• 1

    D’Alessandro U, Olaleye BO, McGuire W, Langerock P, Bennett S, Aikins MK, Thomson MC, Cham MK, Cham BA, Greenwood BM, 1995. Mortality and morbidity from malaria in Gambian children after introduction of an impregnated bed-net programme. Lancet 345 :479–483.

    • Search Google Scholar
    • Export Citation
  • 2

    Nevill CG, Some ES, Mung’ala VO, Mutemi W, New L, Marsh K, Lengeler C, Snow RW, 1996. Insecticide-treated bednets reduce mortality and severe morbidity from malaria among children on the Kenyan coast. Trop Med Int Health 1 :139–146.

    • Search Google Scholar
    • Export Citation
  • 3

    Binka FN, Kubaje A, Adjuik M, Williams LA, Lengeler C, Maude GH, Armah GE, Kajihara B, Adiamah JH, Smith P, 1996. Impact of permethrin impregnated bednets on child mortality in Kassena-Nankana district, Ghana: a randomized controlled trial. Trop Med Int Health 1 :147–154.

    • Search Google Scholar
    • Export Citation
  • 4

    Habluetzel A, Diallo DA, Esposito F, Lamizana L, Pagnoni F, Lengeler C, Traore C, Cousens SN, 1997. Do insecticide-treated curtains reduce all-cause child mortality in Burkina Faso? Trop Med Int Health 2 :855–862.

    • Search Google Scholar
    • Export Citation
  • 5

    Binka FN, Mensah OA, Mills A, 1997. The cost-effectiveness of permethrin impregnated bednets in preventing child mortality in Kassena-Nankana district of northern Ghana. Health Policy 41 :229–239.

    • Search Google Scholar
    • Export Citation
  • 6

    Picard J, Aikins M, Alonso PL, Armstrong Schellenberg JR, Greenwood BM, Mills A, 1993. A malaria control trial using insecticide-treated bed nets and targeted chemoprophylaxis in a rural area of The Gambia, west Africa. 8. Cost-effectiveness of bed net impregnation alone or combined with chemoprophylaxis in preventing mortality and morbidity from malaria in Gambian children. Trans R Soc Trop Med Hyg 87 (Suppl 2):53–57.

    • Search Google Scholar
    • Export Citation
  • 7

    Aikins MK, Fox-Rushby J, D’Alessandro U, Langerock P, Cham K, New L, Bennett S, Greenwood B, Mills A, 1998. The Gambian National Impregnated Bednet Programme: costs, consequences and net cost-effectiveness. Soc Sci Med 46 :181–191.

    • Search Google Scholar
    • Export Citation
  • 8

    Ilboudo-Sanogo E, Cuzin-Ouattara N, Diallo DA, Cousens SN, Esposito F, Habluetzel A, Sanon S, Ouedraogo AP, 2001. Insecticide-treated materials, mosquito adaptation and mass effect: entomological observations after five years of vector control in Burkina Faso. Trans R Soc Trop Med Hyg 95 :353–360.

    • Search Google Scholar
    • Export Citation
  • 9

    Hawley WA, Phillips-Howard PA, ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, Nahlen BL, Gimnig JE, Kariuki SK, Kolczak MS, Hightower AW, 2003. Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya. Am J Trop Med Hyg 68 (Suppl 4):121–127.

    • Search Google Scholar
    • Export Citation
  • 10

    Phillips-Howard PA, ter Kuile FO, Nahlen BL, Alaii JA, Gimnig JE, Kolczak MS, Terlouw DJ, Kariuki SK, Shi YP, Kachur SP, Hightower AW, Vulule JM, Hawley WA, 2003. The efficacy of permethrin-treated bed nets on child mortality and morbidity in western Kenya. II. Study design and methods. Am J Trop Med Hyg 68 (Suppl 4):10–15.

    • Search Google Scholar
    • Export Citation
  • 11

    Drummond M, O’Brien B, Stoddart G, Torrance G, 1997. Methods for the Economic Evaluation of Health Care Programs New York: Oxford University Press.

  • 12

    Walker D, Kumaranayake L, 2002. Allowing for differential timing in cost analyses: discounting and annualization. Health Policy Plan 17 :112–118.

    • Search Google Scholar
    • Export Citation
  • 13

    Phillips-Howard PA, Nahlen BL, Kolczak MS, Hightower AW, ter Kuile FO, Alaii JA, Gimnig JE, Arudo J, Vulule JM, Odhacha A, Kachur SP, Schoute E, Rosen DH, Sexton JD, Oloo AJ, Hawley WA, 2003. Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. Am J Trop Med Hyg 68 (Suppl 4):23–29.

