title: 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.
abstract: In The Gambia, insecticide impregnation of bed nets, used alone or combined with Maloprim, reduced morbidity and mortality from malaria amongst children between one and 4 years of age. Taking expenditure of both time and money by public authorities and village volunteers into account, the costs and cost-effectiveness of each intervention were estimated. Bed net impregnation alone and the combined strategy cost US $5.65 and US $7.49 per child-year protected respectively (1990 figures). Insecticide (and drugs) accounted for more than 80% of the costs of each intervention strategy. They were both highly cost-effective. Estimated costs per death and per clinical episode of malaria averted were US $188 and US $28 for bed net impregnation and $257 and $19 for impregnation combined with chemoprophylaxis. Estimated costs per healthy year of life saved, discounted at 3%, were US $7.90 and US $10.84.
authors.affiliation: London School of Hygiene and Tropical Medicine, UK.
authors.forename: J
authors.initials: J
authors.lastname: Picard
authors.forename: M
authors.initials: M
authors.lastname: Aikins
authors.forename: P L
authors.initials: PL
authors.lastname: Alonso
authors.forename: J R
authors.initials: JR
authors.lastname: Armstrong Schellenberg
authors.forename: B M
authors.initials: BM
authors.lastname: Greenwood
authors.forename: A
authors.initials: A
authors.lastname: Mills
mesh_terms: D000962:Antimalarials / Q000191:economics* / Q000627:therapeutic use; D001512:Bedding and Linens; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003622:Dapsone / Q000191:economics* / Q000627:therapeutic use; D004338:Drug Combinations; D005714:Gambia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007306:Insecticides / Q000191:economics*; D008288:Malaria / Q000191:economics / Q000453:epidemiology* / Q000401:mortality; D009017:Morbidity; D009032:Mosquito Control / Q000191:economics*; D011739:Pyrimethamine / Q000191:economics* / Q000627:therapeutic use
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D007306:Insecticides; C001678:Maloprim; D003622:Dapsone; D011739:Pyrimethamine