Journal of the Operational Research Society

, Volume 56, Issue 2, pp 222–233

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

Special Features

DOI: 10.1057/palgrave.jors.2601884

Cite this article as:
Rauner, M., Brailsford, S. & Flessa, S. J Oper Res Soc (2005) 56: 222. doi:10.1057/palgrave.jors.2601884

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.

Keywords

vertical HIV/AIDS transmissiondiscrete event simulationcost-effectiveness analysisepidemic policy modeldecision-support-system

Copyright information

© Palgrave Macmillan Ltd 2005

Authors and Affiliations

  1. 1.University of ViennaViennaAustria
  2. 2.University of SouthamptonSouthamptonUK
  3. 3.University of HeidelbergHeidelbergGermany