The economic costs of malaria in children in three sub-Saharan countries: Ghana, Tanzania and Kenya

Sicuri, Elisa; Vieta, Ana; Lindner, Leandro; Constenla, Dagna; Sauboin, Christophe

doi:10.1186/1475-2875-12-307

Cited by 82 publications

(102 citation statements)

References 44 publications

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“…Direct prehospital costs (pre-hospitalization) differed according to the type of recourse (self-medication, health center, and traditional therapy); they were higher for households who resorted to traditional therapists and for those who consulted on-the-spot health centers before going to the hospital, compared to households who opted for self-medication. Our results confirm the observations of Sicuri et al in Ghana, Tanzania, and Kenya [27], and those of Couitchéré et al in Ivory Coast [28]. In terms of direct hospital costs, our study showed that medication and hospital stays constitute the highest proportion of costs.…”

Section: Discussionsupporting

confidence: 82%

“…Health expenditures not only depend on the socioeconomic status, but also on the child's clinical picture and the care delay (time before taking the child to the hospital). Costs associated with the neurological form remained clearly higher compared to other clinical forms (anemia and respiratory distress); our results thus confirm the studies of Sicuri et al performed in Tanzania [27], and of Mulumba et al performed in the DRC [29]. The prescriber, the child's status upon leaving the hospital, and the child's age did not equally contribute to the costs in the three categories of hospitals.…”

Section: Discussionsupporting

confidence: 82%

“…The low number of households having declared informal costs would clearly generate an underestimation of treatment costs incurred by households. Previous studies have shown that, when considering informal payments, the global expenditures of treating malaria can be three times higher than the costs declared by healthcare providers [27,33,34].…”

Section: Limitations Of the Studymentioning

confidence: 99%

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Costs of treatment of children affected by severe malaria in reference hospitals of Kinshasa, Democratic Republic of Congo

Ilunga-Ilunga

Lévêque

Ngongo

et al. 2014

J Infect Dev Ctries

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Introduction: Malaria remains a real problem of public health. Its hospital care generates important expenditures for affected households. The present study aimed to estimate direct and indirect costs of severe child malaria in reference hospitals in Kinshasa. Methodology: This prospective study included 1,350 children under 15 years of age suffering from severe malaria. The study was performed between 1 January and 30 November, 2011. Data were collected in nine reference hospitals. The studied parameters were direct pre-hospital costs, direct hospital costs, and indirect costs. Costs were assessed from the household point of view. Results: Median costs associated with the disease ranged from 114 USD in confessional hospitals to 173 USD in state hospitals and 308 USD in private hospitals. Direct pre-hospital median costs ranged between 3 and 11 USD. Direct hospital costs reached 72 USD in confessional hospitals, 139 USD in state hospitals, and 254 USD in private hospitals. Indirect costs ranged from 22 USD in state hospitals to 30 USD in confessional hospitals and 46 USD in private hospitals, regardless of the status of the accompanying parent or guardian. Factors explaining the variability of costs were the neurological form of malaria, indirect recourse to hospital, socioeconomic level, type of prescribing person, child's status upon leaving the hospital, and child's transfusion status. Conclusions: The care of severe child malaria appeared to be expensive in private and state hospitals. A state subsidy of health care and regulation of the private sector would contribute to the reduction of malaria's financial impact.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 82%

Section: Limitations Of the Studymentioning

confidence: 99%

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Costs of treatment of children affected by severe malaria in reference hospitals of Kinshasa, Democratic Republic of Congo

Ilunga-Ilunga

Lévêque

Ngongo

et al. 2014

J Infect Dev Ctries

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“…The average per capita monthly income of respondents (N42,156.79) was lower than the international per capita income of employee [17]. This is an indication that the population still live below the poverty line.…”

Section: Discussionmentioning

confidence: 85%

The Cost Implications of Malaria Burden on House Hold Expenditure among Socio-Economic Classes in Bayelsa State, Nigeria

