Summary of Personal Interventions| Condition | Intervention | Intervention description | Intervention setting | Objective | Target populationa | Cost-effectiveness (US$/DALY) | Cost-effectiveness rangeb (US$/DALY) | Number of DALYs avertedb (hundreds) | Number of deaths avertedb | Quality of cost-effectiveness analysis evidencec |
| African trypanosomiasis | Case finding and treatment | Identification and treatment of Trypanosoma brucei gambiense using the card agglutination try-panosomiasis test with parasitological confirmation, allowing for rapid diagnosis and treatment | Clinic | Primary prevention, cure | All ages | 15 (Sub-Saharan Africa) | — | — | — | 2 (Sub-Saharan Africa) |
| African trypanosomiasis | Melarsoprol | Used in the second stage of the disease | Clinic | Secondary prevention | All ages | 10 (Sub-Saharan Africa) | — | — | — | 2 (Sub-Saharan Africa) |
| African trypanosomiasis | Eflornithine | Used in the second stage of the disease | Clinic | Secondary prevention | All ages | 20 (Sub-Saharan Africa) | — | — | — | 2 (Sub-Saharan Africa) |
| Alcohol abuse | Brief advice to heavy drinkers by primary health care providers | During primary health care visits, provision of advice by physicians through education sessions and psychosocial counseling | Clinic | Primary prevention | Adolescents and adults | 642 | — | 1.75 | — | 5 |
| Bipolar disorder | Lithium, valproate, with optional psychosocial treatment, hospital-based | Episodic treatment in a hospital setting with lithium or valproate with or without maintenance or episodic psychosocial treatment | District or referral hospital | Secondary prevention | Adults over 15 | 4,417 | 3,590-5,244 | 1.00 | — | 5 |
| Bipolar disorder | Lithium, valproate, with optional psychosocial treatment, community-based | Episodic treatment of bipolar disorder in a community setting using lithium or valproate with or without maintenance or episodic psychosocial treatment | District or referral hospital | Secondary prevention | Adults over 15 | 3,113 | 2,498-3,728 | 1.35 | — | 5 |
| Cataract | Extracapsular surgery | Extracapsular cataract extraction with implantation of a posterior chamber intraocular lens; removal of the lens and the front portion of the capsule, which are then replaced with an artificial lens | District or referral hospital | Cure | Adults over 40 | 183 | — | — | — | 3 |
| Congestive heart failure | ACE inhibitor and beta-blocker, with diuretics | Use of ACE inhibitor and an optional beta-blocker (metoprolol), incremental to diuretics | District hospital | Secondary prevention | Adults | 150 | 27-274 | 11.59 | — | 5 |
| Dengue | Improved case management | No specific treatment: early recognition of symptoms such as intense continuous abdominal pain, persistent vomiting, restlessness or lethargy; supportive treatment includes fluid replacement and electrolytic therapy | Clinic or district hospital | Acute management | All ages | 587 | — | — | — | 2 |
| Depression | Drugs with optional episodic or maintenance psychosocial treatment | Antidepressant drugs (tricyclic antidepressant or selective serotonin reuptake inhibitor) used alone or in combination with psychosocial treatment for episodic depression or maintenance treatment | District or referral hospital | Secondary prevention | Adults over 15 | 1,699 | 657-2,741 | 3.96 | — | 5 |
| Diarrheal disease | Oral rehydration therapy for package costing US$5.50 per episode | Case management of acute diarrheal infection with oral rehydration salt solutions, for package costing US$5.50 per child per episode | Clinic | Acute management | Children | 1,062 | — | 16.57 | 58.20 | 5 |
| Epilepsy | First-line treatment with Phenobarbital | First line treatment with phenobarbital to treat epilepsy patients | District hospital | Secondary prevention | All ages | 89 | — | 2.99 | 3.32 | 5 |
| Epilepsy(refractory) | Second-line treatment with phenobarbital and lamotrigine or surgery | Antiepileptic drugs, phenobarbital and lamotrigine, or a combination of phenobarbital and surgery to treat epilepsy patients unresponsive to phenobarbital | Referral hospital | Secondary prevention | All ages | 3,027 | 2,994-3,060 | 0.29 | 0.32 | 5 |
