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Malaria Journal
Published in: Malaria Journal 1/2011

Open Access 01-12-2011 | Review

Costs and cost-effectiveness of malaria control interventions - a systematic review

Published in: Malaria Journal | Issue 1/2011

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Abstract

Background

The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs), indoor residual spraying (IRS), intermittent preventive treatment (IPT), diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness.

Methods

A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives.

Results

Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54) for ITNs, $6.70 (range $2.22-$12.85) for IRS, $0.60 (range $0.48-$1.08) for IPT in infants, $4.03 (range $1.25-$11.80) for IPT in children, and $2.06 (range $0.47-$3.36) for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34). The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65) and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87). Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110) for ITNs, $143 (range $135-$150) for IRS, and $24 (range $1.08-$44.24) for IPT.

Conclusions

A transparent evidence base on the costs and cost-effectiveness of malaria control interventions is provided to inform rational resource allocation by donors and domestic health budgets and the selection of optimal packages of interventions by malaria control programmes.
Appendix
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Literature
1.
WHO: World Malaria Report -. 2010, Geneva: WHO
2.
Chima RI, Goodman CA, Mills A: The economic impact of malaria in Africa: a critical review of the evidence. Health Policy. 2003, 63: 17-36. 10.1016/S0168-8510(02)00036-2.CrossRefPubMed
3.
Sachs J, Malaney P: The economic and social burden of malaria. Nature. 2002, 415: 680-685. 10.1038/415680a.CrossRefPubMed
4.
Flaxman AD, Fullman N, Otten MW, Menon M, Cibulskis RE, Ng M, Murray CJL, Lim SS: Rapid scaling up of insecticide-treated bed net coverage in Africa and its relationship with development assistance for health: A systematic synthesis of supply, distribution, and household survey data. Plos Medicine. 2010, 7: e1000328-10.1371/journal.pmed.1000328.PubMedCentralCrossRefPubMed
5.
Noor AM, Mutheu JJ, Tatem AJ, Hay SI, Snow RW: Insecticide-treated net coverage in Africa: mapping progress in 2000-07. Lancet. 2009, 373: 58-67. 10.1016/S0140-6736(08)61596-2.PubMedCentralCrossRefPubMed
6.
Kilian A, Wijayanandana N, Ssekitoleeko J: Review of delivery strategies for insecticide treated mosquito nets - are we ready for the next phase of malaria control efforts?. TropIKA. 2010, 1 (1):
7.
Yukich JO, Lengeler C, Tediosi F, Brown N, Mulligan J-A, Chavasse D, Stevens W, Justino J, Conteh L, Maharaj R, Erskine M, Mueller DH, Wiseman V, Ghebremeskel T, Zerom M, Goodman C, McGuire D, Urrutia J-M, Sakho F, Hanson K, Sharp B: Costs and consequences of large-scale vector control for malaria. Malar J. 2008, 7:
8.
Whitty CJM, Chandler C, Ansah E, Leslie T, Staedke SG: Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities. Malar J. 2008, 7 (Suppl 1): S7-10.1186/1475-2875-7-S1-S7.PubMedCentralCrossRefPubMed
9.
Bosman A, Mendis KN: A major transition in malaria treatment: The adoption and deployment of artemisinin-based combination therapies. Am J Trop Med Hyg. 2007, 77: 193-197.PubMed
10.
Lengeler C: Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev. 2004, CD000363-
11.
Pluess B, Tanser FC, Lengeler C, Sharp BL: Indoor residual spraying for preventing malaria. Cochrane Database Syst Rev. 2010, CD006657-4
12.
Sinclair D, Zani B, Donegan S, Olliaro P, Garner P: Artemisinin-based combination therapy for treating uncomplicated malaria. Cochrane Database of Systematic Reviews. 2009, 3
