The Burden of Malaria Epidemics and Cost-Effectiveness of Interventions in Epidemic Situations in Africa

Worrall, Eve; Rietveld, Aafje; Delacollette, Charles

doi:10.4269/ajtmh.2004.71.136

Cited by 82 publications

(74 citation statements)

References 13 publications

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“…Past research on malaria epidemics has largely focussed on forecasting and early detection. By contrast, there is very little evidence on appropriate operational responses once epidemics do occur (Worrall et al 2004). The World Health Organization (WHO) currently recommends prioritising case management, and providing free, highly efficacious artemisinin-based combination therapy (ACT) from the start at all levels of care (WHO 2004).…”

Section: Introductionmentioning

confidence: 99%

Operational response to malaria epidemics: are rapid diagnostic tests cost‐effective?

Rolland¹,

Checchi

Pinoges³

et al. 2006

Tropical Med Int Health

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Summaryobjective To compare the cost-effectiveness of malaria treatment based on presumptive diagnosis with that of malaria treatment based on rapid diagnostic tests (RDTs).methods We calculated direct costs (based on experience from Ethiopia and southern Sudan) and effectiveness (in terms of reduced over-treatment) of a free, decentralised treatment programme using artesunate plus amodiaquine (AS + AQ) or artemether-lumefantrine (ART-LUM) in a Plasmodium falciparum epidemic. Our main cost-effectiveness measure was the incremental cost per false positive treatment averted by RDTs.results As malaria prevalence increases, the difference in cost between presumptive and RDT-based treatment rises. The threshold prevalence above which the RDT-based strategy becomes more expensive is 21% in the AS + AQ scenario and 55% in the ART-LUM scenario, but these thresholds increase to 58 and 70%, respectively, if the financing body tolerates an incremental cost of 1 € per false positive averted. However, even at a high (90%) prevalence of malaria consistent with an epidemic peak, an RDT-based strategy would only cost moderately more than the presumptive strategy: +29.9% in the AS + AQ scenario and +19.4% in the ART-LUM scenario. The treatment comparison is insensitive to the age and pregnancy distribution of febrile cases, but is strongly affected by variation in non-biomedical costs. If their unit price were halved, RDTs would be more cost-effective at a malaria prevalence up to 45% in case of AS + AQ treatment and at a prevalence up to 68% in case of ART-LUM treatment.conclusion In most epidemic prevalence scenarios, RDTs would considerably reduce over-treatment for only a moderate increase in costs over presumptive diagnosis. A substantial decrease in RDT unit price would greatly increase their cost-effectiveness, and should thus be advocated. A tolerated incremental cost of 1 € is probably justified given overall public health and financial benefits. The RDTs should be considered for malaria epidemics if logistics and human resources allow.

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Section: Introductionmentioning

confidence: 99%

Operational response to malaria epidemics: are rapid diagnostic tests cost‐effective?

Rolland¹,

Checchi

Pinoges³

et al. 2006

Tropical Med Int Health

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“…In India there were 1.49 million cases and 767 deaths due to malaria in the year 2010 2 . Malaria is associated with seasonally warm semi-arid areas where nearly 124 million people are considered at risk of climate-related malaria 3 . Most cases of malaria in India occur in Orissa.…”

Section: Introductionmentioning

confidence: 99%

Lipid Peroxidation In Cerebral Malaria And Role Of Antioxidants

Raza¹

2013

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“…P. falciparum malaria epidemics were detected in 41 African sites from year 1997 through 2002 (WHO/UNICEF, 2003). A total of 125 million persons are considered at risk for malaria epidemics, with an estimated yearly death rate of 155,000 to 310,000 (Worrall et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Comparative prevalence level of plasmodium in freshmen (first year students) of Nnamdi Azikwe University in Awka, South-Eastern, Nigeria

Ibekwe¹,

Okonko²,

Onunkwo³

et al. 2009

MJM

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This study examines and reports the prevalence of plasmodium species between gender of freshmen (first year students) of Nnamdi Azikwe University, Akwa, South-Eastern, Nigeria. Blood film examination for malaria parasites in 200 (100.0%) freshmen; 82 (41.0%) males and 118 (59.0%) females was carried out over a 6-month period. Microscopic examinations of both thick and thin blood films techniques were employed for this study. A high malaria parasite prevalence rate of 80% was noted in these subjects. Of the 200 samples examined, 160 (80.0%) were Plasmodiumpositive. There was a female preponderance (F/M 2:1). A higher Plasmodium prevalence was recorded amongst females 102 (86.4%) than in the males 58 (70.7%) and there was no significant increase in malaria infection rate in any particular sex (P=0.05). Plasmodium falciparum was the most prevalent of all the other species. This study also shows that a good percentage of people were infested by malaria with P. falciparum [134 (83.8%)] being the most prevalent species, followed by P. malariae [14 (8.9%)], P. vivax [8 (5.0%)] and P. ovale [4 (2.5%)]. P. ovale was only found among the female subjects and none was found among the male subjects. The findings of this study are of a practical impact, with female subjects having the highest proportion of parasitic contamination. The higher prevalence of malaria Plasmodium found in this study could be attributed to the stagnant drainage systems in the University, which created favorable environmental conditions for the breeding of mosquitoes that act as vectors of malaria parasites and so this enhances the proliferation of the Plasmodium. It could also be attributed to the effect of climatic features on vector breeding and transmission. Wet season usually promote mosquito breeding. Also, the prevalence of P. falciparum could be attributed to its ability to resist attack of most drugs that are commonly in use in the study area. However, there should be a high index for the needs to take appropriate measures aimed at preventing malaria by intensifying efforts in mosquitoes eradication program through operation roll back malaria in Africa, especially in Nigeria.

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The Burden of Malaria Epidemics and Cost-Effectiveness of Interventions in Epidemic Situations in Africa

Cited by 82 publications

References 13 publications

Operational response to malaria epidemics: are rapid diagnostic tests cost‐effective?

Operational response to malaria epidemics: are rapid diagnostic tests cost‐effective?

Lipid Peroxidation In Cerebral Malaria And Role Of Antioxidants

Comparative prevalence level of plasmodium in freshmen (first year students) of Nnamdi Azikwe University in Awka, South-Eastern, Nigeria

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