| HIV/AIDS | Mother-to-child transmission prevention | All pregnant women offered screening to prevent mother-to-child transmission; administration of a short-course of AZT, lamivudine, or nevirapine to mothers prepartum and intrapartum and to newborns postpartum to reduce the risk of mother-to-child transmission; also includes breastfeeding advice | Clinic | Primary prevention | Mothers and infants | 192 | 7-377 | — | — | 2 |
| HIV/AIDS | Sexually transmitted infection diagnosis and treatment | Sexually transmitted infection screening and treatment promotion to prevent future infection and to identify and treat high-risk populations | Clinic | Primary prevention, cure | Adolescents | 57 (Sub-Saharan Africa) | 9-105 (Sub-Saharan Africa) | — | — | 2 (Sub-Saharan Africa) |
| HIV/AIDS | Treatment of Kaposi's sarcoma | Treatment before or after anti-retroviral treatment, including failed antiretroviral treatment; local or systemic treatment of lesions to provide largely cosmetic benefit | Clinic or district hospital | Primary prevention, palliation | All ages | 52,449 | 34,968-69,930 | — | — | 3 |
| HIV/AIDS | Treatment of opportunistic infections | Opportunistic infection prophylaxis; necessary for patients without access to antiretroviral treatment, for immunosuppressed patients waiting for antiretroviral treatment to take effect, for patients who refuse or cannot take antiretroviral treatment, for patients for whom antiretroviral treatment fails, and for groups of patients who are unable to recover sufficient CD4 cells despite good inhibition of viral replication | Clinic or district hospital | Primary prevention, cure | All ages | 156 | 3-310 | — | — | 3 |
| HIV/AIDS | Tuberculosis coinfection prevention and treatment | Preventive therapy, short-course chemotherapy, or co-trimoxazole prophylaxis | Clinic | Primary prevention, cure | All ages | 121 (Sub-Saharan Africa) | 6-235 (Sub-Saharan Africa) | — | — | 2 (Sub-Saharan Africa) |
| HIV/AIDS | Home care | Home visits providing basic care to sick AIDS patients or comprehensive schemes that provide palliative care, nutrition, psychosocial support and counseling, and links to primary and secondary health care | Household | Secondary prevention, palliation | All ages | 673 (Sub-Saharan Africa) | — | — | — | 2 (Sub-Saharan Africa) |
| HIV/AIDS | Antiretroviral therapy | Combination therapy with multiple antiretroviral drugs associated with prolonged survival in treated patients | Clinic | Primary prevention | All ages | 922 (Sub-Saharan Africa) | 350-1,494 (Sub-Saharan Africa) | — | — | 3 (Sub-Saharan Africa) |
| Integrated management of childhood illness | Integrated management of childhood illness | Integration of effective interventions to improve child health and nutrition into a coordinated strategy by improving health worker performance, child health service delivery, and family and community practices | Clinic | Primary prevention, secondary prevention, cure | Children | 39 (Sub-Saharan Africa) | — | — | — | 3 (Sub-Saharan Africa) |
| Ischemic heart disease | Aspirin, beta-blocker, and optional ACE inhibitor | Aspirin plus beta-blocker(atenolol) with optional ACE inhibitor (enalapril), with or with-out hospital availability | District or referral hospital | Secondary prevention | Adults | 688 | 451-926 | 8.40 | — | 5 |
| Ischemic heart disease | Statin, with aspirin, beta-blocker and ACE inhibitor | Statin (lovastatin), incremental to aspirin, beta-blocker(atenolol), and ACE inhibitor(enalapril), with or without hospital availability | District or referral hospital | Secondary prevention | Adults | 2,028 | 1,864-2,193 | 3.54 | — | 5 |
| Ischemic heart disease | Coronary artery bypass graft | Placement of grafts (usually saphenous vein or internal mammary artery) to bypass stenosed coronary arteries, while maintaining cerebral and peripheral circulation by cardiopulmonary bypass | Referral hospital | Secondary prevention | Adults | 36,793 | — | 0.76 | — | 5 |
| Leishmaniasis | Case finding and treatment | Combination of identification and treatment, vector control where feasible, and (in zoonotic foci) control of animal reservoirs | Clinic or district hospital | Primary prevention | All ages | 9 | — | — | — | 2 |
| Lower acute respiratory infections (nonsevere) | Case management at community or facility level | Nonsevere infection diagnosed by breath rate and treated by a community health worker or at a health facility, with amoxicillin, acetaminophen, and possibly salbutamol | Clinic, community | Cure | Children under 5 | 129 | 50-208 | 5.15 | 17.36 | 5 |
