Application of the malaria management model to the analysis of costs and benefits of DDT versus non-DDT malaria control.

<h4>Introduction</h4>DDT is considered to be the most cost-effective insecticide for combating malaria. However, it is also the most environmentally persistent and can pose risks to human health when sprayed indoors. Therefore, the use of DDT for vector control remains controversial.<...

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Autores principales:	Matteo Pedercini, Santiago Movilla Blanco, Birgit Kopainsky
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/066ff99e4b144b5995853a292c0f6fd4
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spelling	oai:doaj.org-article:066ff99e4b144b5995853a292c0f6fd42021-11-18T07:33:23ZApplication of the malaria management model to the analysis of costs and benefits of DDT versus non-DDT malaria control.1932-620310.1371/journal.pone.0027771https://doaj.org/article/066ff99e4b144b5995853a292c0f6fd42011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22140467/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>DDT is considered to be the most cost-effective insecticide for combating malaria. However, it is also the most environmentally persistent and can pose risks to human health when sprayed indoors. Therefore, the use of DDT for vector control remains controversial.<h4>Methods</h4>In this paper we develop a computer-based simulation model to assess some of the costs and benefits of the continued use of DDT for Indoor Residual Spraying (IRS) versus its rapid phase out. We apply the prototype model to the aggregated sub Saharan African region. For putting the question about the continued use of DDT for IRS versus its rapid phase out into perspective we calculate the same costs and benefits for alternative combinations of integrated vector management interventions.<h4>Results</h4>Our simulation results confirm that the current mix of integrated vector management interventions with DDT as the main insecticide is cheaper than the same mix with alternative insecticides when only direct costs are considered. However, combinations with a stronger focus on insecticide-treated bed nets and environmental management show higher levels of cost-effectiveness than interventions with a focus on IRS. Thus, this focus would also allow phasing out DDT in a cost-effective manner. Although a rapid phase out of DDT for IRS is the most expensive of the tested intervention combinations it can have important economic benefits in addition to health and environmental impacts that are difficult to assess in monetary terms. Those economic benefits captured by the model include the avoided risk of losses in agricultural exports.<h4>Conclusions</h4>The prototype simulation model illustrates how a computer-based scenario analysis tool can inform debates on malaria control policies in general and on the continued use of DDT for IRS versus its rapid phase out in specific. Simulation models create systematic mechanisms for analyzing alternative interventions and making informed trade offs.Matteo PederciniSantiago Movilla BlancoBirgit KopainskyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 11, p e27771 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Matteo Pedercini Santiago Movilla Blanco Birgit Kopainsky Application of the malaria management model to the analysis of costs and benefits of DDT versus non-DDT malaria control.
description	<h4>Introduction</h4>DDT is considered to be the most cost-effective insecticide for combating malaria. However, it is also the most environmentally persistent and can pose risks to human health when sprayed indoors. Therefore, the use of DDT for vector control remains controversial.<h4>Methods</h4>In this paper we develop a computer-based simulation model to assess some of the costs and benefits of the continued use of DDT for Indoor Residual Spraying (IRS) versus its rapid phase out. We apply the prototype model to the aggregated sub Saharan African region. For putting the question about the continued use of DDT for IRS versus its rapid phase out into perspective we calculate the same costs and benefits for alternative combinations of integrated vector management interventions.<h4>Results</h4>Our simulation results confirm that the current mix of integrated vector management interventions with DDT as the main insecticide is cheaper than the same mix with alternative insecticides when only direct costs are considered. However, combinations with a stronger focus on insecticide-treated bed nets and environmental management show higher levels of cost-effectiveness than interventions with a focus on IRS. Thus, this focus would also allow phasing out DDT in a cost-effective manner. Although a rapid phase out of DDT for IRS is the most expensive of the tested intervention combinations it can have important economic benefits in addition to health and environmental impacts that are difficult to assess in monetary terms. Those economic benefits captured by the model include the avoided risk of losses in agricultural exports.<h4>Conclusions</h4>The prototype simulation model illustrates how a computer-based scenario analysis tool can inform debates on malaria control policies in general and on the continued use of DDT for IRS versus its rapid phase out in specific. Simulation models create systematic mechanisms for analyzing alternative interventions and making informed trade offs.
format	article
author	Matteo Pedercini Santiago Movilla Blanco Birgit Kopainsky
author_facet	Matteo Pedercini Santiago Movilla Blanco Birgit Kopainsky
author_sort	Matteo Pedercini
title	Application of the malaria management model to the analysis of costs and benefits of DDT versus non-DDT malaria control.
title_short	Application of the malaria management model to the analysis of costs and benefits of DDT versus non-DDT malaria control.
title_full	Application of the malaria management model to the analysis of costs and benefits of DDT versus non-DDT malaria control.
title_fullStr	Application of the malaria management model to the analysis of costs and benefits of DDT versus non-DDT malaria control.
title_full_unstemmed	Application of the malaria management model to the analysis of costs and benefits of DDT versus non-DDT malaria control.
title_sort	application of the malaria management model to the analysis of costs and benefits of ddt versus non-ddt malaria control.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/066ff99e4b144b5995853a292c0f6fd4
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Application of the malaria management model to the analysis of costs and benefits of DDT versus non-DDT malaria control.

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