Costs and consequences of large-scale vector control for malaria.

Area of Science:

• Public Health
• Vector Control
• Health Economics

Background:

• Comparison of five large insecticide-treated net (ITN) programs and two indoor residual spraying (IRS) programs.
• Utilized a standardized costing methodology for direct comparison.

Purpose of the Study:

• To evaluate and compare the cost-effectiveness of insecticide-treated nets (ITNs) and indoor residual spraying (IRS) for malaria vector control.
• To determine the most efficient strategies for increasing and maintaining coverage.

Main Methods:

• Standardized costing methodology from a provider perspective, including user net purchases.
• Effectiveness estimated by combining program outputs with standard impact indicators.
• Costs reported in 2005 USD.

Main Results:

• Conventional ITNs: Cost per child death averted ranged from $438 to $2,199.
• Long-lasting insecticidal nets (LLINs): Cost per child death averted ranged from $502 to $692.
• IRS: Cost per child death averted ranged from $3,933 to $4,357, significantly higher than ITNs.

Conclusions:

• Both ITNs and IRS are highly cost-effective vector control strategies.
• Integrated ITN free distribution campaigns are efficient for rapid coverage increases.
• ITNs are more cost-effective than IRS in highly endemic settings, especially with high coverage and demographic targeting.