Research
Cost analysis of school-based intermittent screening and treatment of malaria in Kenya
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* Corresponding author: Thomas L Drake thomas.drake@lshtm.ac.uk
1 Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
2 Malaria Public Health & Epidemiology Group, Kenya Medical Research Institute-Wellcome Trust Collaborative Programme, Nairobi, Kenya
3 Division of Malaria Control, Ministry of Public Health & Sanitation, Nairobi, Kenya
4 Graduate School of Education, Harvard University, Cambridge, Massachusetts, USA
5 Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
Malaria Journal 2011, 10:273 doi:10.1186/1475-2875-10-273
Published: 20 September 2011Abstract
Background
The control of malaria in schools is receiving increasing attention, but there remains currently no consensus as to the optimal intervention strategy. This paper analyses the costs of intermittent screening and treatment (IST) of malaria in schools, implemented as part of a cluster-randomized controlled trial on the Kenyan coast.
Methods
Financial and economic costs were estimated using an ingredients approach whereby all resources required in the delivery of IST are quantified and valued. Sensitivity analysis was conducted to investigate how programme variation affects costs and to identify potential cost savings in the future implementation of IST.
Results
The estimated financial cost of IST per child screened is US$ 6.61 (economic cost US$ 6.24). Key contributors to cost were salary costs (36%) and malaria rapid diagnostic tests (RDT) (22%). Almost half (47%) of the intervention cost comprises redeployment of existing resources including health worker time and use of hospital vehicles. Sensitivity analysis identified changes to intervention delivery that can reduce programme costs by 40%, including use of alternative RDTs and removal of supervised treatment. Cost-effectiveness is also likely to be highly sensitive to the proportion of children found to be RDT-positive.
Conclusion
In the current context, school-based IST is a relatively expensive malaria intervention, but reducing the complexity of delivery can result in considerable savings in the cost of intervention.
(Costs are reported in US$ 2010).