A new disease model for malaria during pregnancy has been developed with a group of experts that provides a more holistic assessment of the health impacts to both the mother and the child.

The new disease model promises to help malaria researchers and policy-makers more effectively evaluate the cost-effectiveness of health policy tackling malaria, as well provide a methodology that is transferrable to many other diseases.

Cost-effectiveness analysis compares the costs of a healthcare intervention to its health effects in tackling a specific disease. They have become an important tool for healthcare policy, particularly for low- and middle-income countries as they look to optimise spending their constrained healthcare resources.

An effective cost-effectiveness analysis requires a strong model of the disease, one which includes all the known disease mechanisms and associated health problems. However, most disease models will be developed ad-hoc by small research teams, leading to models which aren't as holisitc as they could be.

Researchers from the London School of Hygiene & Tropical Medicine have developed a more comprehensive disease model, using the case study of malaria during pregnancy. Malaria particularly dangerous during pregnancy as it affects both the mother and child, leading to complications such as stillbirth, low birth weight and severe malaria.

The model was developed initially using scientific publications, and then developed using input from a wide range of expert stakeholders (including epidemiologists, clinicians and health economists) who identified the most important health outcomes and relationships for the mother and child.

Published in PLos Global Public Health, the article outlines ten health outcomes each for the mother and child, including but not limited to: anaemia, hypertension, problems with cognitive and physical development for the child. The paper also suggests four important variables that divide the patients into different sub-groups which should be considered.

By formally collecting insights from a wider range of experts and stakeholders, the new malaria disease model includes many new outcomes that are not considered in current models. This will allow policy-makers to capture a more complete picture of the disease and make better informed decisions about the impact of a new treatment or intervention.

As well as improving cost-effectiveness analyses for malaria during pregnancy, the methodology used can be applied to a range of other diseases and conditions. The publication offers a new approach to developing disease models for researchers informing key decision-makers in healthcare policy.

Silke Fernandes, Research Fellow at LSHTM, said: "Understanding the holistic impact of malaria during pregnancy is essential for improving maternal and child outcomes in malaria endemic settings. 

"This study illustrates a methodology to co-develop a comprehensive disease policy model with expert stakeholders, highlighting the complexity required to depict fully the consequences of malaria during pregnancy for both the mother and the child."

Publication

Fernandes S, Briggs A, Hanson K. Co-developing a comprehensive disease policy model with stakeholders: The case of malaria during pregnancy. PLoS Global Public Health. DOI: http://doi.org/10.1371/journal.pgph.0003775