Rezaei-Hemami Mohsen, Akbari-Sari Ali, Raiesi Ahmad, Vatandoost Hassan, Majdzadeh Reza
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
J Arthropod Borne Dis. 2013 Dec 18;8(1):43-52. eCollection 2014.
Malaria still is considered as a public health problem in Iran. The aim of the National Malaria Control Department is to reach the elimination by 2024. By decreasing the number of malaria cases in preelimination phase the cost effectiveness of malaria interventions decreases considerably. This study estimated the cost effectiveness of various strategies to combat malaria in preelimination and elimination phases in Iran.
running costs of the interventions at each level of intervention was estimated by using evidence and expert opinions. The effect of each intervention was estimated using the documentary evidence available and expert opinions. Using a point estimate and distribution of each variable the sensitivity was evaluated with the Monte Carlo method.
The most cost-effective interventions were insecticide treated net (ITN), larviciding, surveillance for diagnosis and treatment of patients less than 24 hours, and indoor residual spraying (IRS) respectively, No related evidence found for the effectiveness of the border facilities.
This study showed that interventions in the elimination phase of malaria have low cost effectiveness in Iran like many other countries. However ITN is the most cost effective intervention among the available interventions.
疟疾在伊朗仍被视为一个公共卫生问题。国家疟疾控制部门的目标是到2024年实现疟疾消除。在消除前阶段，随着疟疾病例数量的减少，疟疾干预措施的成本效益大幅下降。本研究估计了伊朗在疟疾消除前和消除阶段对抗疟疾的各种策略的成本效益。
通过使用证据和专家意见估计每个干预水平的干预措施运行成本。利用现有文献证据和专家意见估计每种干预措施的效果。使用每个变量的点估计和分布，采用蒙特卡罗方法评估敏感性。
最具成本效益的干预措施分别是经杀虫剂处理的蚊帐（ITN）、杀幼虫、对24小时内患者的诊断和治疗监测以及室内滞留喷洒（IRS），未发现有关边境设施有效性的相关证据。
本研究表明，与许多其他国家一样，伊朗疟疾消除阶段的干预措施成本效益较低。然而，在现有干预措施中，经杀虫剂处理的蚊帐是最具成本效益的干预措施。
