A Cost-Effectiveness Analysis of Plasmodium falciparum Malaria Elimination in Hainan Province, 2002–2012

Sun, Dianjun; Du, Jian; Wang, Guangze; Li, Yuchun; He, Chao; Xue, Rui‐De; Wang, Shanqing; Hu, Xiaoyun

doi:10.4269/ajtmh.14-0486

Cited by 13 publications

(11 citation statements)

References 19 publications

(23 reference statements)

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“…The analysis measured effectiveness of the packages implemented at the district level by the number of DALYs averted per 1000 population over the study period [ 11 ]. Because of the mix of preventive and curative interventions in each package, the DALYs averted were used to obtain a common measure of effectiveness.…”

Section: Methodsmentioning

confidence: 99%

Scaling up malaria intervention “packages” in Senegal: using cost effectiveness data for improving allocative efficiency and programmatic decision-making

Faye

Cico

Guèye

et al. 2018

Malar J

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BackgroundSenegal’s National Malaria Control Programme (NMCP) implements control interventions in the form of targeted packages: (1) scale-up for impact (SUFI), which includes bed nets, intermittent preventive treatment in pregnancy, rapid diagnostic tests, and artemisinin combination therapy; (2) SUFI + reactive case investigation (focal test and treat); (3) SUFI + indoor residual spraying (IRS); (4) SUFI + seasonal malaria chemoprophylaxis (SMC); and, (5) SUFI + SMC + IRS. This study estimates the cost effectiveness of each of these packages to provide the NMCP with data for improving allocative efficiency and programmatic decision-making.MethodsThis study is a retrospective analysis for the period 2013–2014 covering all 76 Senegal districts. The yearly implementation cost for each intervention was estimated and the information was aggregated into a package cost for all covered districts. The change in the burden of malaria associated with each package was estimated using the number of disability adjusted life-years (DALYs) averted. The cost effectiveness (cost per DALY averted) was then calculated for each package.ResultsThe cost per DALY averted ranged from $76 to $1591 across packages. Using World Health Organization standards, 4 of the 5 packages were “very cost effective” (less than Senegal’s GDP per capita). Relative to the 2 other packages implemented in malaria control districts, the SUFI + SMC package was the most cost-effective package at $76 per DALY averted. SMC seems to make IRS more cost effective: $582 per DALY averted for SUFI + IRS compared with $272 for the SUFI + IRS + SMC package. The SUFI + focal test and treat, implemented in malaria elimination districts, had a cost per DALY averted of $1591 and was only “cost-effective” (less than three times Senegal’s per capita GDP).ConclusionSenegal’s choice of deploying malaria interventions by packages seems to be effectively targeting high burden areas with a wide range of interventions. However, not all districts showed the same level of performance, indicating that efficiency gains are still possible.

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Section: Methodsmentioning

confidence: 99%

Scaling up malaria intervention “packages” in Senegal: using cost effectiveness data for improving allocative efficiency and programmatic decision-making

Faye

Cico

Guèye

et al. 2018

Malar J

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“…Given that the cost effectiveness of interventions depends as much on the cost estimates as the effectiveness estimates, as well as the heterogeneity of costs and effects across time and space, it is surprising at times how little information is reported in the peer-reviewed literature on the detailed analyses and processes followed to estimate the cost of implementing malaria interventions or programmes. For example, the ‘costing’ section may include a brief summary of the generic methods prior to reporting results [ 13 , 14 ] or delegate the costing methods to an appendix that also quickly summarizes the analysis but provides few practical details [ 15 ]. This lack of practical detail, driven by journal requirements for brevity, makes it difficult for academic as well as non-academic researchers, such as national malaria control programme staff or local NGO staff, to apply similar methods for their own programme activities and to understand how and why results vary across location and time.…”

Section: Introductionmentioning

confidence: 99%

A framework for evaluating the costs of malaria elimination interventions: an application to reactive case detection in Southern Province of Zambia, 2014

