Conteh Lesong, Sharp Brian L, Streat Elisebeth, Barreto Avertino, Konar Sundragasen
Health Economics and Financing Programme & Gates Malaria Partnership, London School of Hygiene and Tropical Medicine, UK.
Trop Med Int Health. 2004 Jan;9(1):125-32. doi: 10.1046/j.1365-3156.2003.01150.x.
To compare two separately funded, but operationally similar, residual household-spraying (RHS) initiatives; one rural and one peri-urban in southern Mozambique.
The rural programme is a regional project involving the participation and co-ordination of organizations across three countries in southern Africa and is focussed on control in an area in Mozambique of 7552 km2. The second programme focuses on spraying a peri-urban community within a 10-km radius around MOZAL, an aluminium smelter plant of area 410 km2. An ingredients approach was used to derive unit costs for both the rural and peri-urban spraying programmes using detail retrospective cost data and effectiveness indicators.
The economic cost per person covered per year using Carbamates for indoor residual spraying (IRS) in the rural area, excluding the costs of project management and monitoring and surveillance was $3.48 and in the peri-urban area, $2.16. The financial costs per person covered in the rural area and peri-urban area per year were $3.86 and $2.41, respectively. The economic costs per person covered were respectively increased by 39% and 31% when project management and monitoring and surveillance were included. The main driving forces behind the costs of delivering RHS are twofold: the population covered and insecticide used. Computed economic and financial costs are presented for all four insecticide families available for use in RHS.
The results from both these initiatives, especially the rural area, should be interpreted as conservative cost estimates as they exclude the additional health gains that the newly introduced programmes have had on malaria rates in the neighbouring areas of South Africa and Swaziland. Both these initiatives show that introducing an IRS programme can deliver a reduction in malaria-related suffering providing financial support, political will, collaborative management and training and community involvement are in place.
比较莫桑比克南部两个资金来源独立但运作方式相似的室内滞留喷洒（RHS）项目；一个是农村项目，另一个是城郊项目。
农村项目是一个区域项目，涉及南部非洲三个国家的组织参与和协调，重点是在莫桑比克一个面积为7552平方公里的地区进行控制。第二个项目重点是在面积为410平方公里的铝冶炼厂MOZAL周围半径10公里范围内的城郊社区进行喷洒。采用成分法，利用详细的回顾性成本数据和有效性指标，得出农村和城郊喷洒项目的单位成本。
农村地区使用氨基甲酸酯类进行室内滞留喷洒（IRS），每年覆盖每人的经济成本（不包括项目管理以及监测和监督成本）为3.48美元，城郊地区为2.16美元。农村地区和城郊地区每年覆盖每人的财务成本分别为3.86美元和2.41美元。纳入项目管理以及监测和监督后，每年覆盖每人的经济成本分别增加了39%和31%。实施室内滞留喷洒成本的主要驱动因素有两个：覆盖人口和使用的杀虫剂。列出了可用于室内滞留喷洒的所有四个杀虫剂类别的计算经济成本和财务成本。
这两个项目的结果，尤其是农村地区的结果，应被视为保守的成本估计，因为它们未包括新引入的项目对南非和斯威士兰周边地区疟疾发病率带来的额外健康收益。这两个项目均表明，只要有财政支持、政治意愿、协同管理、培训以及社区参与，引入室内滞留喷洒项目就能减少与疟疾相关的痛苦。
