The household-level economics of using permethrin-treated bed nets to prevent malaria in children less than five years of age.
We measured the two-week household-level economic impact of insecticide (permethrin)-treated bed nets (ITNs) used to prevent malaria among children less than five years of age in Asembo, Kenya. The ITNs induced a two-week reduction of 15 Kenyan shillings (KSH) (0.25 U.S. dollars; P < 0.0001) in health care expenditures, but a statistically insignificant 0.5 day (P = 0.280) reduction in household time lost due to caring for sick children. The equivalent annual threshold cost was estimated at 6.50 U.S. dollars (95% confidence interval = 3.12-9.86). If the actual purchase price and maintenance costs of ITNs were greater than this threshold, then households would pay more than they would save (and vice-versa). Both seasonal effects and number of children per household had larger impacts than ITNs on health care expenditures and time lost from household activities. Health care expenditures by a household without ITNs and one child were only 32 KSH per two weeks (0.50 U.S. dollars; P = 0.002), leaving little opportunity for household-level, ITN-induced direct savings. The widespread adoption of the ITNs will therefore probably require a subsidy.
Office of Surveillance, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Martin I
MI
Meltzer
Dianne J
DJ
Terlouw
Margarette S
MS
Kolczak
Amos
A
Odhacha
Feiko O
FO
ter Kuile
John M
JM
Vulule
Jane A
JA
Alaii
Bernard L
BL
Nahlen
William A
WA
Hawley
Penelope A
PA
Phillips-Howard
D000962:Antimalarials / Q000191:economics / Q000627:therapeutic use; D001512:Bedding and Linens; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D006798:Housing; D006801:Humans; D007306:Insecticides / Q000191:economics / Q000494:pharmacology; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D009017:Morbidity; D010298:Parity; D026023:Permethrin / Q000191:economics / Q000494:pharmacology*; D012044:Regression Analysis; D012959:Socioeconomic Factors
D000962:Antimalarials; D007306:Insecticides; D026023:Permethrin