A MALARIA CONTROL TRIAL USING INSECTICIDE-TREATED BED NETS AND TARGETED CHEMOPROPHYLAXIS IN A RURAL AREA OF THE GAMBIA, WEST-AFRICA .8. COST-EFFECTIVENESS OF BED NET IMPREGNATION ALONE OR COMBINED WITH CHEMOPROPHYLAXIS IN PREVENTING MORTALITY AND MORBIDITY FROM MALARIA IN GAMBIAN CHILDREN

In The Gambia, insecticide impregnation of bed nets, used alone or com bined with Maloprim(R), reduced morbidity and mortality from malaria a mongst children between one and 4 years of age. Taking expenditure of both time and money by public authorities and village volunteers into account, the costs and cost-effectiveness of each intervention were es timated. Bed net impregnation alone and the combined strategy cost US $5.65 and US $7.49 per child-year protected respectively (1990 figures ). Insecticide (and drugs) accounted for more than 80% of the costs of each intervention strategy. They were both highly cost-effective. Est imated costs per death and per clinical episode of malaria averted wer e US $188 and US $28 for bed net impregnation and $257 and $19 for imp regnation combined with chemoprophylaxis. Estimated costs per healthy year of life saved, discounted at 3%, were US $7.90 and US $10.84.