Abstract
IntroductionBangladesh has a history of endemic malaria transmission, with 17.5 million people at risk. The objective of this study was to assess the cost-effectiveness of universal childhood malaria vaccination in Chittagong Hill Tracts (CHT) of Bangladesh with newly developed RTS,S/AS01 malaria vaccines.MethodsA decision model was been developed using Microsoft® Excel to examine the potential impact of future vaccination in Bangladesh. We estimated the economic and health burden due to malaria and the cost-effectiveness of malaria vaccination from the health system and societal perspective. The primary outcomes include the incremental cost per Disability-Adjusted Life Year (DALY) averted, incremental cost per case averted, and the incremental cost per death averted.ResultsIntroducing childhood malaria vaccination in CHT in Bangladesh for a single birth cohort could prevent approximately 500 malaria cases and at least 30 deaths from malaria during the first year of vaccination. The cost per DALY averted of introducing the malaria vaccine compared to status quo is US$ 2,629 and US$ 2,583 from the health system and societal perspective, respectively.ConclusionsIntroduction of malaria vaccination in CHT region is estimated to be a cost-effective preventive intervention and would offer substantial future benefits particularly for young children vaccinated today. Policies should, thus, consider the operational advantages of targeting these populations, particularly in the CHT area, with the vaccine along with other malaria control initiatives.
Highlights
Bangladesh has a history of endemic malaria transmission, with 17.5 million people at risk
The cost per disability adjusted life years (DALYs) averted of introducing the malaria vaccine compared to status quo is US$ 2,629 and US$ 2,583 from the health system and societal perspective, respectively
Approximately 80% belong to the 3 most malarial-prone districts (Bandarban, Khagrachari and Rangamati), which are collectively known as Chittagong Hill Tracts (CHT); it has the highest malarial incidence reported within the country [7]
Summary
Bangladesh has a history of endemic malaria transmission, with 17.5 million people at risk. The objective of this study was to assess the cost-effectiveness of universal childhood malaria vaccination in Chittagong Hill Tracts (CHT) of Bangladesh with newly developed RTS,S/AS01 malaria vaccines. CHT region is estimated to be a cost-effective preventive intervention and would offer substantial future benefits for young children vaccinated today. Bangladesh has a history of endemic malaria transmission in 13 out of its 64 districts, and approximately 17.5 million people are at risk, only 27,737 cases were reported in 2016 [4]. Approximately 80% belong to the 3 most malarial-prone districts (Bandarban, Khagrachari and Rangamati), which are collectively known as Chittagong Hill Tracts (CHT); it has the highest malarial incidence reported within the country [7]. The treatment costs have been shown to be proportionately higher for poor households, and are catastrophic to poorer households and rural dwellers [11]
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