13.
Wongsrichanalai C, Barcus MJ, Muth S, Sutamihardja A, Wernsdorfer WH: A review of malaria diagnostic tools: Microscopy and rapid diagnostic test (RDT). Am J Trop Med Hyg. 2007, 77: 119-127.PubMed
14.
Murray CK, Bennett JW: Rapid diagnosis of malaria. Interdisciplinary Perspectives on Infectious Diseases. 2009, 2009: Article ID 415953
15.
Greenwood B: Review: Intermittent preventive treatment - a new approach to the prevention of malaria in children in areas with seasonal malaria transmission. Trop Med Int Health. 2006, 11: 983-991. 10.1111/j.1365-3156.2006.01657.x.CrossRefPubMed
16.
Aponte JJ, Schellenberg D, Egan A, Breckenridge A, Carneiro I, Critchley J, Danquah I, Dodoo A, Kobbe R, Lell B, May J, Premji Z, Sanz S, Seven E, Soulaymani-Becheikh R, Winstanley P, Adjei S, Anemana S, Chandramohan D, Issifou S, Mockenhaupt F, Owusu-Agyei S, Greenwood B, Grobusch MP, Kremsner PG, Macete E, Mshinda H, Newman RD, Slutsker L, Tanner M, Alonso P, Menendez : Efficacy and safety of intermittent preventive treatment with sulfadoxine-pyrimethamine for malaria in African infants: a pooled analysis of six randomised, placebo-controlled trials. Lancet. 2009, 374: 1533-1542. 10.1016/S0140-6736(09)61258-7.CrossRefPubMed
17.
Pitt C, Ndiaye M, Patouillard E, Milligan PJ, Conteh L: Economic report for the WHO Technical Expert Group Meeting on intermittent preventive treatment of malaria in children. 2011
18.
Kolaczinski J, Hanson K: Costing the distribution of insecticide-treated nets: a review of cost and cost-effectiveness studies to provide guidance on standardization of costing methodology. Malar J. 2006, 5: 37-10.1186/1475-2875-5-37.PubMedCentralCrossRefPubMed
19.
Goodman CA, Mills AJ: The evidence base on the cost-effectiveness of malaria control measures in Africa. Health Policy and Planning. 1999, 14: 301-312. 10.1093/heapol/14.4.301.CrossRefPubMed
20.
Walker D, Fox-Rushby JA: Economic evaluation of communicable disease interventions in developing countries: A critical review of the published literature. Health Economics. 2000, 9: 681-698. 10.1002/1099-1050(200012)9:8<681::AID-HEC545>3.0.CO;2-X.CrossRefPubMed
21.
Goodman CA, Coleman PG, Mills AJ: Cost-effectiveness of malaria control in sub-Saharan Africa. Lancet. 1999, 354: 378-385. 10.1016/S0140-6736(99)02141-8.CrossRefPubMed
22.
Morel CM, Lauer JA, Evans DB: Achieving the millennium development goals for health - Cost effectiveness analysis of strategies to combat malaria in developing countries. BM J. 2005, 331: 1299-1302B. 10.1136/bmj.38639.702384.AE.CrossRef
23.
Adam T, Evans DB, Murray CJL: Econometric estimation of country-specific hospital costs. Cost Eff Resour Alloc. 2003, 1 (3):
24.
Snow RW, Okiro EA, Gething PW, Atun R, Hay SI: Equity and adequacy of international donor assistance for global malaria control:an analysis of populations at risk and external funding commitments. Lancet. 2010, 376: 1409-1416. 10.1016/S0140-6736(10)61340-2.PubMedCentralCrossRefPubMed
25.
Akhavan D, Musgrove P, Abrantes A, Gusmao RD: 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: 1385-1399. 10.1016/S0277-9536(99)00214-2.CrossRefPubMed
26.
Conteh L, Sicuri E, Manzi F, Hutton G, Obonyo B, Tediosi F, Biao P, Masika P, Matovu F, Otieno P, Gosling RD, Hamel M, Odhiambo FO, Grobusch MP, Kremsner PG, Chandramohan D, Aponte JJ, Egan A, Schellenberg D, Macete E, Slutsker L, Newman RD, Alonso P, Menendez C, Tanner M: The cost-effectiveness of intermittent preventive treatment for malaria in infants in Sub-Saharan Africa. PLoS One. 2010, 5 (6): e10313-10.1371/journal.pone.0010313.PubMedCentralCrossRefPubMed
27.
Kumaranayake L: The real and the nominal? Making inflationary adjustments to cost and other economic data. Health Policy and Planning. 2000, 15: 230-234. 10.1093/heapol/15.2.230.CrossRefPubMed