Larson

Ngoma

Silumbe

et al. 2016

Malar J

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BackgroundThis paper summarizes a framework for evaluating the costs of malaria elimination interventions and applies this approach to one key component of the elimination strategy—reactive case detection (RCD)—implemented through 173 health facilities across 10 districts in Southern Province of Zambia during 2014.MethodsThe primary unit of analysis is the health facility catchment area (HFCA). A five-step approach was followed to estimate implementation costs: organize preliminary information; estimate basic unit costs; estimate activity unit costs; estimate and organize final unit cost database; and create the final costing database (one row of data per HFCA). By working through a specific application, the overall logic of the analysis and details of each step are presented. An electronic annex also provides all details of the analysis. Because population varies substantially across HFCAs, all results are reported per 1000 population in HFCAs.ResultsDuring 2014, 38.9 households per HFCA were visited for RCD services; 166.8 individuals were tested and 32.3 tested positive and were treated. The mean annual cost per HFCA was $1177 (median = $923, IQR $651–$1417). Variation in costs was driven by the number of CHWs and passive cases detected. CHW-related costs and data review meetings accounted for the largest share of costs. Rapid diagnostic tests and drugs accounted for less than 10 % of total costs.ConclusionsThe framework presented here follows standard methods in applied costing of public health interventions (combining ingredients- and activity-based costing approaches into one final cost analysis). Through an application to a specific programme implemented in Zambia in 2014, the details of how to apply such methods to an actual programme are presented. Such details are not typically presented in existing costing analyses but are required for applied analysts working with national malaria control programmes and other organizations to complete such analyses as part of routine programme implementation. Obtaining data and information for implementing the approach remains complicated, in part because analysts from one organization may not have easy access to information from another organization. This basic approach is transparent and easily applied to other malaria elimination interventions being implemented in sub-Saharan Africa and elsewhere.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1457-5) contains supplementary material, which is available to authorized users.

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“…There was only one county (Motuo County in the Tibet Autonomous Region) that had an incidence of indigenous malaria of more than 1/10 000 in 2014. Hainan Province was the most seriously affected malaria-endemic area, as it had the highest transmission of Plasmodium falciparum and P. vivax malaria in history [ 13 ], however, no locally-acquired falciparum malaria cases have been reported since 2010 and the number of vivax malaria cases has declined sharply to zero since 2012 (see Fig. 1b ).…”

Section: Resultsmentioning

confidence: 99%

Shrinking the malaria map in China: measuring the progress of the National Malaria Elimination Programme

Liu

Zhang

et al. 2016

Infect Dis Poverty

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BackgroundRemarkable progress has been made towards the elimination of malaria in China since the National Malaria Elimination Programme (NMEP) was launched in 2010. The incidence of locally-acquired malaria cases has declined rapidly and endemic areas have also dramatically shrunk. In total, 3 078 malaria cases were reported in 2014, but only 56 cases were indigenous. In order to further promote the elimination programme, we reviewed the progress of and experiences associated with malaria elimination in China, and identified the challenges and priorities for the next stage of the programme.MethodsData were collected from the web-based China Information System for Disease Control and Prevention, and the China Annual Report of Malaria Elimination. The progress towards the elimination of malaria from 2010 to 2014 was measured.ResultsDuring the implementation of the NMEP from 2010 to 2014, local malaria incidence has declined continuously, only remaining in the Yunnan Province and Tibet Autonomous Region in 2014. By the end of 2015, 75.6 % (1 636/2 163) of the malaria-endemic counties passed the sub-national elimination assessment. The main challenges are cases of border malaria and imported malaria from other countries. Sustainable support and investment from the government, the establishment of an effective surveillance and response system, and risk assessments for the potential reintroduction of malaria are priorities for the next stage of the elimination programme.ConclusionsThe NMEP in China has been successfully implemented thus far and the malaria map has shrunk dramatically. The priorities for malaria elimination are interventions to block transmission at border areas, management of imported malaria cases, preventing malaria reintroduction, capacity building, and sustainability of malaria surveillance and response.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0146-5) contains supplementary material, which is available to authorized users.

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A Cost-Effectiveness Analysis of Plasmodium falciparum Malaria Elimination in Hainan Province, 2002–2012

Cited by 13 publications

References 19 publications

Scaling up malaria intervention “packages” in Senegal: using cost effectiveness data for improving allocative efficiency and programmatic decision-making

Scaling up malaria intervention “packages” in Senegal: using cost effectiveness data for improving allocative efficiency and programmatic decision-making

A framework for evaluating the costs of malaria elimination interventions: an application to reactive case detection in Southern Province of Zambia, 2014

Shrinking the malaria map in China: measuring the progress of the National Malaria Elimination Programme

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