Cost-Effectiveness of Screening and Correcting Refractive Errors in School Children in Africa, Asia, America and Europe
Rob Baltussen, Jeroen Naus, and Hans Limburg
To estimate the costs and effects of alternative strategies for annual screening of school children for refractive errors, and the provision of spectacles, in different WHO sub-regions in Africa, Asia, America and Europe.
In all regions, screening of 5–15 years old children yields most health effects, followed by screening of 11–15 years old, 5–10 years old, and screening of 8 and 13 years old.
Screening of broad-age intervals is always more costly than screening of single-age intervals, and there are important economies of scale for simultaneous screening of both 5–10 and 11–15-year-old children.
In all regions, screening of 11–15 years old is the most cost-effective intervention, with the cost per DALY averted ranging from I$67 per DALY averted in the Asian sub-region to I$458 per DALY averted in the European sub-region.
The incremental cost per DALY averted of screening 5–15 years old ranges between I$111 in the Asian sub-region to I$672 in the European sub-region.
Considering the conservative study assumptions and the robustness of study conclusions towards changes in these assumptions, screening of schoolchildren for refractive error is economically attractive in all regions in the world.