28.
Hay SI, Guerra CA, Gething PW, Patil AP, Tatem AJ, Noor AM, Kabaria CW, Manh BH, Elyazar IRF, Brooker S, Smith DL, Moyeed RA, Snow RW: A world malaria map: Plasmodium falciparum endemicity in 2007. Plos Medicine. 2009, 6 (3): e1000048-PubMedCentralCrossRefPubMed
29.
Fernando SD, Karunaweera ND, Fernando WP, Attanayake N, Wickremasinghe AR: A cost analysis of the use of the rapid, whole-blood, immunochromatographic P.f/P.v assay for the diagnosis of Plasmodium vivax malaria in a rural area of Sri Lanka. Annals Trop Med Parasitol. 2004, 98: 5-13. 10.1179/000349804225003064.CrossRef
30.
Chanda P, Castillo-Riquelme M, Masiye F: Cost-effectiveness analysis of the available strategies for diagnosing malaria in outpatient clinics in Zambia. Cost Effectiveness and Resource Allocation. 2009, 7 (5):
31.
Yukich J: Lack of cost-savings from Rapid Diagnostics Tests for malaria in Dar es Salaam, Tanzania. PhD Thesis, Swiss Tropical Institute. 2009
32.
Lemma H, San Sebastian M, Lofgren C, Barnabas G: Cost-effectiveness of three malaria treatment strategies in rural Tigray, Ethiopia where both Plasmodium falciparum and Plasmodium vivax co-dominate. Cost effectiveness and resource allocation: C/E. 2011, 9: 2-10.1186/1478-7547-9-2.PubMedCentralCrossRefPubMed
33.
Rolland E, Checchi F, Pinoges L, Balkan S, Guthmann JP, Guerin PJ: Operational response to malaria epidemics: are rapid diagnostic tests cost-effective?. Trop Med Int Health. 2006, 11: 398-408. 10.1111/j.1365-3156.2006.01580.x.CrossRefPubMed
34.
World Bank: World development report 1993: Investing in health. 1993, New York: Oxford University Press, 342-
35.
Shillcutt SD, Walker DG, Goodman CA, Mills AJ: Cost effectiveness in low- and middle-income countries. A review of the debates surrounding decision rules. Pharmacoeconomics. 2009, 27: 903-917. 10.2165/10899580-000000000-00000.PubMedCentralCrossRefPubMed
36.
Bhatia MR, Fox-Rushby J, Mills A: Cost-effectiveness of malaria control interventions when malaria mortality is low: insecticide-treated nets versus in-house residual spraying in India. Soc Sci Med. 2004, 59: 525-539. 10.1016/j.socscimed.2003.11.005.CrossRefPubMed
37.
Kamolratanakul P, Butraporn P, Prasittisuk M, Prasittisuk C, Indaratna K: Cost-effectiveness and sustainability of lambdacyhalothrin-treated mosquito nets in comparison to DDT spraying for malaria control in western Thailand. Am J Trop Med Hyg. 2001, 65: 279-284.PubMed
38.
Goodman CA, Mnzava AEP, Dlamini SS, Sharp BL, Mthembu DJ, Gumede JK: Comparison of the cost and cost-effectiveness of insecticide-treated bednets and residual house-spraying in KwaZulu-Natal, South Africa. Trop Med Int Health. 2001, 6: 280-295. 10.1046/j.1365-3156.2001.00700.x.CrossRefPubMed
39.
Guyatt HL, Kinnear J, Burini M, Snow RW: A comparative cost analysis of insecticide-treated nets and indoor residual spraying in highland Kenya. Health Policy and Planning. 2002, 17: 144-153. 10.1093/heapol/17.2.144.CrossRefPubMed
40.
Tediosi F, Hutton G, Maire N, Smith TA, Ross A, Tanner M: Predicting the cost-effectiveness of introducing a pre-erythrocytic malaria vaccine into the expanded program on immunization in Tanzania. Am J Trop Med Hyg. 2006, 75: 131-143.PubMed
41.
Tediosi F, Maire N, Penny M, Studer A, Smith TA: Simulation of the cost-effectiveness of malaria vaccines. Malar J. 2009, 8: 127-10.1186/1475-2875-8-127.PubMedCentralCrossRefPubMed
42.
Wiseman V, Hawley WA, ter Kuile FO, Phillips-Howard PA, Vulule JM, Nahlen BL, Mills AJ: The cost-effectiveness of permethrin-treated bed nets in an area of intense malaria transmission in western Kenya. Am J Trop Med Hyg. 2003, 68: 161-167.PubMed
43.
