title: Cost analysis of school-based intermittent screening and treatment of malaria in Kenya.
abstract: BACKGROUND
  The control of malaria in schools is receiving increasing attention, but there remains currently no consensus as to the optimal intervention strategy. This paper analyses the costs of intermittent screening and treatment (IST) of malaria in schools, implemented as part of a cluster-randomized controlled trial on the Kenyan coast.
  
  
  METHODS
  Financial and economic costs were estimated using an ingredients approach whereby all resources required in the delivery of IST are quantified and valued. Sensitivity analysis was conducted to investigate how programme variation affects costs and to identify potential cost savings in the future implementation of IST.
  
  
  RESULTS
  The estimated financial cost of IST per child screened is US$ 6.61 (economic cost US$ 6.24). Key contributors to cost were salary costs (36%) and malaria rapid diagnostic tests (RDT) (22%). Almost half (47%) of the intervention cost comprises redeployment of existing resources including health worker time and use of hospital vehicles. Sensitivity analysis identified changes to intervention delivery that can reduce programme costs by 40%, including use of alternative RDTs and removal of supervised treatment. Cost-effectiveness is also likely to be highly sensitive to the proportion of children found to be RDT-positive.
  
  
  CONCLUSIONS
  In the current context, school-based IST is a relatively expensive malaria intervention, but reducing the complexity of delivery can result in considerable savings in the cost of intervention. (Costs are reported in US$ 2010).
authors.affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. thomas.drake@lshtm.ac.uk
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Drake
authors.forename: George
authors.initials: G
authors.lastname: Okello
authors.forename: Kiambo
authors.initials: K
authors.lastname: Njagi
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Halliday
authors.forename: Matthew Ch
authors.initials: MCh
authors.lastname: Jukes
authors.forename: Lindsay
authors.initials: L
authors.lastname: Mangham
authors.forename: Simon
authors.initials: S
authors.lastname: Brooker
mesh_terms: D000293:Adolescent; D000962:Antimalarials / Q000008:administration & dosage* / Q000191:economics*; D002648:Child; D003365:Costs and Cost Analysis; D006801:Humans; D007630:Kenya; D008288:Malaria / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D008403:Mass Screening / Q000191:economics* / Q000379:methods*; D012574:Schools
chemical_list: D000962:Antimalarials