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Cost- effectiveness of a simplified acute malnutrition program: a secondary analysis of the OptiMA randomized clinical trial in the Democratic Republic of the Congo

dc.rights.licenseopenen_US
dc.contributor.authorRESCH, Stephen C
dc.contributor.authorSATO, Ryoko
dc.contributor.authorPHELAN, Kevin
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorCAZES, Cecile
dc.contributor.authorOMBOTIMBE, Abdramane
dc.contributor.authorHUBERT, Victoire
dc.contributor.authorBOUBACAR, Harouna
dc.contributor.authorBOZAMA, Lievin Izie
dc.contributor.authorSAKUBU, Gilbert Tshibangu
dc.contributor.authorTSHIALA, Beatrice Kalenga
dc.contributor.authorTUSUKU, Toussaint
dc.contributor.authorALITANOU, Rodrigue
dc.contributor.authorKOUAME, Antoine
dc.contributor.authorYAO, Cyrille
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorGABILLARD, Delphine
dc.contributor.authorKINDA, Moumouni
dc.contributor.authorBECQUET, Renaud
dc.contributor.authorSHEPHERD, Susan
dc.contributor.authorHECHT, Robert M
dc.date.accessioned2024-12-18T09:25:11Z
dc.date.available2024-12-18T09:25:11Z
dc.date.issued2024-11-08
dc.identifier.issn1460-2237en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/203983
dc.description.abstractEnAcute malnutrition (AM) causes large loss of life and disability in children in Africa. Researchers are testing innovative approaches to increase efficiency of treatment programs. This paper presents results of a cost-effectiveness analysis of one such program in the Democratic Republic of the Congo (DRC) based on a secondary analysis of a randomized controlled trial Optimizing Treatment for Acute Malnutrition (OptiMA), conducted in DRC in 2018-20. 896 children aged 6-59 months with a mid-upper arm circumference (MUAC) <125 mm or with oedema were treated and followed for six months. Cost-effectiveness of OptiMA using ready-to-use therapeutic food (RUTF) at a tapered dose was compared with the standard national program in which severe cases (SAM) received RUTF proportional to weight, and moderate cases (MAM) were referred to another clinic for a fixed dose regimen of ready-to-use supplementary food. Cost analysis from provider perspective used data collected during the trial and from administrative records. Statistical differences were derived using t-tests. The mean cost per enrolled child under OptiMA was $123 [95%CI: 114-132], not statistically different from the standard group ($127 [95%CI: 118-136], p=0.549), while treatment success (i.e. recovery to MUAC > 125mm and no relapse for 6 months) under OptiMA was 9 percentage points higher (72% vs 63%, p=0.004). Among children with SAM at enrollment, there was no significant difference in treatment success between OptiMA and standard (70% vs 62%, p=0.12) but OptiMA's mean cost per enrolled child was 23% lower ($128 vs $166, p<0.0001). OptiMA was more effective at preventing progression to SAM among those enrolled with MAM (5% vs 16%, p<0.0001) with an incremental cost-effectiveness ratio (ICER) of $234 per progression to SAM prevented. Overall, OptiMA had significantly better outcomes and was no more expensive than standard care. Its adoption could enable more children to be successfully treated in contexts where therapeutic food products are scarce.
dc.language.isoENen_US
dc.subject.enCost- effectiveness
dc.subject.enDemocratic Republic of the Congo
dc.subject.enacute malnutrition
dc.subject.enrandomized clinical trial
dc.title.enCost- effectiveness of a simplified acute malnutrition program: a secondary analysis of the OptiMA randomized clinical trial in the Democratic Republic of the Congo
dc.title.alternativeHealth Policy Planen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/heapol/czae106en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed39513752en_US
bordeaux.journalHealth Policy and Planningen_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamGHIGS_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.identifier.funderIDInstitut de Recherche pour le Développementen_US
bordeaux.identifier.funderIDEuropean Civil Protection and Humanitarian Aid Operationsen_US
hal.identifierhal-04844977
hal.version1
hal.date.transferred2024-12-18T09:25:21Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=Health%20Policy%20and%20Planning&amp;rft.date=2024-11-08&amp;rft.eissn=1460-2237&amp;rft.issn=1460-2237&amp;rft.au=RESCH,%20Stephen%20C&amp;SATO,%20Ryoko&amp;PHELAN,%20Kevin&amp;CAZES,%20Cecile&amp;OMBOTIMBE,%20Abdramane&amp;rft.genre=article


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