| Lower acute respiratory infections (severe and very severe) | Case management at hospital level | Severe or very severe infection diagnosed by breath rate and with x-ray tests and treated at a hospital with antibiotics and possibly salbutamol, oxygen, and prednisolone | District hospital | Cure | Children under 5 | 4,530 | 2,916-6,144 | 0.48 | 1.57 | 5 |
| Lower acute respiratory infections | Case-management package at community, facility, and hospital levels | Comprehensive case-management strategy covering nonsevere infection being treated by a community health worker or at a health facility, severe infection treated at a hospital, and very severe infection treated at a hospital | Clinic or district hospital | Cure | Children under 5 | 398 | — | 11.26 | 37.86 | 5 |
| Malaria | Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine | Intermittent preventive treatment in areas with high and stable transmission of Plasmodium falciparum malaria; two curative doses of sulfadoxine-pyrimethamine given during the second and third trimesters of pregnancy during prenatal care visits | Clinic | Primary prevention | Pregnant women | 19 (Sub-Saharan Africa) | 13-24 (Sub-Saharan Africa) | 208.00 (Sub-Saharan Africa) | 827.80 (Sub-Saharan Africa) | 5 (Sub-Saharan Africa) |
| Malaria | Intermittent preventive treatment in pregnancy with drug other than sulfadoxine-pyrimethamine | Intermittent preventive treatment in areas with high and stable transmission of Plasmodiumfalciparum malaria; two curative doses of antimalarial treatment given with a possible change in first-line therapies from chloroquine to sulfadoxine-pyrimethamine, chloroquine to artemisinin combination therapy, or sulfadoxine-pyrimethamine to artemisinin combination therapy | Clinic | Primary prevention | Pregnant women | 7 (Sub-Saharan Africa) | 2-11 (Sub-Saharan Africa) | — | 77,500.00 (Sub-Saharan Africa) | 5 (Sub-Saharan Africa) |
| Maternal mortality | Increased primary care coverage | Increased percentage of women accessing routine prenatal, intranatal, and postnatal care | Clinic or district hospital | Primary prevention | Pregnant women | 132 (South Asia), 88 (Sub-Saharan Africa) | — | 13.09 (South Asia), 27.88 (Sub-Saharan Africa) | 32.00 (South Asia), 77.00 (Sub-Saharan Africa) | 5 (South Asia), 5 (Sub-Saharan Africa) |
| Maternal mortality | Improved quality of comprehensive emergency obstetric care | Increased percentage of women with severe complications receiving comprehensive emergency obstetric care | Clinic or district hospital | Acute management | Pregnant women | 127 (South Asia), 87 (Sub-Saharan Africa) | — | 13.28 (South Asia), 28.28(Sub-Saharan Africa) | 32.00 (South Asia), 78.00 (Sub-Saharan Africa) | 5 (South Asia), 5 (Sub-Saharan Africa) |
| Maternal mortality | Improved overall quality of care | Improvements to quality of prenatal and delivery care; enhanced package including availability of doctor and full range of basic and comprehensive emergency obstetric care(all six essential obstetric functions: administering antibiotics intravenously or intramuscularly, administering oxytocics intravenously or intramuscularly, manually removing the placenta, administering anticonvulsants intravenously or intramuscularly, carrying out instrumental delivery, and removing retained products of conception; optional nutritional supplementation | Clinic | Primary prevention, acute management | Pregnant women | 147 (South Asia), 83 (Sub-Saharan Africa) | 133-160 (South Asia), 82-85 (Sub-Saharan Africa) | 21.90 (South Asia), 53.05(Sub-Saharan Africa) | 56.20 (South Asia), 153.20(Sub-Saharan Africa) | 5 (South Asia), 5 (Sub-Saharan Africa) |
| Maternal mortality | Improved quality of care and coverage | Improvements to quality of prenatal and delivery care and increase in the proportion of women receiving needed care; enhanced package including availability of doctor and full range of basic and comprehensive emergency obstetric care(all six essential obstetric functions noted above); optional nutritional supplementation | Clinic | Primary prevention, acute management | Pregnant women | 152 (South Asia), 86 (Sub-Saharan Africa) | 138-167 (South Asia), 85-86 (Sub-Saharan Africa) | 23.51 (South Asia), 56.93(Sub-Saharan Africa) | 60.29 (South Asia), 164.14(Sub-Saharan Africa) | 5 (South Asia), 5 (Sub-Saharan Africa) |
