{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:17:14Z","timestamp":1783113434163,"version":"3.54.6"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Malaria remains a significant global health burden, especially in endemic regions where efficient use of limited resources is critical. Economic evaluations provide essential evidence to guide strategic resource allocation and optimise intervention outcomes. This systematic review synthesises recent evidence (2018\u20132025) on the cost-effectiveness of malaria prevention and treatment interventions in endemic settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A systematic search of Scopus, Web of Science, and PubMed identified English-language studies published between 2018 and 2025. Eligible studies included full economic evaluations cost effectiveness (CEA), cost utility (CUA), and cost benefit analysis (CBA) assessing malaria prevention or treatment programs. Data extracted included intervention types, comparators, outcomes, costs, and incremental cost-effectiveness ratios (ICERs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen studies met the inclusion criteria, mainly randomised trials evaluating insecticide-treated or long-lasting insecticidal nets (ITNs\/LLINs), indoor residual spraying (IRS), diagnostics, treatment strategies, and combined interventions. Most were conducted in Sub-Saharan Africa LLINs and IRS were highly cost-effective, with costs per disability-adjusted life year (DALY) averted below national GDP thresholds. Combined approaches enhanced effectiveness in high-resistance or high-burden settings, while complex strategies, such as tafenoquine with G6PD screening, showed higher ICERs due to additional costs and operational challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most malaria interventions in Sub-Saharan Africa were highly cost-effective, including LLINs (with PBO nets), IRS (Actellic\/3GIRS), combined LLIN + IRS, SMC\/PDMC, IPTp, and ACT + RDT. RTS,S vaccination and RDT\u202f+\u202fmicroscopy were moderately cost-effective, while G6PD screening with tafenoquine and traveller chemoprophylaxis were context-specific or less cost-effective. A socio-ecological framework underscores the need to align policies with economic evidence for optimal resource allocation and accelerated malaria elimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024546911<\/jats:ext-link>\n                      , PROSPERO Registration: CRD42024546911.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1718225","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T12:56:42Z","timestamp":1770641802000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Strategic resource allocation for malaria elimination in endemic settings: a systematic review of cost-effectiveness evidence"],"prefix":"10.3389","volume":"13","author":[{"given":"Misra Helma","family":"Firdaus","sequence":"first","affiliation":[{"name":"Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia","place":["Kuala Lumpur, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina Syazana","family":"Ho Imran","sequence":"additional","affiliation":[{"name":"Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia","place":["Kuala Lumpur, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharifa Ezat Wan","family":"Puteh","sequence":"additional","affiliation":[{"name":"Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia","place":["Kuala Lumpur, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tam Jenn","family":"Zhueng","sequence":"additional","affiliation":[{"name":"Vector Borne Disease, Disease Control Division, Ministry of Health (MOH)","place":["Putrajaya, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Hafizi Abdul","family":"Hamid","sequence":"additional","affiliation":[{"name":"Vector Borne Disease, Disease Control Division, Ministry of Health (MOH)","place":["Putrajaya, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulkarnain MD","family":"Idris","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia","place":["Kuala Lumpur, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Rizal Abdul","family":"Manaf","sequence":"additional","affiliation":[{"name":"Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia","place":["Kuala Lumpur, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref1","article-title":"World malaria report","volume-title":"Addressing inequity in the global malaria response","year":"2024"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e1512","DOI":"10.1016\/S2214-109X(20)30369-7","article-title":"Cost-effectiveness of intermittent preventive treatment with dihydroartemisinin-piperaquine for malaria during pregnancy: an analysis using efficacy results from Uganda and Kenya, and pooled data","volume":"8","author":"Fernandes","year":"2020","journal-title":"Lancet Glob Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e1524","DOI":"10.1016\/S2214-109X(20)30386-7","article-title":"Cost-effectiveness of intermittent preventive treatment with dihydroartemisinin-piperaquine versus single screening and treatment for the control of malaria in pregnancy in Papua, Indonesia: a 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