Skip to main content
Top
Published in: Cost Effectiveness and Resource Allocation 1/2017

Open Access 01-12-2017 | Review

Cost-effectiveness analysis of malaria interventions using disability adjusted life years: a systematic review

Authors: Resign Gunda, Moses John Chimbari

Published in: Cost Effectiveness and Resource Allocation | Issue 1/2017

Login to get access

Abstract

Background

Malaria continues to be a public health problem despite past and on-going control efforts. For sustenance of control efforts to achieve the malaria elimination goal, it is important that the most cost-effective interventions are employed. This paper reviews studies on cost-effectiveness of malaria interventions using disability-adjusted life years.

Methods

A review of literature was conducted through a literature search of international peer-reviewed journals as well as grey literature. Searches were conducted through Medline (PubMed), EMBASE and Google Scholar search engines. The searches included articles published in English for the period from 1996 to 2016. The inclusion criteria for the study were type of malaria intervention, year of publication and cost-effectiveness ratio in terms of cost per DALY averted. We included 40 studies which specifically used the DALY metric in cost-effectiveness analysis (CEA) of malaria interventions.

Results

The majority of the reviewed studies (75%) were done using data from African settings with the majority of the interventions (60.0%) targeting all age categories. Interventions included case treatment, prophylaxis, vector control, insecticide treated nets, early detection, environmental management, diagnosis and educational programmes. Sulfadoxine–pyrimethamine was the most common drug of choice in malaria prophylaxis, while artemisinin-based combination therapies were the most common drugs for case treatment. Based on guidelines for CEA, most interventions proved cost-effective in terms of cost per DALYs averted for each intervention.

