Department of Global Health, University of Washington, Seattle, WA 98104, USA.
Glob Health Action. 2013 Mar 1;6:1-9. doi: 10.3402/gha.v6i0.20056.
Supplementary immunization activity (SIA) campaigns provide children with an additional dose of measles vaccine and deliver other interventions, including vitamin A supplements, deworming medications, and oral polio vaccines.
To assess the cost-effectiveness of the full SIA delivery platform in South Africa (SA).
We used an epidemiologic cost model to estimate the cost-effectiveness of the 2010 SIA campaign. We used province-level campaign data sourced from the District Health Information System, SA, and from planning records of provincial coordinators of the Expanded Programme on Immunization. The data included the number of children immunized with measles and polio vaccines, the number of children given vitamin A supplements and Albendazole tablets, and costs.
The campaign cost $37 million and averted a total of 1,150 deaths (95% uncertainty range: 990-1,360). This ranged from 380 deaths averted in KwaZulu-Natal to 20 deaths averted in the Northern Cape. Vitamin A supplementation alone averted 820 deaths (95% UR: 670-1,040); measles vaccination alone averted 330 deaths (95% UR: 280-370). Incremental cost-effectiveness was $27,100 (95% UR: $18,500-34,400) per death averted nationally, ranging from $11,300 per death averted in the Free State to $91,300 per death averted in the Eastern Cape.
Cost-effectiveness of the SIA child health delivery platform varies substantially across SA provinces, and it is substantially more cost-effective when vitamin A supplementation is included in the interventions administered. Cost-effectiveness assessments should consider health system delivery platforms that integrate multiple interventions, and they should be conducted at the sub-national level.
补充免疫活动（SIA）为儿童提供了一剂额外的麻疹疫苗，并提供了其他干预措施，包括维生素 A 补充剂、驱虫药物和口服脊髓灰质炎疫苗。
评估南非（SA）全面 SIA 交付平台的成本效益。
我们使用流行病学成本模型来估计 2010 年 SIA 运动的成本效益。我们使用了从 District Health Information System（南非）获取的省级运动数据以及省级扩大免疫规划协调员的规划记录。这些数据包括接受麻疹和脊髓灰质炎疫苗免疫的儿童人数、接受维生素 A 补充剂和阿苯达唑片的儿童人数以及成本。
该运动耗资 3700 万美元，总共避免了 1150 人死亡（95%不确定范围：990-1360）。从夸祖鲁-纳塔尔省避免了 380 人死亡到北开普省避免了 20 人死亡不等。仅维生素 A 补充剂就避免了 820 人死亡（95%不确定范围：670-1040）；麻疹疫苗接种单独避免了 330 人死亡（95%不确定范围：280-370）。全国范围内，每避免 1 人死亡的增量成本效益为 27100 美元（95%不确定范围：18500-34400），从自由州每避免 1 人死亡的 11300 美元到东开普省每避免 1 人死亡的 91300 美元不等。
SIA 儿童保健交付平台在南非各省的成本效益差异很大，当干预措施中包括维生素 A 补充剂时，其成本效益大大提高。成本效益评估应考虑整合多种干预措施的卫生系统交付平台，并应在国家以下一级进行。
