The economic burden of malaria on households and the health system in a high transmission district of Mozambique
Abstract Background Malaria remains a leading cause of morbidity and mortality in Mozambique. Increased investments in malaria control have reduced the burden, but few studies have estimated the costs of malaria in the country. This paper estimates the economic costs associated with malaria care to...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | Malaria Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12936-019-2995-4 |
| _version_ | 1819229886314708992 |
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| author | Sergi Alonso Carlos J. Chaccour Eldo Elobolobo Amilcar Nacima Baltazar Candrinho Abuchahama Saifodine Francisco Saute Molly Robertson Rose Zulliger |
| author_facet | Sergi Alonso Carlos J. Chaccour Eldo Elobolobo Amilcar Nacima Baltazar Candrinho Abuchahama Saifodine Francisco Saute Molly Robertson Rose Zulliger |
| author_sort | Sergi Alonso |
| collection | DOAJ |
| description | Abstract Background Malaria remains a leading cause of morbidity and mortality in Mozambique. Increased investments in malaria control have reduced the burden, but few studies have estimated the costs of malaria in the country. This paper estimates the economic costs associated with malaria care to households and to the health system in the high burden district of Mopeia in central Mozambique. Methods Malaria care-seeking and morbidity costs were routinely collected among 1373 households with at least one child enrolled in an active case detection (ACD) cohort in Mopeia, and through cross-sectional surveys with 824 families in 2017 and 805 families in 2018. Household costs included direct medical expenses, transportation and opportunity costs of the time lost due to illness. Structured questionnaires were used to estimate the health system costs associated with malaria care in all 13 district health facilities. Cost estimations followed an ingredient-based approach with a top-down allocation approach for health system expenses. Results Among participants in cross-sectional studies, households sought care for nine severe malaria cases requiring hospital admission and for 679 uncomplicated malaria cases. Median household costs associated with uncomplicated malaria among individuals of all ages were US$ 3.46 (IQR US$ 0.07–22.41) and US$ 81.08 (IQR US$ 39.34–88.38) per severe case. Median household costs were lower among children under five (ACD cohort): US$ 1.63 (IQR US$ 0.00–7.79) per uncomplicated case and US$ 64.90 (IQR US$ 49.76–80.96) per severe case. Opportunity costs were the main source of household costs. Median health system costs associated with malaria among patients of all ages were US$ 4.34 (IQR US$ 4.32–4.35) per uncomplicated case and US$ 26.56 (IQR US$ 18.03–44.09) per severe case. Considering household and health system costs, the overall cost of malaria care to society was US$ 7.80 per uncomplicated case and US$ 107.64 per severe case, representing an economic malaria burden of US$ 332,286.24 (IQR US$ 186,355.84–1,091,212.90) per year only in Mopeia. Conclusions Despite the provision of free malaria services, households in Mopeia incur significant direct and indirect costs associated with the disease. Furthermore, the high malaria cost on the Mozambican health system underscores the need to strengthen malaria prevention to reduce the high burden and improve productivity in the region. |
| first_indexed | 2024-12-23T11:20:18Z |
| format | Article |
| id | doaj.art-2ab73f4b7f194298b46ca69a62245233 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-23T11:20:18Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
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| series | Malaria Journal |
| spelling | doaj.art-2ab73f4b7f194298b46ca69a622452332022-12-21T17:49:05ZengBMCMalaria Journal1475-28752019-11-0118111010.1186/s12936-019-2995-4The economic burden of malaria on households and the health system in a high transmission district of MozambiqueSergi Alonso0Carlos J. Chaccour1Eldo Elobolobo2Amilcar Nacima3Baltazar Candrinho4Abuchahama Saifodine5Francisco Saute6Molly Robertson7Rose Zulliger8Centro de Investigação em Saúde de ManhiçaCentro de Investigação em Saúde de ManhiçaCentro de Investigação em Saúde de ManhiçaCentro de Investigação em Saúde de ManhiçaPrograma Nacional de Controlo da Malaria (NMCP)U.S. President’s Malaria Initiative, US Agency for International DevelopmentCentro de Investigação em Saúde de ManhiçaPATHU.S. President’s Malaria Initiative and Malaria Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and PreventionAbstract Background Malaria remains a leading cause of morbidity and mortality in Mozambique. Increased investments in malaria control have reduced the burden, but few studies have estimated the costs of malaria in the country. This paper estimates the economic costs associated with malaria care to households and to the health system in the high burden district of Mopeia in central Mozambique. Methods Malaria care-seeking and morbidity costs were routinely collected among 1373 households with at least one child enrolled in an active case detection (ACD) cohort in Mopeia, and through cross-sectional surveys with 824 families in 2017 and 805 families in 2018. Household costs included direct medical expenses, transportation and opportunity costs of the time lost due to illness. Structured questionnaires were used to estimate the health system costs associated with malaria care in all 13 district health facilities. Cost estimations followed an ingredient-based approach with a top-down allocation approach for health system expenses. Results Among participants in cross-sectional studies, households sought care for nine severe malaria cases requiring hospital admission and for 679 uncomplicated malaria cases. Median household costs associated with uncomplicated malaria among individuals of all ages were US$ 3.46 (IQR US$ 0.07–22.41) and US$ 81.08 (IQR US$ 39.34–88.38) per severe case. Median household costs were lower among children under five (ACD cohort): US$ 1.63 (IQR US$ 0.00–7.79) per uncomplicated case and US$ 64.90 (IQR US$ 49.76–80.96) per severe case. Opportunity costs were the main source of household costs. Median health system costs associated with malaria among patients of all ages were US$ 4.34 (IQR US$ 4.32–4.35) per uncomplicated case and US$ 26.56 (IQR US$ 18.03–44.09) per severe case. Considering household and health system costs, the overall cost of malaria care to society was US$ 7.80 per uncomplicated case and US$ 107.64 per severe case, representing an economic malaria burden of US$ 332,286.24 (IQR US$ 186,355.84–1,091,212.90) per year only in Mopeia. Conclusions Despite the provision of free malaria services, households in Mopeia incur significant direct and indirect costs associated with the disease. Furthermore, the high malaria cost on the Mozambican health system underscores the need to strengthen malaria prevention to reduce the high burden and improve productivity in the region.http://link.springer.com/article/10.1186/s12936-019-2995-4MalariaMozambiqueHousehold costsHealth system costsEconomic burden |
| spellingShingle | Sergi Alonso Carlos J. Chaccour Eldo Elobolobo Amilcar Nacima Baltazar Candrinho Abuchahama Saifodine Francisco Saute Molly Robertson Rose Zulliger The economic burden of malaria on households and the health system in a high transmission district of Mozambique Malaria Journal Malaria Mozambique Household costs Health system costs Economic burden |
| title | The economic burden of malaria on households and the health system in a high transmission district of Mozambique |
| title_full | The economic burden of malaria on households and the health system in a high transmission district of Mozambique |
| title_fullStr | The economic burden of malaria on households and the health system in a high transmission district of Mozambique |
| title_full_unstemmed | The economic burden of malaria on households and the health system in a high transmission district of Mozambique |
| title_short | The economic burden of malaria on households and the health system in a high transmission district of Mozambique |
| title_sort | economic burden of malaria on households and the health system in a high transmission district of mozambique |
| topic | Malaria Mozambique Household costs Health system costs Economic burden |
| url | http://link.springer.com/article/10.1186/s12936-019-2995-4 |
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