Cost Effectiveness of Malaria Interventions from Preelimination through Elimination: a Study in Iran.
AbstractBackground: Malaria still is considered as a public health problem in Iran. The aim of the National Malaria Control Department is to reach the elimination by 2024. By decreasing the number of malaria cases in preelimination phase the cost effectiveness of malaria interventions decreases considerably. This study estimated the cost effectiveness of various strategies to combat malaria in preelimination and elimination phases in Iran.Methods: running costs of the interventions at each level of intervention was estimated by using evidence and expert opinions. The effect of each intervention was estimated using the documentary evidence available and expert opin- ions. Using a point estimate and distribution of each variable the sensitivity was evaluated with the Monte Carlo method.Results: The most cost-effective interventions were insecticide treated net (ITN), larviciding, surveillance for diag- nosis and treatment of patients less than 24 hours, and indoor residual spraying (IRS) respectively, No related evi - dence found for the effectiveness of the border facilities.Conclusion: This study showed that interventions in the elimination phase of malaria have low cost effectiveness in Iran like many other countries. However ITN is the most cost effective intervention among the available interven- tions.
Carrara VI, Sirilak S, Thonglairuam J, Roja- nawatsirivet C, Proux S, Gilbos V, Ashley EA, McGready R, Krudsood S, Leemingsawat S (2006) Deployment of early diagnosis and mefloquine- artesunate treatment of falciparum ma- laria in Thailand: the Tak Malaria Initi- ative. PLoS Medicine. 3: 856–864.
Conteh L, Sharp BL, Streat E, Barreto A, Konar S (2004) The cost and cost ef- fectiveness of malaria vector control by residual insecticide house spraying in southern Mozambique: a rural and urban analysis. Trop Med Int Health.9: 125–132.
Edrissian GH (2006) Malaria in Iran: Past and present situation. Iran J Parasitol. 1(1):1–14.
Elimination WHOM (2007) A Field Manual for Low and Moderate Endemic Coun- tries. Geneva: World Health Organiza- tion.
Goodman C, Coleman P, Mills A, Research GF (2000) Economic analysis of ma- laria control in sub-Saharan Africa. Global Forum for Health Research Ge- neva, Switzerland.
Goodman C, Mnzava A, Dlamini S, Sharp B, Mthembu D, Gumede J (2001) Com- parison of the cost and cost effective- ness of insecticide treated bednets and residual house spraying in KwaZulu Na- tal, South Africa. Trop Med Int Health.6: 280–295.
Greenwood BM, Fidock DA, Kyle DE, Kappe SHI, Alonso PL, Collins FH, Duffy PE (2008) Malaria: progress, perils, and prospects for eradication. J clin invest.118: 1266–1276.
Hommel M (2008) Towards a research agen- da for global malaria elimination. Ma- laria journal. 7: S1.
Invest J, Lucas J (2008) Pyriproxyfen as a mosquito larvicide. In WH Robinson, D Bajomi (eds), Proceedings of the 6th International Conference on Urban Pests. Veszprem, Hungary, pp. 239–245.
Janssen MA, Martens WJ (1997) Modeling malaria as a complex adaptive system. Artif Life. 3: 213–236.
Kang YH, Lim HS, Lee HM, Lee KS, Choi KM (2008) Evaluation of usefulness of the panel test composed of malaria non-specific tests as a surrogate mark- er. Korean J Lab Med. 28: 332–338.
Konradsen F, Steele P, Perera D, Van Der Hoek W, Amerasinghe P, Amerasinghe F (1999) Cost of malaria control in Sri Lanka. Bull World Health Organ. 77:301–309.
Lengeler C (2004) Insecticide-treated bed nets and curtains for preventing malaria. status and date: Edited (no change to conclusions), published in.
Lengeler C (2004) Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev, 2(2).
Lines J, Whitty C, Hanson K (2007) Pro- spects for eradication and elimination of malaria: a technical briefing for DFID. London: London School of Hy- giene and Tropical Medicine.
Meleigy M (2007) Arabian Peninsula states launch plan to eradicate malaria. BMJ: British Medical Journal. 334(7585): 117.
Mendis K, Rietveld A, Warsame M, Bosman A, Greenwood B, Wernsdorfer WH (2009) From malaria control to eradi- cation: The WHO perspective. Trop Med Int Health. 14: 802–809.
Moonen B, Cohen JM, Snow RW, Slutsker L, Drakeley C, Smith DL, Abeyasinghe RR, Rodriguez MH, Maharaj R, Tan- ner M, Targett G (2007) Operational strategies to achieve and maintain ma- laria elimination. The Lancet. 376: 1592–1603.
Mueller DH, Wiseman V, Bakusa D, Morgah K, Dare A, Tchamdja P (2008) Cost- effectiveness analysis of insecticide- treated net distribution as part of the Togo Integrated Child Health Cam- paign. Malar J. 7(73): 1–7.
Najera J, Zaim M (2001) Malaria vector control–insecticides for indoor residual spraying.WHO Dengue Bulletin. 25:126–127.
Pluess B, Tanser F, Lengeler C, Sharp B (2010) Indoor residual spraying for preventing malaria. Cochrane Data- base Syst Rev, CD006657.
Raeisi A, Shahbazi A, Ranjbar M, Shoghli A, Vatandoost H, Faraji L (2004) Nation- al strategy Plan for Malaria Control in IR Iran. Diseases Management Center, Ministry of Health and Medical Edu- cation Seda Publ Center.
Sabot O, Cohen JM, Hsiang MS, Kahn JG, Basu S, Tang L, Zheng B, Gao Q, Zou L, Tatarsky A (2010) Costs and finan- cial feasibility of malaria elimination. The Lancet. 376(9752): 1604–1615.
Sachs J, McArthur J (2005) The Millennium Project: a plan for meeting the millen- nium development goals. The Lancet.365: 347–353.
Tatem AJ, Smith DL, Gething PW, Kabaria CW, Snow RW, Hay SI (2010) Rank- ing of elimination feasibility between malaria-endemic countries. The Lancet.376: 1579–1591.
Yukich JO, Lengeler C, Tediosi F, Brown N, Mulligan JA, Chavasse D, Stevens W, Justino J, Conteh L, Maharaj R, Er- skine M, Mueller DH, Wiseman V, Ghebremeskel T, Zerom M, Goodman C, McGuire D, Urrutia JM, Sakho F, Hanson K, Sharp B (2008) Costs and consequences of large-scale vector con- trol for malaria. Malar J. 7: 258. doi:10.1186/1475-2875-7-258.