Cost-effectiveness analysis of the available strategies for diagnosing malaria in outpatient clinics in Zambia

 

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dc.contributor.author Chanda, Pascalina en_ZA
dc.contributor.author Castillo-Riquelme, Marianela en_ZA
dc.contributor.author Masiye, Felix en_ZA
dc.date.accessioned 2015-10-30T09:28:34Z
dc.date.available 2015-10-30T09:28:34Z
dc.date.issued 2009 en_ZA
dc.identifier.citation Chanda, P., Castillo-Riquelme, M., & Masiye, F. (2009). Cost-effectiveness analysis of the available strategies for diagnosing malaria in outpatient clinics in Zambia. Cost Effectiveness and Resource Allocation, 7(1), 5. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14503
dc.identifier.uri http://dx.doi.org/10.1186/1478-7547-7-5
dc.description.abstract BACKGROUND:Malaria in Zambia accounts for about 4 million clinical cases and 8 000 deaths annually. Artemether-lumefantrine (ACT), a relatively expensive drug, is being used as first line treatment of uncomplicated malaria. However, diagnostic capacity in Zambia is low, leading to potentially avoidable wastage of drugs due to unnecessary anti malarial treatment. METHODS: A cost-effectiveness evaluation of the three current alternatives to malaria diagnosis (clinical, microscopy and Rapid Diagnostic Tests- RDT) was conducted in 12 facilities from 4 districts in Zambia. The analysis was conducted along an observational study, thus reflecting practice in health facilities under routine conditions. Average and incremental cost effectiveness ratios were estimated from the providers' perspective. Effectiveness was measured in relation to malaria cases correctly diagnosed by each strategy. RESULTS: Average cost-effectiveness ratios show that RDTs were more efficient (US$ 6.5) than either microscopy (US$ 11.9) or clinical diagnosis (US$ 17.1) for malaria case correctly diagnosed. In relation to clinical diagnoses the incremental cost per case correctly diagnosed and treated was US$ 2.6 and US$ 9.6 for RDT and microscopy respectively. RDTs would be much cheaper to scale up than microscopy. The findings were robust to changes in assumptions and various parameters. CONCLUSION: RDTs were the most cost effective method at correctly diagnosing malaria in primary health facilities in Zambia when compared to clinical and microscopy strategies. However, the treatment prescription practices of the health workers can impact on the potential that a diagnostic test has to lead to savings on antimalarials. The results of this study will serve to inform policy makers on which alternatives will be most efficient in reducing malaria misdiagnosis by taking into account both the costs and effects of each strategy. en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_ZA
dc.source Cost Effectiveness and Resource Allocation en_ZA
dc.source.uri http://resource-allocation.biomedcentral.com/ en_ZA
dc.subject.other Health Economics en_ZA
dc.subject.other Malaria en_ZA
dc.subject.other Zambia en_ZA
dc.title Cost-effectiveness analysis of the available strategies for diagnosing malaria in outpatient clinics in Zambia en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2009 Chanda et al; licensee BioMed Central Ltd. en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Health Economics Unit en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Chanda, P., Castillo-Riquelme, M., & Masiye, F. (2009). Cost-effectiveness analysis of the available strategies for diagnosing malaria in outpatient clinics in Zambia. <i>Cost Effectiveness and Resource Allocation</i>, http://hdl.handle.net/11427/14503 en_ZA
dc.identifier.chicagocitation Chanda, Pascalina, Marianela Castillo-Riquelme, and Felix Masiye "Cost-effectiveness analysis of the available strategies for diagnosing malaria in outpatient clinics in Zambia." <i>Cost Effectiveness and Resource Allocation</i> (2009) http://hdl.handle.net/11427/14503 en_ZA
dc.identifier.vancouvercitation Chanda P, Castillo-Riquelme M, Masiye F. Cost-effectiveness analysis of the available strategies for diagnosing malaria in outpatient clinics in Zambia. Cost Effectiveness and Resource Allocation. 2009; http://hdl.handle.net/11427/14503. en_ZA
dc.identifier.ris TY - Journal Article AU - Chanda, Pascalina AU - Castillo-Riquelme, Marianela AU - Masiye, Felix AB - BACKGROUND:Malaria in Zambia accounts for about 4 million clinical cases and 8 000 deaths annually. Artemether-lumefantrine (ACT), a relatively expensive drug, is being used as first line treatment of uncomplicated malaria. However, diagnostic capacity in Zambia is low, leading to potentially avoidable wastage of drugs due to unnecessary anti malarial treatment. METHODS: A cost-effectiveness evaluation of the three current alternatives to malaria diagnosis (clinical, microscopy and Rapid Diagnostic Tests- RDT) was conducted in 12 facilities from 4 districts in Zambia. The analysis was conducted along an observational study, thus reflecting practice in health facilities under routine conditions. Average and incremental cost effectiveness ratios were estimated from the providers' perspective. Effectiveness was measured in relation to malaria cases correctly diagnosed by each strategy. RESULTS: Average cost-effectiveness ratios show that RDTs were more efficient (US$ 6.5) than either microscopy (US$ 11.9) or clinical diagnosis (US$ 17.1) for malaria case correctly diagnosed. In relation to clinical diagnoses the incremental cost per case correctly diagnosed and treated was US$ 2.6 and US$ 9.6 for RDT and microscopy respectively. RDTs would be much cheaper to scale up than microscopy. The findings were robust to changes in assumptions and various parameters. CONCLUSION: RDTs were the most cost effective method at correctly diagnosing malaria in primary health facilities in Zambia when compared to clinical and microscopy strategies. However, the treatment prescription practices of the health workers can impact on the potential that a diagnostic test has to lead to savings on antimalarials. The results of this study will serve to inform policy makers on which alternatives will be most efficient in reducing malaria misdiagnosis by taking into account both the costs and effects of each strategy. DA - 2009 DB - OpenUCT DO - 10.1186/1478-7547-7-5 DP - University of Cape Town J1 - Cost Effectiveness and Resource Allocation LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Cost-effectiveness analysis of the available strategies for diagnosing malaria in outpatient clinics in Zambia TI - Cost-effectiveness analysis of the available strategies for diagnosing malaria in outpatient clinics in Zambia UR - http://hdl.handle.net/11427/14503 ER - en_ZA


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