Cost effectiveness analysis of the oral cholera vaccine in Kenya: the case of Nakuru county
Abstract
Cholera is caused by exposure to a bacterium Vibrio cholerae and may result in acute
dehydration or even death in severe cases. It has affected many people in Kenya in recent
months and therefore warrants attention. Between December 2014 and July 2015 sixteen
counties had experienced a cholera outbreak with varying case fatalities. A total of 4,938
case and 97 deaths were reported. Nakuru County alone had 281 cases out of which 17
people died. This research work sought to establish if using the oral cholera vaccine is cost
effective for vulnerable populations by taking a case study of Nakuru County. The cost of
treating a cholera incidence was determined from the patient‟s perspective and included
direct medical costs, direct non medical costs and indirect productivity losses. The results
indicate that of the direct medical costs, the medicines used accounted for the largest cost
burden. The Vaccine Introduction Cost Effectiveness Model was then used to determine the
cost effectiveness of the intervention. It was found that giving the oral cholera vaccine to
100,000 vulnerable people would cost USD 78,000 and this would avert 1120 cases and
67.98 deaths. The number vaccinated per death averted would be 1471 and per case averted
would be 89. The cost to save one life was found to be USD 7526.55 and the total cost per
Disability Adjusted Life Year would be 337.21. The GDP per capita for Kenya as at 2014
after rebasing the economy was USD 1246. It was concluded that using the oral cholera
vaccine as a preventive measure is very cost effective and is highly recommended since the
cost per DALY averted is less than the GDP per capita for Kenya.
Publisher
University of Nairobi