Cost-effectiveness of malaria control in sub-Saharan Africa

Goodman, Catherine; Coleman, Peter J.; Mills, Anne

doi:10.1016/s0140-6736(99)02141-8

Cited by 256 publications

(222 citation statements)

References 15 publications

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“…Sensitivity and specificity of strategies are as in Table 1. Other parameters implied in calculations are: (i) per cent of untreated malaria cases becoming severe ¼ 5% (Goodman et al 1999), (ii) severe malaria CFR if treated ¼ 19.2% (Goodman et al 2000), (iii) severe malaria CFR if untreated ¼ 50% (Goodman et al 2000), (iv) percent of untreated ARI cases becoming severe ¼ 9.2% (Rudan et al 2004), (v) percent of treated ARI cases becoming severe ¼ 4.6% [based on 50% reduction in mortality risk if treated promptly; (Enarson et al 2005)], (vi) severe ARI CFR if treated ¼ 9.9% (Rudan et al 2004), (vii) severe ARI CFR if untreated ¼ 40% [based on pre-antibiotic era; (Graham 2002)], (viii) cost to health system of one hospital stay ¼ € 52.3 [based on typical stay of 4.5 days; (Goodman et al 2000 We assume that non-malaria ARI cases that are wrongfully treated with ACT will not visit a second source of outpatient care. They may however, seek inpatient care if they aggravate.…”

Section: Art-lum Scenario As + Aq Scenario (A) (B)mentioning

confidence: 99%

Operational response to malaria epidemics: are rapid diagnostic tests cost‐effective?

Rolland¹,

Checchi

Pinoges³

et al. 2006

Tropical Med Int Health

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Summaryobjective To compare the cost-effectiveness of malaria treatment based on presumptive diagnosis with that of malaria treatment based on rapid diagnostic tests (RDTs).methods We calculated direct costs (based on experience from Ethiopia and southern Sudan) and effectiveness (in terms of reduced over-treatment) of a free, decentralised treatment programme using artesunate plus amodiaquine (AS + AQ) or artemether-lumefantrine (ART-LUM) in a Plasmodium falciparum epidemic. Our main cost-effectiveness measure was the incremental cost per false positive treatment averted by RDTs.results As malaria prevalence increases, the difference in cost between presumptive and RDT-based treatment rises. The threshold prevalence above which the RDT-based strategy becomes more expensive is 21% in the AS + AQ scenario and 55% in the ART-LUM scenario, but these thresholds increase to 58 and 70%, respectively, if the financing body tolerates an incremental cost of 1 € per false positive averted. However, even at a high (90%) prevalence of malaria consistent with an epidemic peak, an RDT-based strategy would only cost moderately more than the presumptive strategy: +29.9% in the AS + AQ scenario and +19.4% in the ART-LUM scenario. The treatment comparison is insensitive to the age and pregnancy distribution of febrile cases, but is strongly affected by variation in non-biomedical costs. If their unit price were halved, RDTs would be more cost-effective at a malaria prevalence up to 45% in case of AS + AQ treatment and at a prevalence up to 68% in case of ART-LUM treatment.conclusion In most epidemic prevalence scenarios, RDTs would considerably reduce over-treatment for only a moderate increase in costs over presumptive diagnosis. A substantial decrease in RDT unit price would greatly increase their cost-effectiveness, and should thus be advocated. A tolerated incremental cost of 1 € is probably justified given overall public health and financial benefits. The RDTs should be considered for malaria epidemics if logistics and human resources allow.

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Section: Art-lum Scenario As + Aq Scenario (A) (B)mentioning

confidence: 99%

Operational response to malaria epidemics: are rapid diagnostic tests cost‐effective?

Rolland¹,

Checchi

Pinoges³

et al. 2006

Tropical Med Int Health

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“…65 The bulk of antimalarial therapy worldwide is oral drugs for uncomplicated falciparum malaria. Oral treatment prevents progression to severe disease and complications, and, if the drugs are efficacious and applied effectively, they reduce overall malaria morbidity and mortality.…”

Section: Treatment Accessmentioning

confidence: 99%

“…The cost-effectiveness of diagnosis for a given situation of disease prevalence and treatment costs can be predicted. 65 Vaccine development will require continued efforts and further financial support, and should be based on a strong rationale for selection of particular vaccine candidates. It requires investment in investigations on the relevance of available models, the development of improved models, and above all the identification of surrogates of protection, preferably defined in human beings.…”

Section: Families Of Antimalarial Drugs In Current Usementioning

confidence: 99%

Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development

Guérin¹,

Olliaro

Nosten

et al. 2002

The Lancet Infectious Diseases

317

201

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“…[6][7][8] One study compared the costs of several disparate control methods in Africa, including insecticide-treated bed nets, residual sprays for adult mosquito control, chemoprophylaxis for children, intermittent treatment of pregnant women and improvement of case management. 9 Cost comparisons for various malaria control methods in Africa may not be applicable to proposed programs in the Republic of Korea due to the presence of multiple species of malaria in the former, as well as significant differences in mosquito bionomics and behavior. Furthermore, there have been no published cost-comparisons of the two control methods of interest to the U.S. Army in the Republic of Korea: larviciding and chemoprophylaxis.…”

Section: Introductionmentioning

confidence: 99%

A cost comparison of two malaria control methods in Kyunggi Province, Republic of Korea, using remote sensing and geographic information systems.

Claborn

Masuoka²,

Klein³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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Abstract. A cost-comparison of two methods for the control of malaria in the Republic of Korea was performed. The cost of larviciding with methoprene granules was estimated at $93.48/hectare. The annual cost of providing chemoprophylaxis was estimated at $37.53/person. Remote sensing and geographic information systems were used to obtain estimates of the size of vector larval habitats around two U.S. Army camps, allowing an estimate of the cost of larviciding around each of the camps. This estimate was compared to the cost of providing chloroquine and primaquine chemoprophylaxis for the camp populations. Costs on each of the camps differed by the size of the larval habitats and the size of the at-risk population. These tools allow extrapolation of larval surveillance data to a regional scale while simultaneously providing site-specific cost analysis, thus reducing the cost and labor associated with vector surveillance over large areas.

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Cost-effectiveness of malaria control in sub-Saharan Africa

Cited by 256 publications

References 15 publications

Operational response to malaria epidemics: are rapid diagnostic tests cost‐effective?

Operational response to malaria epidemics: are rapid diagnostic tests cost‐effective?

Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development

A cost comparison of two malaria control methods in Kyunggi Province, Republic of Korea, using remote sensing and geographic information systems.

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