RESUMO
OBJECTIVE: To evaluate the cost-effectiveness analysis of the measures currently used for malaria prevention in the region of Yuanjiang River Valley. METHODS: The efficacy and cost-effectiveness analysis of chemoprophylaxis, single DDT residual spraying and a combination of both were evaluated through three field intervention trials. RESULTS: (1) From July to November, the rate ratio of malaria incidence among building workers of expressway as the group of chemoprophylaxis using combined piperaquine/sulfadoxine once per month was 0.35 (95% CI: 0.20-0.59); the cost per individual protected (CIP) and the cost per case averted (CCA) were RMB 6.69 yuan and RMB 459 yuan respectively. (2) In the hyper-endemic villages near the river, the rate ratio in the group using chloroquine plus primaquine once every 10 days for 5 months was 0.28 (95% CI: 0.08-0.99); the CIP and CCA were RMB 5.30 yuan and RMB 300 yuan respectively. (3) The standardized morbidity ratio (SMR) was 100%, 98% and 50% respectively for the chemoprophylaxis group with pyrimethamine/sulfadoxine once per month from May to September, the group with single DDT residual spraying in April and the group of combined chemoprophylaxis and DDT spraying. The CIP was RMB 1.49, 2.48 and 3.97 yuan for the three groups respectively. As compared with the previous year, no cases were averted from the chemoprophlaxis group; the CCA was RMB 14,535 yuan and 908 yuan respectively for the DDT spraying group and the group with combined measures. CONCLUSION: There was no significant difference on the chemoprophylaxis cost between the group using piperaquine/sulfadoxine combination once per month and that of chloroquine plus primaquine once per ten days. However, the study proved an efficacy for malaria prevention in the former but not in the latter. In comparison with the groups of single measures, the group with combined measures showed the best efficacy and effectiveness, but highly expensive.
