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Use of discrete-event simulation to evaluate strategies for the prevention of mother-to-child transmission of HIV in developing countries

Author

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  • M S Rauner

    (University of Vienna)

  • S C Brailsford

    (University of Southampton)

  • S Flessa

    (University of Heidelberg)

Abstract

HIV/AIDS affects over 40 million people worldwide, and more than 70% of these people live in Africa. Mother-to-child transmission of HIV accounts for over 90% of all HIV infections in children under the age of 15 years. However, implementing HIV prevention policies in Africa is extremely difficult because of the poor medical and socio-economic infrastructure. In this paper, we present a discrete-event simulation model that evaluates the relative benefits of two potentially affordable interventions aimed at preventing mother-to-child transmission of HIV, namely anti-retroviral treatment at childbirth and/or bottlefeeding strategies. The model uses rural Tanzanian data and compares different treatment policies. Our results demonstrate that strategic guidelines about breastfeeding are highly dependent on the assumed increase in infant mortality due to bottlefeeding, the efficacy of anti-retroviral treatment at childbirth, and the maternal health stage. The cost of averted infections, though low by Western standards, may represent significant obstacles to policy implementation in developing countries.

Suggested Citation

  • M S Rauner & S C Brailsford & S Flessa, 2005. "Use of discrete-event simulation to evaluate strategies for the prevention of mother-to-child transmission of HIV in developing countries," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(2), pages 222-233, February.
    • Handle: RePEc:pal:jorsoc:v:56:y:2005:i:2:d:10.1057_palgrave.jors.2601884
    DOI: 10.1057/palgrave.jors.2601884
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    Cited by:

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    3. Eren Demir & Christos Vasilakis & Reda Lebcir & David Southern, 2015. "A simulation-based decision support tool for informing the management of patients with Parkinson’s disease," International Journal of Production Research, Taylor & Francis Journals, vol. 53(24), pages 7238-7251, December.
    4. Margaret Brandeau & Gregory Zaric, 2009. "Optimal investment in HIV prevention programs: more is not always better," Health Care Management Science, Springer, vol. 12(1), pages 27-37, March.
    5. M D Stevenson & J E Oakley & S E Chick & K Chalkidou, 2009. "The cost-effectiveness of surgical instrument management policies to reduce the risk of vCJD transmission to humans," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(4), pages 506-518, April.
    6. R M Lebcir & R A Atun & R J Coker, 2010. "System Dynamic simulation of treatment policies to address colliding epidemics of tuberculosis, drug resistant tuberculosis and injecting drug users driven HIV in Russia," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(8), pages 1238-1248, August.
    7. Steffen Flessa, 2009. "Cost effectiveness of antiretrovirals — long term or short term?," Applied Health Economics and Health Policy, Springer, vol. 7(4), pages 225-227, December.
    8. Amir Elalouf & Dmitry Tsadikovich & Sharon Hovav, 2021. "A simulation-based approach for improving the clinical blood sample supply chain," Health Care Management Science, Springer, vol. 24(1), pages 216-233, March.
    9. Reda Lebcir & Rifat Atun, 2021. "Resources management impact on neonatal services performance in the United Kingdom: A system dynamics modelling approach," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(3), pages 793-812, May.
    10. White, Leroy & Smith, Honora & Currie, Christine, 2011. "OR in developing countries: A review," European Journal of Operational Research, Elsevier, vol. 208(1), pages 1-11, January.
    11. Nadia N Abuelezam & Kathryn Rough & George R Seage III, 2013. "Individual-Based Simulation Models of HIV Transmission: Reporting Quality and Recommendations," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.

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