Cost effectiveness analysis of strategies to combat malaria in developing countries
- 10 November 2005
- Vol. 331 (7528) , 1299
- https://doi.org/10.1136/bmj.38639.702384.ae
Abstract
Objective To determine the cost effectiveness of selected malaria control interventions in the context of reaching the millennium development goals for malaria. Design Generalised cost effectiveness analysis. Data sources Efficacy data came from the literature and authors' calculations supported by expert opinion. Quantities for resource inputs came from the literature and from expert opinion; prices came from the WHO-CHOICE database. Methods Costs were assessed in year 2000 international dollars, and effects were assessed as disability adjusted life years averted by a 10 year implementation programme. Analysis was restricted to sub-Saharan regions where the most deadly form of malaria, Plasmodium falciparum, is most prevalent. The impact on population health for various interventions, and their combinations, was evaluated at selected coverage levels by using a state-transition model. Sensitivity analysis was done for age weights and discounting. Results High coverage with artemisinin based combination treatments was found to be the most cost effective strategy for control of malaria in most countries in sub-Saharan Africa. Conclusions A much larger infusion of resources than those currently available is needed to make headway in the fight to roll back malaria. On cost effectiveness grounds, in most areas in sub-Saharan Africa greater coverage with highly effective combination treatments should be the cornerstone of malaria control. However, treatment alone can achieve less than half the total benefit obtainable through a combination of interventions—scaling up the use of impregnated mosquito nets or indoor spraying with insecticides is also critical. Intermittent presumptive treatment of pregnant women can bring a small but important additional health gain at relatively low cost. This article is part of a series examining the cost effectiveness of strategies to achieve the millennium development goals for healthKeywords
This publication has 21 references indexed in Scilit:
- SULFADOXINE-PYRIMETHAMINE PLUS CHLOROQUINE OR AMODIAQUINE FOR UNCOMPLICATED FALCIPARUM MALARIA: A RANDOMIZED, MULTISITE TRIAL TO GUIDE NATIONAL POLICY IN UGANDAThe American Journal of Tropical Medicine and Hygiene, 2005
- The global distribution and population at risk of malaria: past, present, and futureThe Lancet Infectious Diseases, 2004
- Accounting for the cost of scaling‐up health interventionsHealth Economics, 2004
- Comparison of house spraying and insecticide-treated nets for malaria control.2003
- Programme costs in the economic evaluation of health interventionsCost Effectiveness and Resource Allocation, 2003
- The assessment of antimalarial drug efficacyTrends in Parasitology, 2002
- The economic impact of malaria in Africa: a critical review of the evidenceHealth Policy, 2002
- Comparison of the cost and cost‐effectiveness of insecticide‐treated bednets and residual house‐spraying in KwaZulu‐Natal, South AfricaTropical Medicine & International Health, 2001
- Delaying antimalarial drug resistance with combination chemotherapy.1999
- EFFECT OF DDT ON SURVIVAL AND BLOOD FEEDING SUCCESS OF ANOPHELES-ARABIENSIS IN NORTHERN KWAZULU, REPUBLIC-OF-SOUTH-AFRICA1990