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19. Diarrheal Diseases

Table 19.1: Cost and Effectiveness Values Used to Calculate Cost-Effectiveness Ratios for Select Interventions for Diarrhea for Children under Age Five

Cost and Effectiveness Values Used to Calculate Cost-Effectiveness Ratios for Select Interventions for Diarrhea for Children under Age Five
Model regionsSourcesSource regions or countriesMedian cost/child (2001 US$)Cost/child range (2001 US$)Median diarrhea morbidity reduction (percent)Morbidity reduction range (percent)Median diarrhea mortality reduction (percent)Mortality reduction range (percent)
Breastfeeding promotion
Costs
LMICs, EAP, MENA, SA, SSAHorton and others 1996; Martinez, Phillips, and Feachem 1993LMICs, Brazil, Honduras, Mexico8.980.46-17.50
LACHorton and others 1996Brazil, Honduras, Mexico1.860.46-3.26
Effectiveness (age 0 to 5)
AllFeachem and Koblinsky 1984LMICs4.51-810.54-17
Rotavirus immunization with RRV-TV
Costs
LMICs, EAP, LAC,Martinez, Phillips, andLMICs, India53.803.33-104.30
MENA, SSAFeachem 1993; Narula, Tiwari, and Puliyeh 2004
SANarula, Tiwari, and Puliyeh 2004India104.30—
Effectiveness (age 0 to 5)
AllParashar and others 1998aBrazil, Peru, R. B. de Venezuela8.54—24.1—
Cholera immunization with live oral vaccine
Costs
LMICs, EAP, MENA, SA, SSACookson and others 1997; Martinez, Phillips, and Feachem 1993LMICs, Argentina3.651.70-5.60
LACCookson and others 1997Argentina1.70—
Effectiveness (age 0 to 5)
Allde Zoysa and Feachem 1985Bangladesh0.0950.06-0.131.51-2
Measles immunization
Costs
LMICs, LAC, MENA, SADuke 1999; Feachem and Koblinsky 1983; Phillips, Feachem, and Mills 1987; Martinez, Phillips, and Feachem 1993; Shann 2000LMICs, Cote d'Ivoire, Ghana, Indonesia, Papua New Guinea, Zambia13.260.52-26.00
EAPDuke 1999; Phillips, Feachem, and Mills 1987; Shann 2000Indonesia, Papua New Guinea1.620.52-1.10
SSAFeachem and Koblinsky 1983; Phillips, Feachem, and Mills 1987Cote d'Ivoire, Ghana, Zambia15.004.00-26.00
Effectiveness (age 0 to 5)
AllFeachem and Koblinsky 1983LMICs2.20.6-3.8166.4-25.6
Water supply and sanitation improvement
Costs (rural)
AllEsrey, Feachem, and Hughes 1985LMICs25.00—
Costs (urban)
AllEsrey, Feachem, and Hughes 1985LMICs81.00—
Effectiveness (age 0 to 5)
AllEsrey, Feachem, and Hughes 1985; Esrey and others 1991LMICs2422-2665—
Oral rehydration therapy
Costs
LMICsHorton and Claquin 1983; Islam, Mahalanabis, and Majid 1994; Qualls and Robertson 1989; Shepard, Brenzel, and Nemeth 1986; WHO and UNICEF 2001Bangladesh, Arab Rep. of Egypt, The Gambia, Honduras, Indonesia, Malawi, Swaziland, Turkey5.500.02-11.00
EAPShepard, Brenzel, and Nemeth 1986Indonesia0.710.02-1.40
LACShepard, Brenzel, and Nemeth 1986Honduras2.590.02-5.16
MENAShepard, Brenzel, and Nemeth 1986Arab Rep. of Egypt4.890.02-9.75
SAHorton and Claquin 1983; Islam, Mahalanabis, and Majid 1994Bangladesh2.910.02-5.80
SSAShepard, Brenzel, and Nemeth 1986; Qualls and Robertson 1989The Gambia, Malawi, Swaziland5.510.02-11.00
Effectiveness (age 0 to 5)
AllBoschi-Pinto and Tomaskovic forthcomingLMICs0—95—

Source: Authors.

LMICs = low- and middle-income countries; EAP = East Asia and the Pacific; LAC = Latin America and the Caribbean; MENA = Middle East and North Africa; SA = South Asia; SSA = Sub-Saharan Africa; — = not available.

a. Effectiveness calculated based on vaccine efficacy reported in Parashar and others (1998) and under the assumption that rotavirus infection is responsible for 20 percent of all diarrheal morbidity and severe infection is responsible for 33.3 percent of all diarrheal mortality.

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