Conclusion

The DALY metric is a useful tool for determining the cost-effectiveness of malaria interventions. This paper demonstrates the importance of CEA in informing decisions made by policy makers.
Literature
1.
go back to reference WHO. World malaria report. Geneva: WHO; 2015. WHO. World malaria report. Geneva: WHO; 2015.
2.
go back to reference Githeko AK, Ndegwa W. Predicting malaria epidemics in the Kenyan highlands using climate data: a tool for decision makers. Glob Chang Hum Health. 2001;2(1):54–63.CrossRef Githeko AK, Ndegwa W. Predicting malaria epidemics in the Kenyan highlands using climate data: a tool for decision makers. Glob Chang Hum Health. 2001;2(1):54–63.CrossRef
3.
go back to reference Goodman CA, Coleman PG, Mills AJ. Cost-effectiveness of malaria control in sub-Saharan Africa. Lancet. 1999;354(9176):378–85.CrossRefPubMed Goodman CA, Coleman PG, Mills AJ. Cost-effectiveness of malaria control in sub-Saharan Africa. Lancet. 1999;354(9176):378–85.CrossRefPubMed
4.
go back to reference Evans DB, et al. Methods to assess the costs and health effects of interventions for improving health in developing countries. BMJ. 2005;331(7525):1137–40.CrossRefPubMedPubMedCentral Evans DB, et al. Methods to assess the costs and health effects of interventions for improving health in developing countries. BMJ. 2005;331(7525):1137–40.CrossRefPubMedPubMedCentral
7.
go back to reference Creese A, et al. Cost-effectiveness of HIV/AIDS interventions in Africa: a systematic review of the evidence. Lancet. 2002;359(9318):1635–43.CrossRefPubMed Creese A, et al. Cost-effectiveness of HIV/AIDS interventions in Africa: a systematic review of the evidence. Lancet. 2002;359(9318):1635–43.CrossRefPubMed
8.
go back to reference Lubell Y, et al. Cost-effectiveness of parenteral artesunate for treating children with severe malaria in sub-Saharan Africa. Bull World Health Organ. 2011;89(7):504–12.CrossRefPubMedPubMedCentral Lubell Y, et al. Cost-effectiveness of parenteral artesunate for treating children with severe malaria in sub-Saharan Africa. Bull World Health Organ. 2011;89(7):504–12.CrossRefPubMedPubMedCentral
9.
go back to reference Bener A, et al. Measuring burden of diseases in a rapidly developing economy: state of Qatar. Glob J Health Sci. 2013;5(2):134–44. Bener A, et al. Measuring burden of diseases in a rapidly developing economy: state of Qatar. Glob J Health Sci. 2013;5(2):134–44.
10.
go back to reference Murray CJL, Lopez A. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. 1st ed. Cambridge: Harvard University Press; 1996. Murray CJL, Lopez A. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. 1st ed. Cambridge: Harvard University Press; 1996.
11.
go back to reference Murray CJ, Lopez AD, editors. The Global Burden of Disease. Havard School of Public Health: Geneva; 1998. p. 1–46. Murray CJ, Lopez AD, editors. The Global Burden of Disease. Havard School of Public Health: Geneva; 1998. p. 1–46.
12.
go back to reference Donev D, Zaletel-Kragelj L, Bjegovic V, Burazeri G. Measuring the burden of disease: disability adjusted life year (daly). Methods and tools in public health. In: Zaletel-Kragelj L, Boţikov J, editors. A handbook for teachers, researchers and health professionals. Lage: Hans Jacobs Publishing Company; 2010. Donev D, Zaletel-Kragelj L, Bjegovic V, Burazeri G. Measuring the burden of disease: disability adjusted life year (daly). Methods and tools in public health. In: Zaletel-Kragelj L, Boţikov J, editors. A handbook for teachers, researchers and health professionals. Lage: Hans Jacobs Publishing Company; 2010.
13.
14.
go back to reference Murray CJL, Lopez AD. Global health statistics: a compendium of incidence, prevalence and mortality estimates for over 200 conditions. 2nd ed. Cambridge: Harvard University Press; 1996. Murray CJL, Lopez AD. Global health statistics: a compendium of incidence, prevalence and mortality estimates for over 200 conditions. 2nd ed. Cambridge: Harvard University Press; 1996.
15.
go back to reference WHO. Making choices in health: WHO guide to cost-effectiveness analysis. In: Tan-Torres Edejer T, Baltussen R, Adam T, Hutubessy R, Acharya A, Evans DB, Murray DB, Murray CJL, editors. Geneva: WHO; 2003. WHO. Making choices in health: WHO guide to cost-effectiveness analysis. In: Tan-Torres Edejer T, Baltussen R, Adam T, Hutubessy R, Acharya A, Evans DB, Murray DB, Murray CJL, editors. Geneva: WHO; 2003.
16.
go back to reference Moher D, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Open Med. 2009;3(3):e123–30.PubMedPubMedCentral Moher D, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Open Med. 2009;3(3):e123–30.PubMedPubMedCentral
17.
