Incremental cost and cost-effectiveness of the addition of indoor residual spraying with pirimiphos-methyl in sub-Saharan Africa versus standard malaria control: results of data collection and analysis in the Next Generation Indoor Residual Sprays (NgenIRS) project, an economic-evaluation

• Published in: Malaria Journal
• Main Authors: Joshua Yukich, Peder Digre, Sara Scates, Luc Boydens, Emmanuel Obi, Nicky Moran, Allison Belemvire, Mariandrea Chamorro, Benjamin Johns, Keziah L. Malm, Lena Kolyada, Ignatius Williams, Samuel Asiedu, Seydou Fomba, Jules Mihigo, Desire Boko, Baltazar Candrinho, Rodaly Muthoni, Jimmy Opigo, Catherine Maiteki-Sebuguzi, Damian Rutazaana, Josephat Shililu, Asaph Muhanguzi, Kassahun Belay, Joel Kisubi, Joselyn Annet Atuhairwe, Presley Musonda, Nduka Iwuchukwu, John Ngosa, Elizabeth Chizema, Reuben Zulu, Emmanuel Kooma, John Miller, Adam Bennett, Kyra Arnett, Kenzie Tynuv, Christelle Gogue, Joseph Wagman, Jason H. Richardson, Laurence Slutsker, Molly Robertson
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2022
• Subjects: Indoor residual spraying; IRS; 3GIRS; NgenIRS; Malaria; Vector control; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-022-04160-3; https://doaj.org/article/c333112299a046da93ca3ded43f46124

Abstract Background Malaria is a major cause of morbidity and mortality globally, especially in sub-Saharan Africa. Widespread resistance to pyrethroids threatens the gains achieved by vector control. To counter resistance to pyrethroids, third-generation indoor residual spraying (3GIRS) products have been developed. This study details the results of a multi-country cost and cost-effectiveness analysis of indoor residual spraying (IRS) programmes using Actellic®300CS, a 3GIRS product with pirimiphos-methyl, in sub-Saharan Africa in 2017 added to standard malaria control interventions including insecticide-treated bed nets versus standard malaria control interventions alone. Methods An economic evaluation of 3GIRS using Actellic®300CS in a broad range of sub-Saharan African settings was conducted using a variety of primary data collection and evidence synthesis methods. Four IRS programmes in Ghana, Mali, Uganda, and Zambia were included in the effectiveness analysis. Cost data come from six IRS programmes: one in each of the four countries where effect was measured plus Mozambique and a separate programme conducted by AngloGold Ashanti Malaria Control in Ghana. Financial and economic costs were quantified and valued. The main indicator for the cost was cost per person targeted. Country-specific case incidence rate ratios (IRRs), estimated by comparing IRS study districts to adjacent non-IRS study districts or facilities, were used to calculate cases averted in each study area. A deterministic analysis and sensitivity analysis were conducted in each of the four countries for which effectiveness evaluations were available. Probabilistic sensitivity analysis was used to generate plausibility bounds around the incremental cost-effectiveness ratio estimates for adding IRS to other standard interventions in each study setting as well as jointly utilizing data on effect and cost across all settings. Results Overall, IRRs from each country indicated that adding IRS with Actellic®300CS to the local standard intervention ...