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Cost analysis of school-based intermittent screening and treatment of malaria in Kenya

BACKGROUND: The control of malaria in schools is receiving increasing attention, but there remains currently no consensus as to the optimal intervention strategy. This paper analyses the costs of intermittent screening and treatment (IST) of malaria in schools, implemented as part of a cluster-rando...

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Autores principales: Drake, Thomas L, Okello, George, Njagi, Kiambo, Halliday, Katherine E, Jukes, Matthew CH, Mangham, Lindsay, Brooker, Simon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3187739/
https://www.ncbi.nlm.nih.gov/pubmed/21933376
http://dx.doi.org/10.1186/1475-2875-10-273
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author Drake, Thomas L
Okello, George
Njagi, Kiambo
Halliday, Katherine E
Jukes, Matthew CH
Mangham, Lindsay
Brooker, Simon
author_facet Drake, Thomas L
Okello, George
Njagi, Kiambo
Halliday, Katherine E
Jukes, Matthew CH
Mangham, Lindsay
Brooker, Simon
author_sort Drake, Thomas L
collection PubMed
description BACKGROUND: The control of malaria in schools is receiving increasing attention, but there remains currently no consensus as to the optimal intervention strategy. This paper analyses the costs of intermittent screening and treatment (IST) of malaria in schools, implemented as part of a cluster-randomized controlled trial on the Kenyan coast. METHODS: Financial and economic costs were estimated using an ingredients approach whereby all resources required in the delivery of IST are quantified and valued. Sensitivity analysis was conducted to investigate how programme variation affects costs and to identify potential cost savings in the future implementation of IST. RESULTS: The estimated financial cost of IST per child screened is US$ 6.61 (economic cost US$ 6.24). Key contributors to cost were salary costs (36%) and malaria rapid diagnostic tests (RDT) (22%). Almost half (47%) of the intervention cost comprises redeployment of existing resources including health worker time and use of hospital vehicles. Sensitivity analysis identified changes to intervention delivery that can reduce programme costs by 40%, including use of alternative RDTs and removal of supervised treatment. Cost-effectiveness is also likely to be highly sensitive to the proportion of children found to be RDT-positive. CONCLUSION: In the current context, school-based IST is a relatively expensive malaria intervention, but reducing the complexity of delivery can result in considerable savings in the cost of intervention. (Costs are reported in US$ 2010).
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spelling pubmed-31877392011-10-06 Cost analysis of school-based intermittent screening and treatment of malaria in Kenya Drake, Thomas L Okello, George Njagi, Kiambo Halliday, Katherine E Jukes, Matthew CH Mangham, Lindsay Brooker, Simon Malar J Research BACKGROUND: The control of malaria in schools is receiving increasing attention, but there remains currently no consensus as to the optimal intervention strategy. This paper analyses the costs of intermittent screening and treatment (IST) of malaria in schools, implemented as part of a cluster-randomized controlled trial on the Kenyan coast. METHODS: Financial and economic costs were estimated using an ingredients approach whereby all resources required in the delivery of IST are quantified and valued. Sensitivity analysis was conducted to investigate how programme variation affects costs and to identify potential cost savings in the future implementation of IST. RESULTS: The estimated financial cost of IST per child screened is US$ 6.61 (economic cost US$ 6.24). Key contributors to cost were salary costs (36%) and malaria rapid diagnostic tests (RDT) (22%). Almost half (47%) of the intervention cost comprises redeployment of existing resources including health worker time and use of hospital vehicles. Sensitivity analysis identified changes to intervention delivery that can reduce programme costs by 40%, including use of alternative RDTs and removal of supervised treatment. Cost-effectiveness is also likely to be highly sensitive to the proportion of children found to be RDT-positive. CONCLUSION: In the current context, school-based IST is a relatively expensive malaria intervention, but reducing the complexity of delivery can result in considerable savings in the cost of intervention. (Costs are reported in US$ 2010). BioMed Central 2011-09-20 /pmc/articles/PMC3187739/ /pubmed/21933376 http://dx.doi.org/10.1186/1475-2875-10-273 Text en Copyright ©2011 Drake et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Drake, Thomas L
Okello, George
Njagi, Kiambo
Halliday, Katherine E
Jukes, Matthew CH
Mangham, Lindsay
Brooker, Simon
Cost analysis of school-based intermittent screening and treatment of malaria in Kenya
title Cost analysis of school-based intermittent screening and treatment of malaria in Kenya
title_full Cost analysis of school-based intermittent screening and treatment of malaria in Kenya
title_fullStr Cost analysis of school-based intermittent screening and treatment of malaria in Kenya
title_full_unstemmed Cost analysis of school-based intermittent screening and treatment of malaria in Kenya
title_short Cost analysis of school-based intermittent screening and treatment of malaria in Kenya
title_sort cost analysis of school-based intermittent screening and treatment of malaria in kenya
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3187739/
https://www.ncbi.nlm.nih.gov/pubmed/21933376
http://dx.doi.org/10.1186/1475-2875-10-273
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