Cost of malaria control in Sri Lanka

The study provides estimates of the cost of various malaria control measure s in an area of North-Central Province of Sri lanka where the disease is en demic. We assumed that each measure was equally effective. In these terms, impregnating privately purchased bednets with insecticide was estimated to cost Rs 48 (US$ 0.87) per individual protected per year, less than half the cost of spraying houses with residual insecticides. Larviciding of vector breeding sites and especially the elimination of breeding habitats by flush ing streams through seasonal release of water from upstream reservoirs was estimated to be cheaper than other preventive measures (Rs 27 (US$ 0.49) an d Rs 13 (US$ 0.24) per individual protected, respectively). Inclusion of bo th operational and capital costs of treatment indicates that the most cost- effective intervention for the government was a centrally located hospital with a relatively large catchment area (Rs 71 (US$ 1.29) per malaria case t reated). Mobile clinics (Rs 153 (US$ 2.78) per malaria case treated) and a village treatment centre (Rs 112 (US$ 2.04)) per malaria case treated) were more expensive options for the government, but were considerably cheaper f or households than the traditional hospital facilities. This information ca n guide health planners and government decision-makers in choosing the most appropriate combination of curative a nd preventive measures to control ma laria. However, the option that is ch ea pest for the govern ment may not b e so for the householders, and further studies are needed to estimate the e ffectiveness of the various preventive measures.