title: Cost-effectiveness of long-lasting insecticide-treated hammocks in preventing malaria in South-central Vietnam.
abstract: BACKGROUND
  Despite much success in reducing the burden of malaria in Vietnam, pockets of malaria persist and eliminating them remains an important development goal. In central Vietnam, insecticide-treated hammocks have recently been introduced to help counter the disease in the highly forested, mountainous areas, where other measures have so far been unsuccessful. This study assesses the cost-effectiveness of using long-lasting insecticide-treated hammocks in this area.
  
  
  RESULTS
  This cost-effectiveness study was run alongside a randomized control trial testing the efficacy of the long-lasting insecticide-treated hammocks. Data were collected through an exit survey, a household survey, expenditure records and key informant interviews. The study estimates that under normal (non-trial) conditions the total net societal cost per malaria episode averted in using long-lasting insecticide-treated hammocks in this area was 126 USD. Cost per hammock, including insecticidal netting, sewing, transport, and distribution was found to be approximately 11.76 USD per hammock. Average savings per episode averted were estimated to be $14.60 USD for the health system and 14.37 USD for households (including both direct and indirect cost savings). The study estimates that the annual financial outlay required of government to implement this type of programme to be 3.40 USD per person covered per year.
  
  
  CONCLUSIONS
  The study finds that the use of a hammock intervention could represent good value for money to help prevent malaria in more remote areas, where traditional control measures such as insecticide-treated bednets and indoor residual spraying are insufficient or inappropriate to control malaria. However, the life span of the hammock-the number of years over which it effectively deters mosquitoes-has a significant impact on the cost-effectiveness of the intervention and study results should be interpreted in light of the evidence on effectiveness gathered in the years to come.
authors.affiliation: LSE Health, London School of Economics & Political Science, London, United Kingdom. C.M.Morel@lse.ac.uk
authors.forename: Chantal M
authors.initials: CM
authors.lastname: Morel
authors.forename: Ngo Duc
authors.initials: ND
authors.lastname: Thang
authors.forename: Annette
authors.initials: A
authors.lastname: Erhart
authors.forename: Nguyen Xuan
authors.initials: NX
authors.lastname: Xa
authors.forename: Koen
authors.initials: K
authors.lastname: Peeters Grietens
authors.forename: Le
authors.initials: L
authors.lastname: Xuan Hung
authors.forename: Le Khan
authors.initials: le K
authors.lastname: Thuan
authors.forename: Pham
authors.initials: P
authors.lastname: Van Ky
authors.forename: Nguyen Manh
authors.initials: NM
authors.lastname: Hung
authors.forename: Marc
authors.initials: M
authors.lastname: Coosemans
authors.forename: Umberto
authors.initials: U
authors.lastname: D'Alessandro
authors.forename: Anne
authors.initials: A
authors.lastname: Mills
mesh_terms: D001513:Beds; D003362:Cost-Benefit Analysis; D006801:Humans; D007306:Insecticides / Q000191:economics*; D008288:Malaria / Q000191:economics* / Q000517:prevention & control*; D009032:Mosquito Control / Q000191:economics*; D014744:Vietnam
chemical_list: D007306:Insecticides
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