Cost Effectiveness of Long-Lasting Insecticide Treated Bed Nets Distribution in Prevention of Malaria Deaths and Morbidity in Guyana

Malaria continues to pose a significant public health and economic threat in Guyana.In response, over 90,000 Long-Lasting Insecticide Nets (LLINs) were distributed in endemic regions in 2018 to curb malaria incidence.This study conducted a cost-effectiveness analysis from the provider's perspective, comparing the LLIN campaign to a no-intervention scenario.A model-based economic evaluation was used, incorporating cost per LLIN distributed, deaths averted, and disability-adjusted life years (DALYs) averted.The average cost of delivering one LLIN was US$3.29.The intervention averted an estimated 387.42 under-five deaths annually and 1,162.3over three years.The annual cost per death averted was US$129.84,decreasing to US$32.51 over three years.DALYs averted totaled 12,784.86 annually and 38,354.58across three years.The estimated cost per DALY averted was US$3.93, significantly lower than Guyana's 2017 GDP per capita of US$3,883, confirming the intervention's high cost-effectiveness based on the WHO threshold.Sensitivity analyses showed the findings were robust despite variations in LLIN cost, life span, discount rate, and mortality impact.The study concludes that the LLIN campaign was a highly cost-effective malaria intervention and recommends its continuation.It further suggests that similar economic evaluations should be conducted for other preventive measures such as indoor residual spraying and larviciding.