go back to reference Edwards C. Cost-effectiveness analysis in practice. In: Hunter P, Cameron J, Jagals P, Pond K, editors. Valuing water, valuing livelihoods. London: IWA Publishing; 2011. p. 181–197. Edwards C. Cost-effectiveness analysis in practice. In: Hunter P, Cameron J, Jagals P, Pond K, editors. Valuing water, valuing livelihoods. London: IWA Publishing; 2011. p. 181–197.
18.
go back to reference WHO. Investing in health research and development: report of the ad hoc committee on health research relating to future intervention options. Geneve: WHO; 1996. WHO. Investing in health research and development: report of the ad hoc committee on health research relating to future intervention options. Geneve: WHO; 1996.
20.
go back to reference GBD 2013 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet. 2015;386(10009):2145–91.CrossRefPubMedCentral GBD 2013 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet. 2015;386(10009):2145–91.CrossRefPubMedCentral
21.
go back to reference Pfeil J, Borrmann S, Tozan Y. Dihydroartemisinin–piperaquine vs. artemether–lumefantrine for first-line treatment of uncomplicated malaria in African children: a cost-effectiveness analysis. PLoS ONE. 2014;9(4):e95681.CrossRefPubMedPubMedCentral Pfeil J, Borrmann S, Tozan Y. Dihydroartemisinin–piperaquine vs. artemether–lumefantrine for first-line treatment of uncomplicated malaria in African children: a cost-effectiveness analysis. PLoS ONE. 2014;9(4):e95681.CrossRefPubMedPubMedCentral
22.
go back to reference Buchanan J, et al. Cost-effectiveness of pre-referral antimalarial, antibacterial, and combined rectal formulations for severe febrile illness. PLoS ONE. 2010;5(12):e14446.CrossRefPubMedPubMedCentral Buchanan J, et al. Cost-effectiveness of pre-referral antimalarial, antibacterial, and combined rectal formulations for severe febrile illness. PLoS ONE. 2010;5(12):e14446.CrossRefPubMedPubMedCentral
23.
go back to reference Mori AT, et al. Cost-effectiveness of dihydroartemisinin–piperaquine compared with artemether–lumefantrine for treating uncomplicated malaria in children at a district hospital in Tanzania. Malar J. 2014;13:363.CrossRefPubMedPubMedCentral Mori AT, et al. Cost-effectiveness of dihydroartemisinin–piperaquine compared with artemether–lumefantrine for treating uncomplicated malaria in children at a district hospital in Tanzania. Malar J. 2014;13:363.CrossRefPubMedPubMedCentral
24.
go back to reference Tediosi F, et al. An approach to model the costs and effects of case management of Plasmodium falciparum malaria in Sub-Saharan Africa. Am J Trop Med Hyg. 2006;75(2 Suppl):90–103.CrossRefPubMed Tediosi F, et al. An approach to model the costs and effects of case management of Plasmodium falciparum malaria in Sub-Saharan Africa. Am J Trop Med Hyg. 2006;75(2 Suppl):90–103.CrossRefPubMed
25.
go back to reference Tozan Y, et al. Prereferral rectal artesunate for treatment of severe childhood malaria: a cost-effectiveness analysis. Lancet. 2010;376(9756):1910–5.CrossRefPubMed Tozan Y, et al. Prereferral rectal artesunate for treatment of severe childhood malaria: a cost-effectiveness analysis. Lancet. 2010;376(9756):1910–5.CrossRefPubMed
26.
go back to reference Wolfe EB, et al. Cost-effectiveness of sulfadoxine–pyrimethamine for the prevention of malaria-associated low birth weight. Am J Trop Med Hyg. 2001;64(3–4):178–86.CrossRefPubMed Wolfe EB, et al. Cost-effectiveness of sulfadoxine–pyrimethamine for the prevention of malaria-associated low birth weight. Am J Trop Med Hyg. 2001;64(3–4):178–86.CrossRefPubMed
27.
go back to reference Akhavan D, et al. Cost-effective malaria control in Brazil: cost-effectiveness of a malaria control program in the Amazon Basin of Brazil, 1988–1996. Soc Sci Med. 1999;49(10):1385–99.CrossRefPubMed Akhavan D, et al. Cost-effective malaria control in Brazil: cost-effectiveness of a malaria control program in the Amazon Basin of Brazil, 1988–1996. Soc Sci Med. 1999;49(10):1385–99.CrossRefPubMed
28.
go back to reference Utzinger J, Tozan Y, Singer BH. Efficacy and cost-effectiveness of environmental management for malaria control. Trop Med Int Health. 2001;6(9):677–87.CrossRefPubMed Utzinger J, Tozan Y, Singer BH. Efficacy and cost-effectiveness of environmental management for malaria control. Trop Med Int Health. 2001;6(9):677–87.CrossRefPubMed
29.
30.
31.
go back to reference Hutton G. Cost-effectiveness of malaria intermittent preventive treatment in infants (IPTi) in Mozambique and the United Republic of Tanzania. Bull World Health Organ. 2009;87(2):123–9.CrossRefPubMedPubMedCentral Hutton G. Cost-effectiveness of malaria intermittent preventive treatment in infants (IPTi) in Mozambique and the United Republic of Tanzania. Bull World Health Organ. 2009;87(2):123–9.CrossRefPubMedPubMedCentral
32.
33.
