Evidence map›Paper›PMID 41310657›Full record

ArticleMalaria journal2025

Cost-effectiveness of intermittent preventive therapy and insecticide-treated bed nets for malaria prevention among pregnant women in Jos North, Plateau State, Nigeria.

Lenz Nwachinemere Okoro, Ayuba Ibrahim Zoakah, Pokop Bupwatda, Ebuka Louis Anyamene, Naya Gadzama Bulus, Fwangshak D Kumbak, Mirembe Christine Sabano, Kaweesi Abdulrahim Mukisa, Jonathan Mawutor Gmanyami, Michael Yaw Amoakoh and 1 more

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Article in Malaria journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Lenz Nwachinemere OkoroDepartment of Community Medicine, David Umahi Federal University Teaching Hospital, Uburu, Ebonyi State, Nigeria.
Ayuba Ibrahim ZoakahDepartment of Community Medicine, University of Jos and Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
Pokop BupwatdaDepartment of Community Medicine, University of Jos and Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
Ebuka Louis AnyameneCollege of Medicine, University of Nigeria, Enugu City, Enugu State, Nigeria.
Naya Gadzama BulusDepartment of Community Medicine, College of Medical Sciences, Abubakar Tafawa Balewa University, Bauchi, Bauchi State, Nigeria.
Fwangshak D KumbakDepartment of Community Medicine, University of Jos and Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
Mirembe Christine SabanoFaculty of Public Health, Nursing and Midwifery, School of Medicine, Uganda Christian University, Kampala, Uganda.
Kaweesi Abdulrahim MukisaDepartment of Biomolecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda.
Jonathan Mawutor GmanyamiGlobal Health and Infectious Diseases Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana.
Michael Yaw AmoakohBawku West District Health Directorate, Ghana Health Service, Accra, Ghana.
Isaac IsikoSchool of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. isaacisiko12@gmail.com.ORCID http://orcid.org/0000-0002-3612-5054

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalaria remains a major public health concern, particularly among pregnant women in endemic regions. Intermittent preventive therapy using sulfadoxine-pyrimethamine (IPTp-SP) and insecticide-treated nets (ITNs) is widely recommended for malaria prevention in pregnancy. However, the cost-effectiveness of these interventions, particularly in low-resource settings, needs further evaluation to inform policy and resource allocation. This study aimed to assess the cost-effectiveness of IPTp-SP and ITNs as malaria prevention strategies among pregnant women attending antenatal care (ANC) services in Jos North, Plateau State, Nigeria.

methodsA cross-sectional study design was used to conduct a cost-effectiveness analysis (CEA) comparing IPTp-SP alone to a combined IPTp-SP/ITN intervention. A total of 1000 pregnant women accessing ANC services from 2019 to 2020 in five primary healthcare facilities were included. Cost data were collected from a provider's perspective using a cost valuation sheet adapted from the WHO CHOICE tool. Health outcomes were measured in disability-adjusted life years (DALYs) lost, with the primary outcomes being the prevalence of low birth weight (LBW) and maternal anaemia at 36-40 weeks of gestation. Data were analysed using STATA version 16, and an incremental cost-effectiveness ratio (ICER) was calculated. Probabilistic sensitivity analysis (PSA) was conducted using Monte Carlo simulations.

resultsThe total DALYs lost were higher in the IPTp-SP-only group (101.53 DALYs) than in the IPTp-SP/ITN group (85.9 DALYs), yielding an incremental effect of 15.63 DALYs averted. The total cost of the intervention was higher for IPTp-SP/ITN (US$231.98) compared to IPTp-SP alone (US$131.79), with an incremental cost of US$100.19. The ICER was US$2.12 per DALY averted, indicating that IPTp-SP/ITN is a cost-effective intervention. The cost-effectiveness acceptability curve (CEAC) indicates that the probability of IPTp-SP/ITN being more cost-effective than IPTp-SP only at a WTP set at 150 US$/DALY is approximately 60%, suggesting that cost-effectiveness improves at higher WTP thresholds.

conclusionThis study demonstrates that IPTp-SP/ITN is a cost-effective intervention for preventing malaria during pregnancy. However, its cost-effectiveness is influenced by integration into ANC services, adherence to ITN use, and funding mechanisms. Policymakers should consider optimizing funding and service delivery models to improve intervention efficiency and sustainability. Further research incorporating household-level costs and long-term economic impacts is recommended.

Indexed as

AntimalarialsCost-Benefit AnalysisInsecticide-Treated BednetsMalariaPregnancy Complications, ParasiticPyrimethamineSulfadoxineAdultCross-Sectional StudiesDrug CombinationsFemaleHumansNigeriaPregnancyYoung AdultAntimalarialsDrug Combinationsfanasil, pyrimethamine drug combinationPyrimethamineSulfadoxineCost-effectivenessInsecticide-treated netsIntermittent preventive therapyMalaria preventionNigeriaPregnant women

Identifiers

PMID41310657
PMCPMC12763952

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.