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Cost Effectiveness and Resource Allocation

, 15:10

First Online: 01 July 2017Received: 13 January 2017Accepted: 24 June 2017


BackgroundMalaria continues to be a public health problem despite past and on-going control efforts. For sustenance of control efforts to achieve the malaria elimination goal, it is important that the most cost-effective interventions are employed. This paper reviews studies on cost-effectiveness of malaria interventions using disability-adjusted life years.

MethodsA review of literature was conducted through a literature search of international peer-reviewed journals as well as grey literature. Searches were conducted through Medline PubMed, EMBASE and Google Scholar search engines. The searches included articles published in English for the period from 1996 to 2016. The inclusion criteria for the study were type of malaria intervention, year of publication and cost-effectiveness ratio in terms of cost per DALY averted. We included 40 studies which specifically used the DALY metric in cost-effectiveness analysis CEA of malaria interventions.

ResultsThe majority of the reviewed studies 75% were done using data from African settings with the majority of the interventions 60.0% targeting all age categories. Interventions included case treatment, prophylaxis, vector control, insecticide treated nets, early detection, environmental management, diagnosis and educational programmes. Sulfadoxine–pyrimethamine was the most common drug of choice in malaria prophylaxis, while artemisinin-based combination therapies were the most common drugs for case treatment. Based on guidelines for CEA, most interventions proved cost-effective in terms of cost per DALYs averted for each intervention.

ConclusionThe DALY metric is a useful tool for determining the cost-effectiveness of malaria interventions. This paper demonstrates the importance of CEA in informing decisions made by policy makers.

KeywordsMalaria Disability-adjusted life years Cost-effectiveness Cost Effectiveness AbbreviationsALartemether–lumefantrine

CEAcost-effectiveness analysis

CERcost-effectiveness ratio


DALYdisability adjusted life year

GBDglobal burden of disease

GDPgross domestic product

ITPintermittent preventive treatment

ITNsinsecticidal treated nets

RDTrapid diagnostic test

US$United States Dollars

WHOWorld Health Organisation

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Author: Resign Gunda - Moses John Chimbari



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