    • Search Google Scholar
    • Export Citation
  • 14

    Phillips-Howard PA, Nahlen BL, Wannemuehler KA, Kolczak MS, ter Kuile FO, Gimnig JE, Alaii JA, Odacha A, Vulule JM, Hawley WA, 2003. Impact of permethrin-treated bed nets on the incidence of sick child visits to peripheral health facilities. Am J Trop Med Hyg 68 (Suppl 4):38–43.

    • Search Google Scholar
    • Export Citation
  • 15

    Boulanger LL, Lee LA, Odhacha A, 1999. Treatment in Kenyan rural health facilities: projected drug costs using the WHO-UNICEF integrated management of childhood illness (IMCI) guidelines. Bull World Health Organ 77 :852–858.

    • Search Google Scholar
    • Export Citation
  • 16

    ter Kuile FO, Terlouw DJ, Phillips-Howard PA, Hawley WA, Friedman JF, Kolczak MS, Kariuki SK, Shi YP, Kwena AM, Vulule JM, Nahlen BL, 2003. Impact of permethrin-treated bed nets on malaria and all-cause morbidity in young children in an area of intense perennial malaria transmission in western Kenya: cross-sectional survey. Am J Trop Med Hyg 68 (Suppl 4):100–107.

    • Search Google Scholar
    • Export Citation
  • 17

    Meltzer MI, Terlouw DJ, Kolczak MS, Odhacha A, ter Kuile FO, Vulule JM, Alaii JA, Nahlen BL, Hawley WA, Phillips-Howard PA, 2003. The household level economics of using permethrin-treated bed nets to prevent malaria in children less than five years of age. Am J Trop Med Hyg 68 (Suppl 4):149–160.

    • Search Google Scholar
    • Export Citation
  • 18

    Luo D, Lu D, Yao R, Li P, Huo X, Li A, Wen L, Ge C, Zhang S, Huo H, 1994. Alphamethrin-impregnated bed nets for malaria and mosquito control in China. Trans R Soc Trop Med Hyg 88 :625–628.

    • Search Google Scholar
    • Export Citation
  • 19

    WHO Statistical Information System (WHOSIS), 2001. Evidence and Information for Health Policy: Burden of Disease Statistics. Geneva: World Health Organization.

  • 20

    Goodman C, Colemans P, Mills A, 2000. Economics of Malaria Control in Sub-Saharan Africa. Geneva: World Health Organization.

  • 21

    Goodman CA, Mills AJ, 1999. The evidence base on the cost-effectiveness of malaria control measures in Africa. Health Policy Plan 14 :301–312.

    • Search Google Scholar
    • Export Citation
  • 22

    Lengeler C, 2001. Comparison of malaria control interventions. Bull World Health Organ 79 :77.

  • 23

    Some ES, 1998. Optimizing the Community Effectiveness of Insecticide-Impregnated Bednets Used for Malaria Control in Coastal Kenya: Implications of Perceptions, Programme Organization, Compliance, and Costs. London: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine.

  • 24

    World Health Organization, 1996. Report of the Ad Hoc Committee on Health Research Relating to Future Intervention Options. TDR/Gen/96.1. Geneva: World Health Organization.

  • 25

    Snow RW, McCabe E, Mbogo CN, Molyneux CS, Some ES, Mung’ala VO, Nevill CG, 1999. The effect of delivery mechanisms on the uptake of bed net re- impregnation in Kilifi District, Kenya. Health Policy Plan 14 :18–25.

    • Search Google Scholar
    • Export Citation
  • 26

    Evans DB, Azene G, Kirigia J, 1997. Should governments subsidize the use of insecticide-impregnated mosquito nets in Africa? Implications of a cost-effectiveness analysis. Health Policy Plan 12 :107–114.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

THE COST-EFFECTIVENESS OF PERMETHRIN-TREATED BED NETS IN AN AREA OF INTENSE MALARIA TRANSMISSION IN WESTERN KENYA

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  • 1 Health Economics and Financing Programme & Gates Malaria Partnership, London School of Hygiene and Tropical Medicine, London, United Kingdom; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

This study compared the costs and effects of insecticide (permethrin)-treated bed net (ITN) use in children less than five years of age in an area of intense, perennial malaria transmission in western Kenya. The data were derived from a group-randomized controlled trial of ITNs conducted between 1996 and 1999. The annual net cost per life-year gained was U.S. $34 and the net annual cost per all-cause sick child clinic visit averted was U.S. $49. After taking into account a community effect (protection from malaria afforded to non-ITN users who lived within 300 meters from users) these estimates decreased to U.S. $25 and U.S. $38, respectively. This study provides further evidence that ITNs are a highly cost-effective use of scarce health care resources.

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