Cost Effectiveness of Malaria Interventions

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Helpdesk Query:

Compare the cost effectiveness/ benefits of anti malarials and Rapid Diagnostic Testing (RDT) against Insecticide Treated Nets (ITNs), Indoor Residual Spraying (IRS) and microscopy.


There have been many academic studies and analyses of malaria interventions and their cost effectiveness. Unfortunately however, as the studies have varying methodologies and countries of focus, they are difficult to compare. The information in this report outlines cost effectiveness data and conclusions.

One article did a comparison of various trials which led the authors to conclude that the difference in costs between ITNs and IRS is not usually large (although these studies all included the cost of the nets). Treating nets only was found to have a median cost of $1 per year vs. a median cost of $8 for a single round of IRS. Providing both nets and insecticide had a median cost of $7.2 per year (similar to a round of IRS). Choosing between these methods is therefore identified as a matter of feasibility and availability of local resources, rather than one of epidemiology or cost-effectiveness.

Another article found that in moderate to low levels of malaria transmission, RDT was more cost beneficial than microscopy and both were more beneficial than presumptive treatment but this was only where treatment was consistent with results. Where treatment is provided to those testing negatively, neither approach is cost beneficial. Where microscopy is more operationally sensitive, it becomes more cost beneficial than RDT.


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