Optimal control and cost-effectiveness analysis of HPV vaccination, screening, and treatment for cervical cancer reduction in Tanzania

Human papillomavirus (HPV) is the leading sexually transmitted infection and the primary cause of cervical cancer, a major contributor to cancer-related morbidity and mortality among women in sub-Saharan Africa, including Tanzania. This persistent burden highlights the need for effective, evidence-based, and cost-efficient control strategies. Deterministic compartmental ODE model describing HPV transmission in both sexes and progression to cervical cancer, incorporating screening, vaccination, and treatment is developed. Using graph theoretic approach, R e , is derived and used to characterize disease dynamics. Stability analysis shows that the HPV-free equilibrium is globally stable when R e ≤ 1 , while an endemic equilibrium exists when R e > 1 . Model parameters are calibrated using Bayesian MCMC methods with Tanzanian data (2018–2023), ensuring local relevance. Optimal control and ICER analysis are then used to assess intervention efficiency. Results show that screening alone reduces infections ( R e = 0.96 ), vaccination alone substantially reduces transmission ( R e = 0.19 ) but has limited impact on existing infections, while the combined strategy achieves the greatest reduction and drives R e < 1 , indicating herd immunity. Cost-effectiveness analysis identifies screening alone as the least costly per infection averted, whereas screening combined with vaccination provides the best overall balance of epidemiological impact and economic efficiency. We recommend prioritizing HPV vaccination for girls aged 9–14 years and integrating it with routine cervical cancer screening within primary healthcare systems, while ensuring timely treatment only for screen-positive cases. This combined strategy should be guided by, R e , as a monitoring threshold to support efficient, cost-effective, and population-level HPV control policies.