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Cost-effectiveness analysis of insecticide-treated net distribution as part of the Togo Integrated Child Health Campaign

29 Apr 2008

Replace with author name(s).

Source: Malaria Journal (see original article)

Insecticide-treated bednets are now seen as an important way of controlling malaria. Different ways of distributing the nets to those who need them are being investigated in many parts of the world. In Togo, West Africa, long-lasting insecticide-treated nets (LLITNs) were distributed to all children between nine months and five years as part of a measles vaccination campaign. An analysis of the costs and effectiveness of the programme has concluded that delivering LLITNs as part of a broader health campaign compares well with other malaria control interventions.

Abstract (provisional)

Background

To evaluate the cost-effectiveness of the first nationwide delivery of long-lasting insecticide-treated nets (LLITNs) as part of the 2004 measles vaccination campaign in Togo to all children between nine months and five years.

Methods

An incremental approach was used to calculate the economic costs and effects from a provider perspective. Effectiveness was estimated in terms of malaria cases averted, deaths averted and Disability-Adjusted Life Years (DALYs) averted. Malaria cases were modelled using regional estimates. Programme and treatment costs were derived through reviews of financial records and interviews with key stakeholders. Uncertain variables were subjected to a univariate sensitivity analysis.

Results

Assuming equal attribution of shared costs between the LLITN distribution and the measles vaccination, the net costs per LLITN distributed were 4.41 USD when saved treatment costs were taken into account. Assuming a constant utilization of LLITNs by the target group over three years, 1.2 million cases could be prevented at a net cost per case averted of 3.26 USD. The net costs were 635 USD per death averted and 16.39 USD per DALY averted, respectively.

Conclusions

The costs per case, death and DALY averted are well within commonly agreed benchmarks set by other malaria prevention studies. Varying transmission levels are shown to have a significant impact on cost-effectiveness ratios. Results also suggest that substantial efficiency gains may be derived from the joint delivery of vaccination campaigns and malaria interventions.

2008 Mueller et al., licensee BioMed Central Ltd.

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