Picard J, Aikins M, Alonso PL, Schellenberg J, Greenwood BM, Mills A: A malaria control trial using insecticide-treated bed nets and targeted chemoprophylaxis in a rural area of The Gambia, West-Africa. 8. Cost-effectiveness of bed net impregnation alone or combined with chemoprophylaxis in preventing mortality and morbidity from malaria in Gambian children. Trans R Soc Trop Med Hyg. 1993, 87: 53-57.CrossRefPubMed
44.
Kleinschmidt I, Schwabe C, Benavente L, Torrez M, Ridl FC, Segura JL, Ehmer P, Nchama GN: Marked increase in child survival after four years of intensive malaria control. Am J Trop Med Hyg. 2009, 80: 882-888.PubMedCentralPubMed
45.
John CC, Riedesel MA, Magak NG, Lindblade KA, Menge DM, Hodges JS, Vulule JM, Akhwale W: Possible interruption of malaria transmission, Highland Kenya, 2007-2008. Emerging Inf Dis. 2009, 15: 1917-1924.
46.
Bhattarai A, Ali AS, Kachur SP, Martensson A, Abbas AK, Khatib R, Al-Mafazy AW, Ramsan M, Rotllant G, Gerstenmaier JF, Molteni F, Abdulla S, Montgomery SM, Kaneko A, Bjorkman A: Impact of artemisinin-based combination therapy and insecticide-treated nets on malaria burden in Zanzibar. Plos Medicine. 2007, 4: 1784-1790.CrossRef
47.
Manzi F, Hutton G, Schellenberg J, Tanner M, Alonso P, Mshinda H, Schellenberg D: From strategy development to routine implementation: the cost of Intermittent Preventive Treatment in Infants for malaria control. Bmc Health Services Research. 2008, 8:
48.
Global Fund: Making a difference: Global Fund Results Report 2011. 2011, Geneva
49.
Molyneux DH, Hotez PJ, Fenwick A, Newman RD, Greenwood B, Sachs J: Neglected tropical diseases and the Global Fund. Lancet. 2009, 373: 296-297. 10.1016/S0140-6736(09)60089-1.CrossRefPubMed
50.
Mills A: Is malaria control a priority? Evidence from Nepal. Health Econ. 1993, 2: 333-347. 10.1002/hec.4730020406.CrossRefPubMed
51.
Evans DB, Adam T, Edejer TTT, Lim SS, Cassels A, Evans TG, Te WCMDG: Achieving the millennium development goals for health - Time to reassess strategies for improving health in developing countries. BMJ. 2005, 331: 1133-1136. 10.1136/bmj.331.7525.1133.PubMedCentralCrossRefPubMed
52.
Tediosi F, Maire N, Smith T, Hutton G, Utzinger J, Ross A, Tanner M: 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: 90-103.PubMed
53.
Smith T, Killeen GF, Maire N, Ross A, Molineaux L, Tediosi F, Hutton G, Utzinger J, Dietz K, Tanner M: Mathematical modeling of the impact of malaria vaccines on the clinical epidemiology and natural history of plasmodium Falciparum malaria: Overview. Am J Trop Med Hyg. 2006, 75: 1-10.PubMed
54.
Ross A, Maire N, Sicuri E, Smith T, Conteh L: Determinants of the cost-effectiveness of intermittent preventive treatment for malaria in infants and children. Plos One. 2011, 6 (4): e18391-10.1371/journal.pone.0018391.PubMedCentralCrossRefPubMed
55.
Creese A, Parker D: Cost analysis in Primary Health Care: a training manual for programme managers. 1994, Geneva: World Health Organization
56.
Ngugi IK, Chiguzo AN, Guyatt HL: A cost analysis of the employer-based bednet programme in Coastal and Western Kenya. Health Policy and Planning. 2004, 19: 111-119. 10.1093/heapol/czh013.CrossRefPubMed
57.
Hanson K, Kikumbih N, Schellenberg JA, Mponda H, Nathan R, Lake S, Mills A, Tanner M, Lengeler C: Cost-effectiveness of social marketing of insecticide-treated nets for malaria control in the United Republic of Tanzania. Bull World Health Org. 2003, 81: 269-276.PubMedCentralPubMed
Metadata
Title
Costs and cost-effectiveness of malaria control interventions - a systematic review
Publication date
01-12-2011
Published in
Malaria Journal / Issue 1/2011
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-10-337

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