Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

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dc.contributor.author Temperley, Matilda
dc.contributor.author Mueller, Dirk H
dc.contributor.author Njagi, J Kiambo
dc.contributor.author Akhwale, Willis
dc.contributor.author Clarke, Siân E.
dc.contributor.author Jukes, Matthew CH
dc.contributor.author Estambale, Benson B.
dc.contributor.author Brooker, Simon
dc.date.accessioned 2018-07-09T10:08:17Z
dc.date.available 2018-07-09T10:08:17Z
dc.date.issued 2008-09-30
dc.identifier.uri http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=5&sid=10cb07a0-bded-443c-93fc-ff4e2d2ce6fb%40sessionmgr4010
dc.identifier.uri http://www.malariajournal.com/content/7/1/196
dc.identifier.uri http://ir.jooust.ac.ke:8080/xmlui/handle/123456789/1362
dc.description.abstract Background: Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT) as delivered by teachers in schools in western Kenya. Methods: Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly). Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated costeffectiveness. Results: The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child) whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year). The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively Conclusion: This study provides the first evidence that IPT administered by teachers is a cost-effective schoolbased malaria intervention and merits investigation in other settings. en_US
dc.language.iso en en_US
dc.publisher Malaria Journal en_US
dc.title Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya en_US
dc.type Other en_US


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