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Costs and cost-effectiveness of a large-scale mass testing and treatment intervention for malaria in Southern Province, Zambia.

AbstractBACKGROUND:
A cluster, randomized, control trial of three dry-season rounds of a mass testing and treatment intervention (MTAT) using rapid diagnostic tests (RDTs) and artemether-lumefantrine (AL) was conducted in four districts in Southern Province, Zambia.
METHODS:
Data were collected on the costs and logistics of the intervention and paired with effectiveness estimated from a community randomized control trial for the purpose of conducting a provider perspective cost-effectiveness analysis of MTAT vs no MTAT (Standard of Care).
RESULTS:
Dry-season MTAT in this setting did not reduce malaria transmission sufficiently to permit transition to a case-investigation strategy to then pursue malaria elimination, however, the intervention did substantially reduce malaria illness and was a highly cost-effective intervention for malaria burden reduction in this moderate transmission area. The cost per RDT administered was estimated to be USD4.39 (range: USD1.62-13.96) while the cost per AL treatment administered was estimated to be USD34.74 (range: USD3.87-3,835). The net cost per disability adjusted life year averted (incremental cost-effectiveness ratio) was estimated to be USD804.
CONCLUSIONS:
The intervention appears to be highly cost-effective relative to World Health Organization thresholds for malaria burden reduction in Zambia as compared to no MTAT. However, it was estimated that population-wide mass drug administration is likely to be more cost-effective for burden reduction and for transmission reduction compared to MTAT.
AuthorsKafula Silumbe, Joshua O Yukich, Busiku Hamainza, Adam Bennett, Duncan Earle, Mulakwa Kamuliwo, Richard W Steketee, Thomas P Eisele, John M Miller
JournalMalaria journal (Malar J) Vol. 14 Pg. 211 (May 20 2015) ISSN: 1475-2875 [Electronic] England
PMID25985992 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antimalarials
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins
  • Drug Combinations
  • Ethanolamines
  • Fluorenes
Topics
  • Antimalarials (therapeutic use)
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins (therapeutic use)
  • Cost-Benefit Analysis
  • Diagnostic Tests, Routine (economics)
  • Drug Combinations
  • Ethanolamines (therapeutic use)
  • Fluorenes (therapeutic use)
  • Malaria (drug therapy)
  • Mass Screening (economics)
  • Zambia

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