Document Detail

Cost-effectiveness of adding bed net distribution for malaria prevention to antenatal services in Kinshasa, Democratic Republic of the Congo.
MedLine Citation:
PMID:  19706921     Owner:  NLM     Status:  MEDLINE    
We evaluated the cost-effectiveness of distributing insecticide-treated bed nets (ITNs) for malaria prevention at antenatal clinics in Kinshasa, Democratic Republic of the Congo. A decision tree model was used to estimate costs, outcomes, and incremental cost-effectiveness for 17,893 pregnant women attending 28 antenatal clinics who received long-lasting ITNs free of charge. Costs including purchase, transportation, storage, and distribution of ITNs were derived from program records. The ITN efficacy and other parameters were derived from peer-reviewed literature. Outcomes modeled included low birth weight (LBW) deliveries, infant deaths averted, life-years saved (LYs), and disability-adjusted life-years (DALYs) averted. Deterministic and probabilistic sensitivity analyses were conducted. For the 17,893 women in our program, ITN distribution would be expected to avert 587 LBW deliveries and 414 infant deaths. The incremental cost-effectiveness was US $17.22 per DALY averted (95% confidence interval [CI] = US $8.54-$30.90), US $15.70 per LY saved (95% CI = US $7.65-$27.68), and US $411.13 per infant death averted (95% CI = US $353.95-$1,085.89). If resources were constrained, the greatest benefit would be among women in their first through fourth pregnancies. Thus, ITN distribution is a cost-effective addition to antenatal services.
Sylvia I Becker-Dreps; Andrea K Biddle; Audrey Pettifor; Gertrude Musuamba; David Nku Imbie; Steven Meshnick; Frieda Behets
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of tropical medicine and hygiene     Volume:  81     ISSN:  1476-1645     ISO Abbreviation:  Am. J. Trop. Med. Hyg.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-26     Completed Date:  2009-09-21     Revised Date:  2014-09-22    
Medline Journal Info:
Nlm Unique ID:  0370507     Medline TA:  Am J Trop Med Hyg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  496-502     Citation Subset:  AIM; IM    
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MeSH Terms
Bedding and Linens / economics*
Cost-Benefit Analysis
Decision Making
Democratic Republic of the Congo
Infant, Newborn
Insecticides / pharmacology
Malaria / economics*,  prevention & control*
Mosquito Control / economics,  methods
Pregnancy Complications, Parasitic / prevention & control*
Prenatal Care / economics*,  methods
Grant Support
5-T32 HP14001-19//PHS HHS; R24 HD050924/HD/NICHD NIH HHS; U 62/CCU422422//PHS HHS
Reg. No./Substance:

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