Amawulu¹,

Dorothy²

2017

J Trop Dis

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Understanding the economic burden of malaria is a pre-requisite to mounting long term control intervention among social classes in malaria endemic areas. The study determined the effect of malaria on house hold expenditure in Yenagoa metropolis during January, 2016 and March, 2016. A descriptive study design was adopted. Data were collected through a structured questionnaire from 287 respondents and analyzed using simple percentage, ANOVAs and Chi-square as statistical tools.The result showed that per capita income of respondents were lower than international standard.The average direct cost (cost of treatment) was higher than the indirect cost (cost of prevention). The monetary values of direct and indirect cost were N19.945.71 and N3423.41 respectively. These values vary across socio economic classes; differences were not significant (χ 2 c=642.99; df=5; P>0.05). The average cost of treatment per malaria episode (including direct and indirect costs) across occupational status ranges between N677.90 and N19,759.07. These values vary across occupational status. The differences were not statistically significant (χ 2 c=642.989; df=5; P>0.05). The average loss days to malaria were 9.51 days, translating to an average of N42,319.50 per loss days per malaria episode. The implication of this result has called for prompt attention from government, health planners and other agency for special interventions.

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“…[2] Over-diagnosis of severe malaria not only induces unnecessary economical burden for the patients and healthcare providers, but also leads to the failure in treating other life-threatening diseases. Sicuri et al [31] indicated that on average the cost for the treatment of severe cases of malaria, which requires hospitalization, is at least an order of magnitude higher than the treatment cost of uncomplicated malaria. Furthermore, 70% of the treatment costs were assumed by the household.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound diagnosis of malaria: examination of the spleen, liver, and optic nerve sheath diameter

Zha¹,

Zhou²,

Hari³

et al. 2015

World Journal of Emergency Medicine

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BACKGROUND: Over 90% of all cases of malaria worldwide occur in Africa. Current methods of diagnosis are time and labor intensive, and could lead to delayed treatment. METHODS:In this study we investigated the effectiveness of measurements of spleen, liver, and optic nerve sheath diameter (ONSD) in identifying patients with malaria or severe malaria through the use of hand-held ultrasound devices. We recruited 40 adult patients with malaria and 16 adult control subjects at two hospitals in Mwanza, Tanzania. Ultrasonographic diagnosis was compared with rapid antigen diagnostic test and peripheral blood smear as the gold standards. An receiver operating characteristic curve test was performed to determine the most optimal diagnostic threshold for malaria and severe malaria, using each of the measurements for liver size, spleen size, and ONSD. The thresholds were determined to be >12 cm for spleen length and >15.1 cm for liver length, whereas ONSD was not signifi cant in this study. RESULTS:The sensitivities for malaria diagnosis were 66.7% and 58.3% for liver and spleen length respectively, suggesting that these measurements may not be suitable for identifying patients with severe malaria. However, the high specificity of 90.9% for spleen length and the acceptable specifi city of 75.0% for liver length suggest that these measurements can be used as a method to eliminate false-positive diagnoses (i.e. patients who do not have severe malaria but are classifi ed as having it by a test with a high sensitivity), giving a high positive predictive value. CONCLUSIONS:We report a high specifi city for spleen size and a moderate specifi city for liver size in the ultrasonographic diagnosis of severe malaria. Thus when paired with a highly sensitive method of malaria diagnosis, ultrasonographic measurement of spleen and liver size is promising as part of a diagnostic algorithm for malaria. It could be used to stratify risk in patients diagnosed with malaria and assist in their triage. If no sensitive tests are available, ultrasound might be useful to suggest malaria as a cause of a patient's constellation of clinical symptoms.

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The economic costs of malaria in children in three sub-Saharan countries: Ghana, Tanzania and Kenya

Cited by 82 publications

References 44 publications

Costs of treatment of children affected by severe malaria in reference hospitals of Kinshasa, Democratic Republic of Congo

Costs of treatment of children affected by severe malaria in reference hospitals of Kinshasa, Democratic Republic of Congo

The Cost Implications of Malaria Burden on House Hold Expenditure among Socio-Economic Classes in Bayelsa State, Nigeria

Ultrasound diagnosis of malaria: examination of the spleen, liver, and optic nerve sheath diameter

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