| Myocardial infarction | Aspirin and beta-blocker | Aspirin with or without beta-blocker (atenolol) | District or referral hospital | Acute management | Adults | 14 | 13-15 | 1.04 | — | 5 |
| Myocardial infarction | Streptokinase, with aspirin and beta-blocker | Incremental use of streptokinase, in addition to aspirin and beta-blocker (atenolol) | District or referral hospital | Acute management | Adults | 671 | — | 1.04 | — | 5 |
| Myocardial infarction | Tissue plasminogen activator, with aspirin and beta-blocker | Incremental use of tissue plasminogen activator in addition to aspirin and beta-blocker(atenolol) | District hospital | Acute management | Adults | 15,869 | — | 0.42 | — | 5 |
| Myocardial infarction and stroke | Polypill | Combination treatment with aspirin, beta-blocker, thiazide diuretic, ACE inhibitor and statin, based on 10-year risk of cardio-vascular disease | District hospital | Secondary prevention | Adults | 409 | — | — | — | 5 |
| Neonatal mortality | Maternal and child health package with no neonatal care after birth | Mother and child health package that includes family planning, prenatal care, and comprehensive obstetric care | Clinic or district hospital | Primary prevention | Mothers and infants | 1,060 (South Asia), 924 (Sub-Saharan Africa) | — | — | — | 4 (South Asia), 5 (Sub-Saharan Africa) |
| Neonatal mortality | Family, community, or clinical neonatal package | Healthy home care practices, including exclusive breastfeeding, warmth protection, clean cord care, care seeking for emergencies; if birth outside a facility, then clean delivery kit | Clinic, community or household | Primary prevention | Mothers and infants | 349 (South Asia), 345 (Sub-Saharan Africa) | 305-394 (South Asia), 338-351(Sub-Saharan Africa) | — | — | 4 (South Asia), 5 (Sub-Saharan Africa) |
| Neonatal mortality | Combined maternal and child health with neonatal packages | Family planning, prenatal care, and comprehensive obstetric care packages, as well as healthy home care practices, including exclusive breastfeeding, warmth protection, clean cord care, care seeking for emergencies; if birth outside a facility, then clean delivery kit | Clinic, community or household | Primary prevention | Mothers and infants | 839 (South Asia), 789 (Sub-Saharan Africa) | — | — | — | 4 (South Asia), 5 (Sub-Saharan Africa) |
| Panic disorder | Drugs with optional psychosocial treatment | Anxiolytic drugs (benzodiazepine), tricyclic antidepressants or selective serotonin reuptake inhibitor used with or without psychosocial treatment | District or referral hospital | Secondary prevention | Adults over 15 | 734 | 384-1,084 | 0.83 | — | 5 |
| Parkinson's disease | Ayurvedic treatment and levodopa or carbidopa | Levodopa (l-dopa), carbidopa, or ayurvedic therapy for partial relief of symptoms | District hospital or referral hospital | Secondary prevention | Adults over 45 | 1,132 | 752-1,512 | 0.13 | — | 5 |
| Parkinson's disease | Levodopa or carbidopa and deep brain stimulation | Levodopa or carbidopa and deep brain stimulation | District hospital or referral hospital | Secondary prevention | Adults over 45 | 31,114 | — | 0.15 | — | 5 |
| Schizophrenia | Antipsychotic drugs with optional psychosocial treatment, hospital-based | Maintenance treatment in a hospital setting with antipsychotic drugs, neuroleptic antipsychotic drug, or an atypical antipsychotic drug, with or without psychosocial treatment | District hospital or referral hospital | Secondary prevention | Adults over 15 | 11,920 | 4,105-19,736 | 0.60 | — | 5 |
| Schizophrenia | Antipsychotic drugs with optional psychosocial treatment, community-based | Maintenance treatment in a community-based setting with antipsychotic drugs, neuroleptic antipsychotic drug, or an atypical antipsychotic drug, with or without psychosocial treatment | Community | Secondary prevention | Adults over 15 | 9,834 | 2,472-17,197 | 0.70 | — | 5 |
| Stroke (ischemic) | Aspirin | Aspirin dose within 48 hours of onset of acute stroke | Clinic or district hospital | Acute management | Adults over 15 | 149 | — | 1.62 | 0.12 | 5 |
