Costs and cost-effectiveness analysis of larval source management and house improvement when added to standard vector control strategies in a rural setting in Malawi with high malaria transmission and seasonal variation

Malaria transmission reduction relies on prompt case management, preventive treatment in pregnant women and vector control, mainly through long lasting insecticide-treated bed nets (LLINs) and indoor residual spraying (IRS). Insecticide resistance threatens current vector control strategies. Larval source management (LSM) and structural house improvement (HI) are potential additional interventions. LSM is being used in an increasing number of countries, but fears about high implementation costs are a barrier to implementation. The costs and effects of LSM and HI in rural settings have not been systematically assessed. From 2016 to 2018, a randomised controlled trial is evaluating the impact of LSM and HI on malaria transmission when added to LLINs in rural Chikwawa, southern Malawi. Changes in incidence of clinical malaria in children aged 6 to 59 months across trial arms is also being measured. We intend to conduct a within-trial cost-effectiveness analysis to determine the cost and cost-effectiveness of adding LSM and HI to LLINs. Using the societal perspective, we will determine financial and economic costs for each intervention. We will also determine the incremental cost per childhood (6 – 59 months) malaria case averted for each intervention. These findings, we hope, will facilitate policy uptake of positive trial outcomes.

Cost-effectiveness analysis, Ancillary sub-study nested study.

Wellcome Trust - Grants awarded

Financing & Economics
Vector Control

Aug 2017 — Feb 2020

$199,356

Malawi

Larval source management
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