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首页> 外文期刊>Cost Effectiveness Resource Allocation >Cost-effectiveness of a combined intervention of long lasting insecticidal nets and indoor residual spraying compared with each intervention alone for malaria prevention in Ethiopia
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Cost-effectiveness of a combined intervention of long lasting insecticidal nets and indoor residual spraying compared with each intervention alone for malaria prevention in Ethiopia

机译：与单独的每种干预相比，长期杀虫网的综合干预的成本效益与单独的埃塞俄比亚疟疾预防的每种干预措施相比

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The effectiveness of long lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), for malaria prevention, have been established in several studies. However, the available evidence about the additional resources required for a combined implementation (LLIN?+?IRS) with respect to the added protection afforded is limited. Therefore, the aim of this study was to compare the cost-effectiveness of combined implementation of LLINs and IRS, compared with LLINs alone, IRS alone, and routine practice in Ethiopia. The study was performed alongside a cluster randomized controlled trial of malaria prevention conducted in Adami Tullu district, in Ethiopia, from 2014 to 2016. In addition, literature-based cost-effectiveness analysis—using effectiveness information from a systematic review of published articles was conducted. Costing of the interventions were done from the providers’ perspective. The health-effect was measured using disability adjusted life years (DALYs) averted, and combined with cost information using a Markov life-cycle model. In the base-case analysis, health-effects were based on the current trial, and in addition, a scenario analysis was performed based on a literature survey. The current trial-based analysis showed that routine practice is not less effective and therefore dominates both the combined intervention and singleton intervention due to lower costs. The literature-based analysis had shown that combined intervention had an incremental cost-effectiveness ratio of USD 1403 per DALY averted, and USD 207 per DALY averted was estimated for LLIN alone. In order for the ICER for the combined intervention to be within a range of 1 GDP per capita per DALY averted, the annual malaria incidence in the area should be at least 13%, and the protective-effectiveness of combined implementation should be at least 53%. Based on the current trial-based analysis, LLINs and IRS are not cost-effective compared to routine practice. However, based on the literature-based analysis, LLIN alone is likely to be cost-effective compared to 3 times GDP per capita per DALY averted. The annual malaria probability and protective-effectiveness of combined intervention are key determinants of the cost-effectiveness of the interventions. Trial registration PACTR201411000882128 (Registered 8 September 2014).
机译：在几项研究中建立了持久杀虫网（LLINS）和室内残留喷涂（IRS）的持久杀虫网（LLINS）和室内残留喷涂（IRS）的有效性。但是，关于联合实施所需资源的可用证据（Llin？+？IRS）关于所添加的保护有限。因此，本研究的目的是比较Llins和IRS联合实施的成本效益，与Llins单独，IRS独自，埃塞俄比亚的常规实践相比。该研究与2014年至2016年在埃塞俄比亚在埃塞俄比亚在埃塞俄比亚进行的Adami Tullu区进行的疟疾预防疟疾预防的集群随机对照试验。此外，在进行的文献的成本效益分析 - 使用来自发表的文章的系统审查的有效信息。干预措施的成本是从提供商的角度完成的。使用残疾调整后的寿命年（DALYS）避免了健康效应，并使用Markov生命周期模型结合成本信息。在基本情况下，健康效应基于当前试验，另外，基于文献调查进行了一种情况分析。目前的试验基分析表明，常规实践不太有效，因此由于成本较低而占据了组合干预和单例干预。基于文献的分析表明，组合干预率为每达利1403美元的增量成本效益率，每单人估计为Llin的每达利避免了207美元。为了使ICER为综合干预率为每达利人均1 GDP的范围内，该地区的年度疟疾发生率应至少为13％，合并实施的保护效果应至少为53 ％。根据当前的基于试验的分析，与常规实践相比，LLINS和IRS并不具有成本效益。然而，根据基于文献的分析，单独的Llin可能与每人均GDP的3倍的GDP相比具有成本效益。综合干预的年度疟疾概率和保护效力是干预措施成本效益的关键决定因素。试验登记Pactr201411000882128（2014年9月8日注册）。

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