The evidence base on the cost-effectiveness of malaria control measures in Africa.

This review assesses the range and quality of the evidence base on the cost-effectiveness of malaria prevention and treatment in sub-Saharan Africa. Fourteen studies are reviewed, covering insecticide-treated nets, residual spraying, chemoprophylaxis for children, chemoprophylaxis or intermittent treatment for pregnant women, a hypothetical vaccine, and changing the first line drug for treatment. The available evidence provides some guidance to decision-makers. However, the potential to inform policy debates is limited by the gross lack of information on the costs and effects of many interventions, the very small number of cost-effectiveness analyses available, the lack of evidence on the costs and effects of packages of measures, and the problems in generalizing or comparing studies that relate to specific settings and use different methodologies and outcome measures.