{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:37:55Z","timestamp":1789025875529,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,3,6]],"date-time":"2019-03-06T00:00:00Z","timestamp":1551830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Burkitt Lymphoma Fund of Africa"},{"name":"Martin Fabert Foundation"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perceptions of high cost and resource intensity remain political barriers to the prioritization of childhood cancer treatment programs in many low\u2010 and middle\u2010income countries (LMICs). Little knowledge exists of the actual cost and cost\u2010effectiveness of such programs. To improve outcomes for children with Burkitt lymphoma (BL), the most common childhood cancer in Africa, the Uganda Cancer Institute implemented a comprehensive BL treatment program in 2012. We undertook an economic evaluation of the program to ascertain the cost\u2010effectiveness of BL therapy in a specific LIC setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared the treatment of BL to usual care in a cohort of 122 patients treated between 2012 and 2014. Costs included variable, fixed, and family costs. Our primary measure of effectiveness was overall survival (OS). Patient outcomes were determined through prospective capture and retrospective chart abstraction. The cost per disability\u2010adjusted life\u2010year (DALY) averted was calculated using the World Health Organization\u2019s Choosing Interventions That Are Cost\u2010Effective (WHO\u2010CHOICE) methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 2\u2010year OS with treatment was 55% (95% CI, 45% to 64%). The cost per DALY averted in the treatment group was US$97 (Int$301). Cumulative estimate of national DALYs averted through treatment was 8607\u00a0years, and the total national annual cost of treatment was US$834,879 (Int$2,590,845). The cost of BL treatment fell well within WHO\u2010CHOICE cost\u2010effectiveness thresholds. The ratio of cost per DALY averted to per capita gross domestic product was 0.14, reflecting a very cost\u2010effective intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates that treating BL with locally tailored protocols is very cost\u2010effective by international standards. Studies of this kind will furnish crucial evidence to help policymakers prioritize the allocation of LMIC health system resources among noncommunicable diseases, including childhood cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.32006","type":"journal-article","created":{"date-parts":[[2019,3,6]],"date-time":"2019-03-06T13:39:55Z","timestamp":1551879595000},"page":"1918-1928","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["The cost effectiveness of treating Burkitt lymphoma in Uganda"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0039-0742","authenticated-orcid":false,"given":"Avram E.","family":"Denburg","sequence":"first","affiliation":[{"name":"The Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazeefah","family":"Laher","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children University of Toronto Toronto Ontario Canada"},{"name":"Wellesley Institute Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Innocent","family":"Mutyaba","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute Makerere University Kampala Uganda"},{"name":"Fred Hutchinson Cancer Research Center Seattle Children\u2019s Hospital Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"McGoldrick","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center Seattle Children\u2019s Hospital Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Kambugu","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute Makerere University Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Sessle","sequence":"additional","affiliation":[{"name":"PATH Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson","family":"Orem","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute Makerere University Kampala Uganda"},{"name":"Fred Hutchinson Cancer Research Center Seattle Children\u2019s Hospital Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey","family":"Casper","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center Seattle Children\u2019s Hospital Seattle Washington"},{"name":"Infectious Disease Research Institute University of Washington School of Medicine Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30186-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.6376"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24858"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61152-X"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001656"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcpo.2016.12.005"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2011-301419"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31022"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.24838"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2011.08.008"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-07-036665"},{"key":"e_1_2_8_13_1","volume-title":"Making choices in health: WHO guide to cost\u2010effectiveness analysis","author":"Tan\u2010Torres Edejer T","year":"2003"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2013.03.024"},{"key":"e_1_2_8_15_1","unstructured":"GDP Deflator: Ugandan Shilling.The World Bank 2016.https:\/\/data.worldbank.org\/indicator\/NY.GDP.DEFL.ZS?locations=UG. 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