| Stroke (ischemic) | Heparin and recombinant tissue plasminogen activator | Heparin within 48 hours of onset of stroke or thrombolytic therapy using recombinant tissue plasminogen activator within 3 hours of onset | District hospital | Acute management | Adults over 15 | 1,977 | 1,278-2,675 | 1.22 | 1.70 | 5 |
| Stroke (recurrent) | Aspirin and dipyridamole | Daily aspirin dose or combination of aspirin and extended release dipyridamole | Clinic or district hospital | Secondary prevention | Adults over 15 | 81 | 70-93 | 1.77 | 14.29 | 5 |
| Stroke (recurrent) | Carotid endarterectomy | Carotid endarterectomy surgery to remove harmful plaque from the carotid arteries | Referral hospital | Secondary prevention | Adults over 15 | 1,458 | — | 4.93 | 39.82 | 5 |
| Stroke and ischemic and hypertensive heart disease | Polypill by absolute risk approach | Combination treatment with aspirin, beta-blocker, thiazide diuretic, ACE inhibitor, and statin based on 10-year risk of cardio-vascular disease | District or referral hospital | Primary prevention | Adults | 2,128 | 773-3,483 | 61.65 | — | 5 |
| Tobacco addiction | Nicotine replacement therapy | Smoking cessation treatments in the form of nicotine replacement therapy | Clinic | Primary prevention | Adults | 396 | — | 37.14 | 452.05 | 5 |
| Trachoma | Trichiasis surgery | Trichiasis surgery (eyelid correction) to prevent blindness and reduce likelihood of other conditions | District hospital or referral hospital | Secondary prevention | Adults over 40 | 39 | — | — | — | 3 |
| Trachoma | Tetracycline or azithromycin | Tetracycline or azithromycin to treat the initial trachoma infection through either mass treatment of all children younger than 10 or through targeted treatment of infected children and household members | Clinic | Primary prevention | Children and adults | 6,269 | 3,752-8,785 | — | — | 3 |
| Tuberculosis(endemic) | Management of drug resistance | Introduction of resistance testing, second-line drugs, longer treatment regimen (12-18 months), and rigorous bacteriological and clinical monitoring; standardized or individualized regimen | District hospital | Secondary prevention, cure | Adults over 15 | 318 | 208-429 | — | — | 5 |
| Tuberculosis(endemic, infectious or noninfectious) | Directly observed short-course chemotherapy | Short-course chemotherapy of infectious or noninfectious tuberculosis (with or without transmission, non-HIV-positive), diagnosed via directly observed treatment strategy | Clinic | Primary prevention, cure | Adults over 15 | 301 | 84-551 | — | — | 5 |
| Tuberculosis(endemic, latent) | Isoniazid treatment | Isoniazid treatment of latent infection (with or without x-ray exclusion of active cases; non-HIV-infected population) | District hospital | Secondary prevention | Adults over 15 | 13,158 | 9,450-16,867 | — | — | 5 |
| Tuberculosis(epidemic) | Management of drug resistance | Management of drug resistance(standard regimen) for epidemic TB conducted via introduction of resistance testing, second-line drugs, longer treatment regimen(12-18 months), and rigorous bacteriological and clinical monitoring | District hospital | Secondary prevention, cure | Adults over 15 | 207 | 201-212 | — | — | 5 |
| Tuberculosis(epidemic, infectious) | Directly observed short-course chemotherapy | Short-course chemotherapy of infectious TB (allowing for transmission, non-HIV positive) carried out for epidemic TB | Clinic | Primary prevention, cure | Adults over 15 | 102 | 15-189 | — | — | 5 |
| Tuberculosis (epidemic, latent) | Isoniazid treatment | Isoniazid treatment of latent infection (x-ray exclusion of active cases; non-HIV-positive population) is conducted for epidemic tuberculosis | District hospital | Secondary prevention | Adults over 15 | 197 | 45-348 | — | — | 5 |
| Unwanted pregnancy | Family-planning programs | Intrauterine devices, voluntary sterilization, condoms and other barrier methods, implants, and oral contraceptives | Clinic | Primary prevention | Women of childbearing age | 117 | — | — | — | 3 |
| Zinc deficiency | Supplements with oral rehydration salts | Provision of zinc as an adjunct to oral rehydration salts in treating diarrhea in young children | Clinic or district hospital | Primary prevention | Children under 5 | 73 | — | — | — | 3 |
