Study 15 — Cancer-Credited Cost-Effectiveness of Insecticide-Treated Net Programmes: Adding the Endemic Burkitt Lymphoma Co-Benefit to Standard Economic Evaluations

Background: Insecticide-treated net (ITN) programmes in sub-Saharan Africa are evaluated exclusively for their malaria prevention benefit in published cost-effectiveness analyses. A 17-country meta-analysis (Study 8 ([10.5281/zenodo.20402639](https://doi.org/10.5281/zenodo.20402639)) of this series) documented a 44% reduction (95% CI 12–64%) in endemic Burkitt lymphoma (eBL) incidence following large-scale ITN deployment, implying approximately 6,600–8,800 childhood cancer cases prevented annually. This benefit has never been incorporated into any published ITN economic evaluation. Methods: A decision-analytic model was constructed comparing two evaluation frameworks for LLIN programmes in sub-Saharan Africa: (A) standard malaria-only cost-effectiveness analysis, and (B) extended cancer-credited analysis incorporating eBL prevention as a joint product. Primary inputs: cost per net distributed USD 10 (range USD 7–15); published malaria-only ICER USD 40/DALY (range USD 20–75); eBL pre-ITN incidence 1.36/100,000 child-years; pooled 44% reduction post-ITN; conservative eBL burden of 10 DALYs per case. Sensitivity analysis varied ITN cost, eBL reduction, and eBL DALY weight across 27...