, using geographically explicit data on transmission intensity and seasonality,population density, treatment access and outpatient costs. DHA–PQP has a modestly higherestimated impact than AL in 64% of the population at risk. Given current higher costestimates for DHA–PQP, there is a slightly greater cost per case averted, except in areas withhigh, seasonally varying transmission where the impact is particularly large. We find that alocally optimized treatment policy can be highly cost effective for reducing clinical malariaburden.
AU  - Okell,LC
AU  - Cairns,M
AU  - Griffin,JT
AU  - Ferguson,NM
AU  - Tarning,J
AU  - Jagoe,G
AU  - Hugo,P
AU  - Baker,M
AU  - D'Alessandro,U
AU  - Bousema,T
AU  - Ubben,D
AU  - Ghani,AC
DO  - 10.1038/ncomms6606
PY  - 2014///
SN  - 2041-1723
TI  - Contrasting benefits of different artemisinin combination therapies as first-line malaria treatments using model-based cost-effectiveness analysis
T2  - Nature Communications
UR  - http://dx.doi.org/10.1038/ncomms6606
UR  - http://hdl.handle.net/10044/1/30719
VL  - 5
ER  - 

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