title: Cost-effectiveness of malaria intermittent preventive treatment in infants (IPTi) in Mozambique and the United Republic of Tanzania.
abstract: OBJECTIVE
  To estimate the cost-effectiveness of malaria intermittent preventive treatment in infants (IPTi) using sulfadoxine-pyrimethamine (SP).
  
  
  METHODS
  In two previous IPTi trials in Ifakara (United Republic of Tanzania) and Manhiça (Mozambique), SP was administered three times to infants before 9 months of age through the Expanded Programme on Immunization. Based on the efficacy results of the intervention and on malaria incidence in the target population, an estimate was made of the number of clinical malaria episodes prevented. This number and an assumed case-fatality rate of 1.57% were used, in turn, to estimate the number of disability-adjusted life years (DALY) averted and the number of deaths averted. The cost of the intervention, including start-up and recurrent costs, was then assessed on the basis of these figures.
  
  
  RESULTS
  The cost per clinical episode of malaria averted was US$ 1.57 (range: US$ 0.8-4.0) in Ifakara and US$ 4.73 (range: US$ 1.7-30.3) in Manhiça; the cost per DALY averted was US$ 3.7 (range: US$ 1.6-12.2) in Ifakara and US$ 11.2 (range: US$ 3.6-92.0) in Manhiça; and the cost per death averted was US$ 100.2 (range: US$ 43.0-330.9) in Ifakara and US$ 301.1 (range: US$ 95.6-2498.4) in Manhiça.
  
  
  CONCLUSIONS
  From the health system and societal perspectives, IPTi with SP is expected to produce health improvements in a cost-effective way. From an economic perspective, it offers good value for money for public health programmes.
authors.affiliation: Swiss Tropical Institute, Basel, Switzerland. guy.hutton@dev-sol-int.com
authors.forename: Guy
authors.initials: G
authors.lastname: Hutton
authors.forename: David
authors.initials: D
authors.lastname: Schellenberg
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Tediosi
authors.forename: Eusebio
authors.initials: E
authors.lastname: Macete
authors.forename: Elizeus
authors.initials: E
authors.lastname: Kahigwa
authors.forename: Betuel
authors.initials: B
authors.lastname: Sigauque
authors.forename: Xavier
authors.initials: X
authors.lastname: Mas
authors.forename: Marta
authors.initials: M
authors.lastname: Trapero
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.forename: Antoni
authors.initials: A
authors.lastname: Trilla
authors.forename: Pedro
authors.initials: P
authors.lastname: Alonso
authors.forename: Clara
authors.initials: C
authors.lastname: Menendez
mesh_terms: D000962:Antimalarials / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis / Q000191:economics*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D009073:Mozambique / Q000453:epidemiology; D015999:Multivariate Analysis; D011739:Pyrimethamine / Q000191:economics / Q000627:therapeutic use; D013413:Sulfadoxine / Q000191:economics / Q000627:therapeutic use; D013636:Tanzania / Q000453:epidemiology
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine