Aikins M K, Fox-Rushby J, D'Alessandro U, Langerock P, Cham K, New L, Bennett S, Greenwood B, Mills A
National Population Council Secretariat, Accra, Ghana.
Soc Sci Med. 1998 Jan;46(2):181-91. doi: 10.1016/s0277-9536(97)00145-7.
Clinical trials have indicated that treating mosquito nets with insecticide could be a potentially cost-effective method of preventing malaria. As malaria is one of the most common causes of death in children under five in developing countries, there has been substantial interest in whether such findings can be replicated for a country's control programme in practice. The cost-effectiveness of the Gambian National Insecticide-impregnated Bednet Programme (NIBP), from the viewpoint of providers (government and non-governmental agencies) and the community, has been calculated. Information was collected from existing records, interviews with NIBP personnel, observation and household surveys. Information is provided on the resource use consequences of the NIBP in terms of reduced expenditure on anti-malaria preventive measures, treatment in government health services, household financed treatment and "charity" (burial, funeral and mourning activities), as well as cash income lost as a result of child death. The annual implementation cost of the NIBP was D757,875 (US$91,864), of which 86% was recurrent cost. The estimated number of death averted was 40.56. The net implementation cost-effectiveness ratio per death averted and discounted life years gained were D3884 (US$471) and D260 (US$31.5), respectively. Adding the cost of all mosquito nets would increase the cost-effectiveness ratios by over five times, which is an important consideration for countries with a lower coverage of mosquito nets per capita. It is concluded that insecticide-impregnated mosquito nets are one of the more efficient ways of reducing deaths in children under 10 years in rural Gambia.
临床试验表明，用杀虫剂处理蚊帐可能是预防疟疾的一种潜在的成本效益高的方法。由于疟疾是发展中国家五岁以下儿童最常见的死亡原因之一，人们对这些研究结果能否在一个国家的实际控制项目中得到复制产生了浓厚兴趣。从提供者（政府和非政府机构）和社区的角度，计算了冈比亚国家杀虫剂浸渍蚊帐项目（NIBP）的成本效益。从现有记录、对NIBP人员的访谈、观察和家庭调查中收集了信息。提供了关于NIBP在减少抗疟疾预防措施支出、政府卫生服务治疗、家庭自费治疗和“慈善”（埋葬、葬礼和哀悼活动）方面的资源使用后果的信息，以及因儿童死亡而损失的现金收入。NIBP的年度实施成本为757,875达拉西（91,864美元），其中86%为经常性成本。估计避免的死亡人数为40.56人。每避免一例死亡和每获得一个贴现生命年的净实施成本效益比分别为3884达拉西（471美元）和260达拉西（31.5美元）。加上所有蚊帐的成本，成本效益比将增加五倍以上，这对于人均蚊帐覆盖率较低的国家来说是一个重要的考虑因素。得出的结论是，杀虫剂浸渍蚊帐是减少冈比亚农村10岁以下儿童死亡的更有效方法之一。
