LSE Health, London School of Economics & Political Science, London, United Kingdom.
PLoS One. 2013;8(3):e58205. doi: 10.1371/journal.pone.0058205. Epub 2013 Mar 11.
Despite much success in reducing the burden of malaria in Vietnam, pockets of malaria persist and eliminating them remains an important development goal. In central Vietnam, insecticide-treated hammocks have recently been introduced to help counter the disease in the highly forested, mountainous areas, where other measures have so far been unsuccessful. This study assesses the cost-effectiveness of using long-lasting insecticide-treated hammocks in this area.
This cost-effectiveness study was run alongside a randomized control trial testing the efficacy of the long-lasting insecticide-treated hammocks. Data were collected through an exit survey, a household survey, expenditure records and key informant interviews. The study estimates that under normal (non-trial) conditions the total net societal cost per malaria episode averted in using long-lasting insecticide-treated hammocks in this area was 126 USD. Cost per hammock, including insecticidal netting, sewing, transport, and distribution was found to be approximately 11.76 USD per hammock. Average savings per episode averted were estimated to be $14.60 USD for the health system and 14.37 USD for households (including both direct and indirect cost savings). The study estimates that the annual financial outlay required of government to implement this type of programme to be 3.40 USD per person covered per year.
The study finds that the use of a hammock intervention could represent good value for money to help prevent malaria in more remote areas, where traditional control measures such as insecticide-treated bednets and indoor residual spraying are insufficient or inappropriate to control malaria. However, the life span of the hammock-the number of years over which it effectively deters mosquitoes-has a significant impact on the cost-effectiveness of the intervention and study results should be interpreted in light of the evidence on effectiveness gathered in the years to come.
尽管越南在减轻疟疾负担方面取得了很大成就，但仍存在一些疟疾流行区，消除这些地区的疟疾仍是一个重要的发展目标。在越南北部，最近引入了经杀虫剂处理的吊床，以帮助在森林茂密、多山的地区对抗疟疾，而其他措施迄今为止都没有成功。本研究评估了在该地区使用长效驱虫处理吊床的成本效益。
本成本效益研究是与一项随机对照试验同时进行的，该试验测试了长效驱虫处理吊床的功效。数据通过出口调查、家庭调查、支出记录和关键知情人访谈收集。研究估计，在正常（非试验）条件下，在该地区使用长效驱虫处理吊床预防每例疟疾的总净社会成本为 126 美元。包括防虫网、缝纫、运输和分发在内的每吊床成本约为 11.76 美元。估计每例疟疾避免的平均节省为卫生系统 14.60 美元，家庭 14.37 美元（包括直接和间接成本节省）。研究估计，政府实施这种类型的计划所需的年度财政支出为每人每年 3.40 美元。
研究发现，使用吊床干预措施可以为预防疟疾提供良好的成本效益，特别是在传统控制措施（如经杀虫剂处理的蚊帐和室内滞留喷洒）不足或不适合控制疟疾的偏远地区。然而，吊床的使用寿命（即有效驱赶蚊子的年限）对干预措施的成本效益有重大影响，研究结果应根据未来几年收集的有效性证据进行解释。
