Comparative impact assessment of child pneumonia interventions
Louis Niessen, Anne ten Hove, Henk Hilderink, Martin Weber, Kim Mulholland & Majid Ezzati
Volume 87, Number 6, June 2009, 472-480
Table 1. Input data for pneumonia intervention effectiveness, estimated health care costs and literature sources, 2005
| Code | Intervention | Effectivenessa low‑high scenario range | Effect level | Source | Costs of intervention low‑high scenario range | Source |
|---|---|---|---|---|---|---|
| Indoor air pollution | ||||||
| E1 | Liquid fuel stoves | RR-based exposure reduction [formula: (1 – (1 ∕ RRl)b) – (1 – (1 ∕ RRh)c)] | Incidence | I$ 8.57–14.47 in AMR Dd per household member, per year | ||
| E2 | Improved solid fuel stoves | RR-based exposure reduction 75% in specific settings | Incidence | I$ 4.82–7.59 in AMR Dd per household member, per year | ||
| Nutrition | ||||||
| N1 | Breastfeeding promotion | 15–23% reduction in infants | Incidence | I$ per child | WHO data sete | |
| N2 | Zinc supplementation | 14–25% (90% CI: 8–30) reduction | Incidence | I$ per child | WHO data sete | |
| Immunization | ||||||
| I1 | Pneumococcal conjugate | 23–35% reduction | Incidence | I$ 19–64 per immunized child | ||
| I2 | Haemophilus influenzae type B | 22–34% reduction | Incidence | I$ 5.83–9.69 per immunized child | ||
| Case management | ||||||
| C1 | Community-based | 34–50% (90% CI: 22–57) for neonatal pneumonia | Case fatality | 1–2 visits of I$ 2.13–9.40 per incident case | ||
| C2 | Facility-based | 29–45% (90% CI: 20–49) | Case fatality | I$ per child | WHO data sete | |
AMR, WHO Region of the Americas; CI, confidence interval; I$, International dollar; RR, relative risk (values from review).
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a Age-specific reductions in exposure among all age groups under 5 years, unless otherwise indicated.
b RRl is the relative risk of pneumonia under low exposure (1.42 in this study).
c RRh is the relative risk of pneumonia under high exposure (2.53 in this study).
d High-tech and low-tech liquid fuel stoves were considered, as well as an improved stove for solid fuels.
23 For the latter, we assumed a 2-year (high-cost scenario) and a 4-year (low-cost scenario) average lifetime. Cost data are WHO-region specific.
e WHO-CHOICE (CHOosing Interventions that are Cost Effective) dataset for child survival interventions (http://www.who.int/choice/en), November 2007. Data are WHO-region specific.