Modeling the Cost Effectiveness of Malaria Control Interventions in the Highlands of Western Kenya

Stuckey, Erin M.; Stevenson, Jennifer; Galactionova, Katya; Baidjoe, Amrish; Bousema, Teun; Odongo, Wycliffe; Kariuki, Simon; Drakeley, Chris; Smith, T.; Cox, Jonathan; Chitnis, Nakul

doi:10.1371/journal.pone.0107700

Cited by 45 publications

(55 citation statements)

References 33 publications

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“…Eight studies used historical expenditures and budgets to extrapolate the costs of intensive control in Africa [28, 31, 32, 61], India [62], Thailand [48], Nepal [41], and globally using varying time periods [63]. …”

Section: Resultsmentioning

confidence: 99%

The economics of malaria control and elimination: a systematic review

Shretta

Avanceña

Hatefi

2016

Malar J

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BackgroundDeclining donor funding and competing health priorities threaten the sustainability of malaria programmes. Elucidating the cost and benefits of continued investments in malaria could encourage sustained political and financial commitments. The evidence, although available, remains disparate. This paper reviews the existing literature on the economic and financial cost and return of malaria control, elimination and eradication.MethodsA review of articles that were published on or before September 2014 on the cost and benefits of malaria control and elimination was performed. Studies were classified based on their scope and were analysed according to two major categories: cost of malaria control and elimination to a health system, and cost-benefit studies. Only studies involving more than two control or elimination interventions were included. Outcomes of interest were total programmatic cost, cost per capita, and benefit-cost ratios (BCRs). All costs were converted to 2013 US$ for standardization.ResultsOf the 6425 articles identified, 54 studies were included in this review. Twenty-two were focused on elimination or eradication while 32 focused on intensive control. Forty-eight per cent of studies included in this review were published on or after 2000. Overall, the annual per capita cost of malaria control to a health system ranged from $0.11 to $39.06 (median: $2.21) while that for malaria elimination ranged from $0.18 to $27 (median: $3.00). BCRs of investing in malaria control and elimination ranged from 2.4 to over 145.ConclusionOverall, investments needed for malaria control and elimination varied greatly amongst the various countries and contexts. In most cases, the cost of elimination was greater than the cost of control. At the same time, the benefits of investing in malaria greatly outweighed the costs. While the cost of elimination in most cases was greater than the cost of control, the benefits greatly outweighed the cost. Information from this review provides guidance to national malaria programmes on the cost and benefits of malaria elimination in the absence of data. Importantly, the review highlights the need for more robust economic analyses using standard inputs and methods to strengthen the evidence needed for sustained financing for malaria elimination.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1635-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

The economics of malaria control and elimination: a systematic review

Shretta

Avanceña

Hatefi

2016

Malar J

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“…The findings shows that preventive measures tends to have a greater health benefit in a cost effective or economical manner in minimizing malaria transmission for the most at risk groups. Stuckey et al [5] showed that increasing coverage of vector control interventions (preventive strategies) had a larger simulated impact compared to adding treatment measures.…”

Section: Discussionmentioning

confidence: 99%

“…Cost effectiveness analysis has become an important tool in understanding the dynamics of disease transmission and in decision making processes regarding intervention programs for disease control [4,5]. Cost effectiveness analysis is carried out to inform decision makers on how to determine where to allocate resources for malaria interventions especially when they are limited.…”

Section: Introductionmentioning

confidence: 99%

“…He further did not consider the cost effective intervention strategies for the at risk group i.e., the pregnant and the under five children. Stukey et al [5] modeled the cost effectiveness of malaria control interventions in the highlands of western Kenya using simulation modeling in OpenMalaria modeling platform but did not consider the effect of IPTp and those at risk population. White et al [4] conducted a systematic review costs and cost-effectiveness of malaria control interventions but not for different transmission setting and for the at risk groups.…”

Section: Introductionmentioning

confidence: 99%

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Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

2016

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Malaria remains a leading cause of mortality and morbidity among the children under five and pregnant women in sub-Saharan Africa, but it is preventable and controllable provided current recommended interventions are properly implemented. Better utilization of malaria intervention strategies will ensure the gain for the value for money and producing health improvements in the most cost effective way. The purpose of the value for money drive is to develop a better understanding (and better articulation) of costs and results so that more informed, evidence-based choices could be made. Cost effectiveness analysis is carried out to inform decision makers on how to determine where to allocate resources for malaria interventions. This study carries out cost effective analysis of one or all possible combinations of the optimal malaria control strategies (Insecticide Treated Bednets-ITNs, Treatment, Indoor Residual Spray-IRS and Intermittent Preventive Treatment for Pregnant Women-IPTp) for the four different transmission settings in order to assess the extent to which the intervention strategies are beneficial and cost effective. For the four different transmission settings in Kenya the optimal solution for the 15 strategies and their associated effectiveness are computed. Cost-effective analysis using Incremental Cost Effectiveness Ratio (ICER) was done after ranking the strategies in order of the increasing effectiveness (total infections averted). The findings shows that for the endemic regions the combination of ITNs, IRS, and IPTp was the most cost-effective of all the combined strategies developed in this study for malaria disease control and prevention; for the epidemic prone areas is the combination of the treatment and IRS; for seasonal areas is the use of ITNs plus treatment; and for the low risk areas is the use of treatment only. Malaria transmission in Kenya can be minimized through tailor-made intervention strategies for malaria control which produces health improvements in the most cost effective way for different epidemiological zones. This offers the good value for money for the public health programs and can guide in the allocation of malaria control resources for the post-2015 malaria eradication strategies and the achievement of the Sustainable Development Goals.

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“…Average cost effectiveness ratio (ACER) will then be calculated as the ratio of the net cost of interventions and the net effect of interventions. [56] Other desired outcomes with policy implications including cost per case, cost per case averted, cost per death averted and disability adjusted life years (DALYs) will also be calculated.…”

Section: Methodsmentioning

confidence: 99%

Towards malaria control and elimination in Ghana: challenges and decision making tools to guide planning

Awine

Malm

Bart-Plange

et al. 2017

Global Health Action

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Ghana is classified as being in the malaria control phase, according to the global malaria elimination program. With many years of policy development and control interventions, malaria specific mortality among children less than 5 years old has declined from 14.4% in 2000 to 0.6% in 2012. However, the same level of success has not been achieved with malaria morbidity. The recently adopted 2015–2020 Ghana strategic action plan aims to reduce the burden of malaria by 75.0%. Planning and policy development has always been guided by evidence from field studies, and mathematical models that are able to investigate malaria transmission dynamics have not played a significant role in supporting policy development. The objectives of this study are to describe the malaria situation in Ghana and give a brief account of how mathematical modelling techniques could support a more informed malaria control effort in the Ghanaian context. A review is carried out of some mathematical models investigating the dynamics of malaria transmission in sub-Saharan African countries, including Ghana. The applications of these models are then discussed, considering the gaps that still remain in Ghana for which further mathematical model development could be supportive. Because of the collaborative approach adopted in their development, some model examples Ghana could benefit from are also discussed. Collaboration between malaria control experts and modellers will allow for more appropriate mathematical models to be developed. Packaging these models with user-friendly interfaces and making them available at various levels of malaria control management could help provide the decision making tools needed for planning and a platform for monitoring and evaluation of interventions in Ghana.

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Modeling the Cost Effectiveness of Malaria Control Interventions in the Highlands of Western Kenya

Cited by 45 publications

References 33 publications

The economics of malaria control and elimination: a systematic review

The economics of malaria control and elimination: a systematic review

Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

Towards malaria control and elimination in Ghana: challenges and decision making tools to guide planning

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