go back to reference Alonzo Gonzalez M, et al. Cost-effectiveness of iron supplementation and malaria chemoprophylaxis in the prevention of anaemia and malaria among Tanzanian infants. Bull World Health Organ. 2000;78(1):97–107.PubMedPubMedCentral Alonzo Gonzalez M, et al. Cost-effectiveness of iron supplementation and malaria chemoprophylaxis in the prevention of anaemia and malaria among Tanzanian infants. Bull World Health Organ. 2000;78(1):97–107.PubMedPubMedCentral
34.
go back to reference Maire N, et al. Cost-effectiveness of the introduction of a pre-erythrocytic malaria vaccine into the expanded program on immunization in sub-Saharan Africa: analysis of uncertainties using a stochastic individual-based simulation model of Plasmodium falciparum malaria. Value Health. 2011;14(8):1028–38.CrossRefPubMed Maire N, et al. Cost-effectiveness of the introduction of a pre-erythrocytic malaria vaccine into the expanded program on immunization in sub-Saharan Africa: analysis of uncertainties using a stochastic individual-based simulation model of Plasmodium falciparum malaria. Value Health. 2011;14(8):1028–38.CrossRefPubMed
36.
go back to reference Penny MA, et al. Public health impact and cost-effectiveness of the RTS, S/AS01 malaria vaccine: a systematic comparison of predictions from four mathematical models. Lancet. 2016;387(10016):367–75.CrossRefPubMedPubMedCentral Penny MA, et al. Public health impact and cost-effectiveness of the RTS, S/AS01 malaria vaccine: a systematic comparison of predictions from four mathematical models. Lancet. 2016;387(10016):367–75.CrossRefPubMedPubMedCentral
37.
go back to reference Ross A, et al. Determinants of the cost-effectiveness of intermittent preventive treatment for malaria in infants and children. PLoS ONE. 2011;6(4):e18391.CrossRefPubMedPubMedCentral Ross A, et al. Determinants of the cost-effectiveness of intermittent preventive treatment for malaria in infants and children. PLoS ONE. 2011;6(4):e18391.CrossRefPubMedPubMedCentral
38.
40.
go back to reference Seo MK, Baker P, Ngo KN. Cost-effectiveness analysis of vaccinating children in Malawi with RTS,S vaccines in comparison with long-lasting insecticide-treated nets. Malar J. 2014;13:66.CrossRefPubMedPubMedCentral Seo MK, Baker P, Ngo KN. Cost-effectiveness analysis of vaccinating children in Malawi with RTS,S vaccines in comparison with long-lasting insecticide-treated nets. Malar J. 2014;13:66.CrossRefPubMedPubMedCentral
43.
go back to reference Becker-Dreps SI, et al. Cost-effectiveness of adding bed net distribution for malaria prevention to antenatal services in Kinshasa, Democratic Republic of the Congo. Am J Trop Med Hyg. 2009;81(3):496–502.PubMed Becker-Dreps SI, et al. Cost-effectiveness of adding bed net distribution for malaria prevention to antenatal services in Kinshasa, Democratic Republic of the Congo. Am J Trop Med Hyg. 2009;81(3):496–502.PubMed
44.
go back to reference Briet OJ, Chitnis N. Effects of changing mosquito host searching behaviour on the cost effectiveness of a mass distribution of long-lasting, insecticidal nets: a modelling study. Malar J. 2013;12:215.CrossRefPubMedPubMedCentral Briet OJ, Chitnis N. Effects of changing mosquito host searching behaviour on the cost effectiveness of a mass distribution of long-lasting, insecticidal nets: a modelling study. Malar J. 2013;12:215.CrossRefPubMedPubMedCentral
45.
go back to reference Briet OJ, et al. Effects of pyrethroid resistance on the cost effectiveness of a mass distribution of long-lasting insecticidal nets: a modelling study. Malar J. 2013;12:77.CrossRefPubMedPubMedCentral Briet OJ, et al. Effects of pyrethroid resistance on the cost effectiveness of a mass distribution of long-lasting insecticidal nets: a modelling study. Malar J. 2013;12:77.CrossRefPubMedPubMedCentral
46.
go back to reference Coleman PG, Goodman CA, Mills A. Rebound mortality and the cost-effectiveness of malaria control: potential impact of increased mortality in late childhood following the introduction of insecticide treated nets. Trop Med Int Health. 1999;4(3):175–86.CrossRefPubMed Coleman PG, Goodman CA, Mills A. Rebound mortality and the cost-effectiveness of malaria control: potential impact of increased mortality in late childhood following the introduction of insecticide treated nets. Trop Med Int Health. 1999;4(3):175–86.CrossRefPubMed
47.
go back to reference Kahn JG, et al. Integrated HIV testing, malaria, and diarrhea prevention campaign in Kenya: modeled health impact and cost-effectiveness. PLoS ONE. 2012;7(2):e31316.CrossRefPubMedPubMedCentral Kahn JG, et al. Integrated HIV testing, malaria, and diarrhea prevention campaign in Kenya: modeled health impact and cost-effectiveness. PLoS ONE. 2012;7(2):e31316.CrossRefPubMedPubMedCentral
48.
