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Table 3 Model results

From: Newborn screening and prophylactic interventions for sickle cell disease in 47 countries in sub-Saharan Africa: a cost-effectiveness analysis

Country name

DALYs averted

Total costs

Incremental cost-effectiveness ration (95 % CI)

Probability that screening is highly cost-effective

Scenario 1: double SCD incidence rate

Scenario 2: double mortality rate

Angola

82,167

$14,874,250

$181 ($115–$710)

99.01 %

$137

$212

Benin

49,138

$7,596,778

$154 ($120–$391)

99.53 %

$120

$178

Botswana

51

$451,506

$8,853 ($4 k–$73 k)b

16.92 %

$5,273

$12,990

Burkina Faso

34,415

$9,652,203

$280 ($197–$497)

99.53 %

$177

$318

Burundi

10,309

$3,607,194

$350 ($241–$607)b

10.78 %

$214

$408

Cameroon

69,142

$12,962,308

$187 ($148–$855)

98.56 %

$139

$219

Cape Verde

196

$116,771

$596 ($363–$2,220)

98.17 %

$342

$723

Central African Republic

9,967

$2,377,372

$239 ($164–$584)

73.16 %

$163

$281

Chad

22,655

$6,738,454

$297 ($199–$601)

99.90 %

$190

$348

Comoros

285

$271,711

$953 ($367–$12,296)b

31.22 %

$517

$1,139

Côte d’Ivoire

35,386

$10,169,638

$287 ($190–$925)

98.36 %

$189

$343

Congo-Brazzaville

15,353

$2,674,621

$174 ($108–$683)

98.37 %

$134

$204

DR Congo

414,120

$62,013,889

$150 ($105–$298)

99.25 %

$117

$171

Djibouti

0

$249,184

n/Aa

0.00 %

n/Aa

n/Aa

Equatorial Guinea

4,060

$586,080

$144 ($98–$323)

99.97 %

$115

$165

Eritrea

139

$1,788,594

$12,852 ($3 K–$125 k)b

0.00 %

$4,368

$14,435

Ethiopia

2,198

$25,480,760

$11,591 ($3–$113 k)b

0.00 %

$4,267

$13,283

Gabon

7,827

$1,175,675

$150 ($103–$989)

95.54 %

$126

$177

Gambia

4,277

$1,021,570

$239 ($160–$770)

93.14 %

$164

$283

Ghana

57,781

$12,272,350

$212 ($144–$635)

99.28 %

$150

$249

Guinea

57,696

$8,528,250

$148 ($100–$320)

99.44 %

$116

$169

Guinea-Bissau

2,021

$786,453

$389 ($238–$1,150)

69.87 %

$239

$466

Kenya

51,539

$18,968,262

$368 ($245–$749)

99.26 %

$225

$435

Lesotho

0

$556,926

n/Aa

0.00 %

n/Aa

n/Aa

Liberia

5,914

$2,037,429

$345 ($219–$1,007

55.39 %

$215

$410

Madagascar

37,917

$9,988,026

$263 ($185–$523)

93.73 %

$172

$307

Malawi

19,335

$8,411,580

$435 ($245–$1,294)b

4.89 %

$258

$513

Mali

29,990

$8,394,677

$280 ($190–$616)

98.29 %

$182

$329

Mauritania

4,774

$1,488,728

$312 ($173–$1,228)

95.98 %

$198

$368

Mauritius

0

$159,242

n/Aa

0.00 %

n/Aa

n/Aa

Mozambique

15,895

$9,851,847

$620 ($348–$1,911)b

32.57 %

$350

$735

Namibia

308

$583,765

$1,895 ($810–$12,129)

88.26 %

$994

$2,307

Niger

59,276

$12,017,462

$203 ($155–$758)

78.01 %

$141

$234

Nigeria

867,551

$136,436,100

$157 ($118–$630)

99.39 %

$123

$182

Rwanda

6,922

$4,690,792

$678 ($443–$4,102)

11.41 %

$123

$191

Sao Tome and Principe

428

$87,930

$205 ($116–$4,875)

88.64 %

$148

$241

Senegal

28,136

$6,901,261

$245 ($190–$1,091)

97.31 %

$165

$288

Sierra Leone

29,522

$4,580,943

$155 ($111–$622)

98.10 %

$121

$178

Somalia

121

$4,008,936

$33,242 ($21 k–$190 k)b

0.00 %

$15,585

$37,835

South Africa

932

$10,364,811

$11,116 ($7 k–$93 k)b

2.06 %

$5,354

$13,209

Sudan

51,262

$17,825,373

$348 ($260–$1,603)

97.98 %

$215

$410

Swaziland

37

$341,676

$9,136 ($3 k–$741 k)b

1.42 %

$4,729

$11,296

Tanzania

123,313

$28,082,629

$228 ($188–$834)

99.98 %

$155

$265

Togo

23,646

$4,018,804

$170 ($134–$600)

96.11 %

$128

$196

Uganda

114,565

$23,587,765

$206 ($162–$712)

96.65 %

$143

$237

Zambia

59,074

$11,031,575

$187 ($147–$704)

99.71 %

$137

$217

Zimbabwe

4,973

$4,030,324

$810 ($520–$5,827)

16.35 %

$450

$981

Sum/Average

2,414,612

$513,842,475

$213

n/A

n/A

n/A

  1. aNot applicable (n/A). The ICER is not defined if the number of DALYs averted in the denominator is equal to zero. For purposes of interpretation, the cost-effectiveness ratios in these three cases are approaching infinity, thus, newborn screening for SCD would not be considered cost-effective
  2. bDenotes ICERs that exceed the cost-effectiveness threshold of a cost per DALY averted of less than one time per capita income as per WHO guidelines [11], thus, newborn screening for sickle cell disease would not be considered highly cost-effective