Abstract
BackgroundLarviciding for malaria control can contribute to an Integrated Vector Management (IVM) approach. This intervention is currently supported in settings where breeding habitats are ‘few, fixed, and findable’, such as urban areas of sub-Saharan Africa, but the knowledge base regarding the cost-effectiveness of larviciding is non-existent.MethodsProgramme costs and effectiveness data were collected from the Dar es Salaam Urban Malaria Control Programme in Tanzania. Cost-effectiveness ratios (CER) were estimated from the provider and societal perspectives for standard indicators using different malaria transmission scenarios.ResultsCER for microbial larviciding were highly dependent on the assumed baseline malaria incidence rates. Using the societal perspective, net CER were estimated (in 2012 US dollars) at $43 (95% uncertainty intervals [UI]: $15-181) per disability-adjusted life year averted (DALY) when malaria incidence was 902 infections per 1,000 individuals, increasing to $545 (95% UI: $337-1,558) per DALY at an incidence of 122 per 1,000. Larviciding was shown to be cost-effective in Tanzania for incidences as low as 40 infections per 1,000 people per year.ConclusionThis is believed to be the first study to estimate the cost-effectiveness of larviciding for urban malaria control in sub-Saharan Africa. The results support the use of larviciding as a cost-effective intervention in urban areas and managers of national malaria control programme should consider this intervention as part of an IVM approach.Electronic supplementary materialThe online version of this article (doi:10.1186/1475-2875-13-477) contains supplementary material, which is available to authorized users.
Highlights
Larviciding for malaria control can contribute to an Integrated Vector Management (IVM) approach
Environmental management was the subject of only one cost-effectiveness study that was based on the analysis of a colonial-era integrated malaria control programme carried out in copper mining communities of former Northern Rhodesia [16]
The economic costs of the 10-year Urban Malaria Control Programme (UMCP) larviciding programme were evaluated at a present value of $5,111,234
Summary
Larviciding for malaria control can contribute to an Integrated Vector Management (IVM) approach. This intervention is currently supported in settings where breeding habitats are ‘few, fixed, and findable’, such as urban areas of sub-Saharan Africa, but the knowledge base regarding the cost-effectiveness of larviciding is non-existent. It is believed that only one cost analysis of larviciding programmes has been performed to date [17,18] and the cost-effectiveness of this type of intervention remains to be assessed. This adds to the paucity of data on the cost-effectiveness of vector control interventions in urban areas
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