在埃塞俄比亚，气泡持续气道正压通气治疗五岁以下儿童重症肺炎和低氧血症的成本效益
Cost-effectiveness of bubble continuous positive airway pressure in treating severe pneumonia and hypoxaemia in under-five children in Ethiopia.
摘要(中文译文)
肺炎是可预防和可治疗的，但它仍然是五岁以下儿童患病和死亡的主要感染性原因。气泡持续气道正压（bCPAP）为氧疗联合适当抗生素及其他支持性治疗提供了一种有前景的选择。然而，在埃塞俄比亚等资源有限环境中，bCPAP的成本效果尚未见文献记载。我们旨在评估bCPAP在埃塞俄比亚五岁以下儿童重症肺炎和低氧血症治疗中的成本效果。我们构建了一个决策分析模型（决策树），以确定在综合医院中本地制造的bCPAP与标准治疗（世界卫生组织推荐的低流量氧疗）相比的成本效果。效果以避免的儿童死亡数和伤残调整生命年（DALYs）来衡量。成本数据提取自已发表的文献和当地市场。计算增量成本效果比（ICER），并参照以埃塞俄比亚人均GDP倍数（0.34、1和3）设定的支付意愿（WTP）阈值进行评估。进行敏感性分析以检验结果的稳健性。对于每10,000名重症肺炎和低氧血症儿童，与标准治疗相比，使用本地制造的bCPAP提供氧疗将额外挽救31名儿童的生命。本地制造的bCPAP每避免一个DALY的ICER为139.5美元。所进行的敏感性分析显示这些结果是稳健的，在埃塞俄比亚人均GDP一倍时具有100%的成本效果概率。本地制造的bCPAP对于埃塞俄比亚综合医院五岁以下儿童重症肺炎和低氧血症的治疗是一项极具成本效果的干预措施。这些发现为决策者支持和扩大bCPAP在埃塞俄比亚及其他类似低收入和中等收入国家的使用提供了关键证据。
Abstract
Pneumonia is preventable and treatable, yet it remains the leading infectious cause of illness and death among under-five children. Bubble continuous positive airway pressure (bCPAP) offers a promising option for oxygen therapy combined with appropriate antibiotics and other supportive care. However, the cost-effectiveness of bCPAP in resource-limited settings such as Ethiopia is not documented. We aimed to evaluate the cost-effectiveness of bCPAP in treating severe pneumonia and hypoxaemia in under-five children in Ethiopia. We developed a decision-analytical model (decision tree) to determine the cost-effectiveness of a locally made bCPAP compared with the standard of care (WHO-recommended low-flow oxygen therapy) in general hospitals. Effectiveness was measured as the number of child deaths and disability adjusted life years (DALYs) averted. Cost data were extracted from published literature and local markets. The incremental cost-effectiveness ratio (ICER) was calculated and evaluated against the willingness-to-pay (WTP) thresholds set at multiples (0.34, 1, and 3) of Ethiopia's GDP per capita. Sensitivity analyses were performed to test the robustness of the results. For every 10,000 children with severe pneumonia and hypoxaemia, providing oxygen using locally made bCPAP will save an additional 31 children compared to the standard of care. A locally made bCPAP has an ICER of 139.5 USD per DALY averted. These results were robust in the sensitivity analysis performed, showing a 100% probability of being cost-effective at one times the GDP per capita of Ethiopia. A locally made bCPAP is a highly cost-effective intervention for treating severe pneumonia and hypoxaemia in under-five children in Ethiopian general hospitals. These findings provide critical evidence for decision-makers to support and scale-up use of bCPAP in Ethiopia and other similar low and middle income countries.
如何引用
AMA
Abdi Gari Negasa, Firew Tekle Bobo, Meseret Gebre, Tsinuel Nigatu, Mirkuzie Woldie, Mideksa Adugna Koricho, et al. Cost-effectiveness of bubble continuous positive airway pressure in treating severe pneumonia and hypoxaemia in under-five children in Ethiopia.. PloS one. 2026; doi:10.1371/journal.pone.0352122.
APA
Abdi Gari Negasa, Firew Tekle Bobo, Meseret Gebre, Tsinuel Nigatu, Mirkuzie Woldie, Mideksa Adugna Koricho, et al (2026). Cost-effectiveness of bubble continuous positive airway pressure in treating severe pneumonia and hypoxaemia in under-five children in Ethiopia.. PloS one. https://doi.org/10.1371/journal.pone.0352122
GB/T 7714
Abdi Gari Negasa, Firew Tekle Bobo, Meseret Gebre, Tsinuel Nigatu, Mirkuzie Woldie, Mideksa Adugna Koricho, et al. Cost-effectiveness of bubble continuous positive airway pressure in treating severe pneumonia and hypoxaemia in under-five children in Ethiopia.[J]. PloS one, 2026 doi:10.1371/journal.pone.0352122.
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