go back to reference Mueller DH, et al. Cost-effectiveness analysis of insecticide-treated net distribution as part of the Togo Integrated Child Health Campaign. Malar J. 2008;7:73.CrossRefPubMedPubMedCentral Mueller DH, et al. Cost-effectiveness analysis of insecticide-treated net distribution as part of the Togo Integrated Child Health Campaign. Malar J. 2008;7:73.CrossRefPubMedPubMedCentral
50.
go back to reference Utzinger J, et al. The economic payoffs of integrated malaria control in the Zambian copperbelt between 1930 and 1950. Trop Med Int Health. 2002;7(8):657–77.CrossRefPubMed Utzinger J, et al. The economic payoffs of integrated malaria control in the Zambian copperbelt between 1930 and 1950. Trop Med Int Health. 2002;7(8):657–77.CrossRefPubMed
51.
go back to reference Chen IT, et al. Cost-effectiveness analysis of malaria rapid diagnostic test incentive schemes for informal private healthcare providers in Myanmar. Malar J. 2015;14:55.CrossRefPubMedPubMedCentral Chen IT, et al. Cost-effectiveness analysis of malaria rapid diagnostic test incentive schemes for informal private healthcare providers in Myanmar. Malar J. 2015;14:55.CrossRefPubMedPubMedCentral
52.
go back to reference Shillcutt S, et al. Cost-effectiveness of malaria diagnostic methods in sub-Saharan Africa in an era of combination therapy. Bull World Health Organ. 2008;86(2):101–10.CrossRefPubMed Shillcutt S, et al. Cost-effectiveness of malaria diagnostic methods in sub-Saharan Africa in an era of combination therapy. Bull World Health Organ. 2008;86(2):101–10.CrossRefPubMed
53.
go back to reference Goodman CA, et al. The cost-effectiveness of improving malaria home management: shopkeeper training in rural Kenya. Health Policy Plan. 2006;21(4):275–88.CrossRefPubMed Goodman CA, et al. The cost-effectiveness of improving malaria home management: shopkeeper training in rural Kenya. Health Policy Plan. 2006;21(4):275–88.CrossRefPubMed
54.
go back to reference Sun DW, et al. A cost-effectiveness analysis of Plasmodium falciparum malaria elimination in Hainan Province, 2002–2012. Am J Trop Med Hyg. 2015;93(6):1240–8.CrossRefPubMedPubMedCentral Sun DW, et al. A cost-effectiveness analysis of Plasmodium falciparum malaria elimination in Hainan Province, 2002–2012. Am J Trop Med Hyg. 2015;93(6):1240–8.CrossRefPubMedPubMedCentral
55.
go back to reference Pfeil J, et al. An economic evaluation of the posttreatment prophylactic effect of dihydroartemisinin–piperaquine versus artemether–lumefantrine for first-line treatment of Plasmodium falciparum malaria across different transmission settings in Africa. Am J Trop Med Hyg. 2015;93(5):961–6.CrossRefPubMedPubMedCentral Pfeil J, et al. An economic evaluation of the posttreatment prophylactic effect of dihydroartemisinin–piperaquine versus artemether–lumefantrine for first-line treatment of Plasmodium falciparum malaria across different transmission settings in Africa. Am J Trop Med Hyg. 2015;93(5):961–6.CrossRefPubMedPubMedCentral
56.
go back to reference Fernandes S, et al. Cost-effectiveness of two versus three or more doses of intermittent preventive treatment for malaria during pregnancy in sub-Saharan Africa: a modelling study of meta-analysis and cost data. Lancet Glob Health. 2015;3(3):e143–53.CrossRefPubMed Fernandes S, et al. Cost-effectiveness of two versus three or more doses of intermittent preventive treatment for malaria during pregnancy in sub-Saharan Africa: a modelling study of meta-analysis and cost data. Lancet Glob Health. 2015;3(3):e143–53.CrossRefPubMed
58.
go back to reference Sicuri E, et al. Economic evaluation of an alternative drug to sulfadoxine–pyrimethamine as intermittent preventive treatment of malaria in pregnancy. PLoS ONE. 2015;10(4):e0125072.CrossRefPubMedPubMedCentral Sicuri E, et al. Economic evaluation of an alternative drug to sulfadoxine–pyrimethamine as intermittent preventive treatment of malaria in pregnancy. PLoS ONE. 2015;10(4):e0125072.CrossRefPubMedPubMedCentral
59.
go back to reference Marseille E, et al. Thresholds for the cost-effectiveness of interventions: alternative approaches. Bull World Health Organ. 2015;93(2):118–24.CrossRefPubMed Marseille E, et al. Thresholds for the cost-effectiveness of interventions: alternative approaches. Bull World Health Organ. 2015;93(2):118–24.CrossRefPubMed
Metadata
Title
Cost-effectiveness analysis of malaria interventions using disability adjusted life years: a systematic review
Authors
Resign Gunda
Moses John Chimbari
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Cost Effectiveness and Resource Allocation / Issue 1/2017
Electronic ISSN: 1478-7547
DOI
https://doi.org/10.1186/s12962-017-0072-9

Other articles of this Issue 1/2017

Cost Effectiveness and Resource Allocation 1/2017 Go to the issue