JLE

Cahiers d'études et de recherches francophones / Santé

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The cost of malaria, and its socio-economic impact in Africa Volume 3, issue 4, Juillet-Août 1993

Authors
laboratoire de protozoologie médicale, Institut de médecine tropicale, 155, Nationalestraat, 2000 Anvers, Belgique, service d’entomologie médicale, Institut de médecine tropicale, 155, Nationalestraat, 2000 Anvers, Belgique.
  • Page(s) : 323-30
  • Published in: 1993

The economic impact of malaria is usually divided into direct and indirect costs. Recent studies show the lack of precision in such estimates and contradictory conclusions. The cost to the community of an adult rendered inactive by malaria will depend on the work position held, the area of activity and the time taken off work (1-6 days in general). The effect of premature death among adults and children is difficult to evaluate in economic terms. The incidence of clinical cases must be calculated for each age group and in the different periods of the year. These are the three elements that must be taken into consideration when assessing indirect costs. From 0 to 60% of visits to health centers are due to malaria, according to the country and time of year. The cost of treatment depends on the drug prescribed. Chloroquine is still the most widely used antimalarial, followed by sulfadoxine-pyrimethamine and quinine. In Kinshasa, health zones spend 0.5 Ecu per inhabitant and per year on chloroquine for the treatment of attacks. About 11% of patients in Burkina Faso are sufficiently ill to warrant hospitalisation. Lethality is difficult to estimate because diagnosis can be imprecise in outlying areas. Prevention based on a single indoor spraying with malathion costs a total of 0.51 Ecu per inhabitant in Burundi. Per household, 2.2 Ecu was used for insecticide purchase and 0.8 Ecu for the salary and transport of the spraying teams. Prevention with impregnated bednets costs from 0.5 to 1.5 Ecu per inhabitant per year, according to the source of the material: products imported from Asia are cheaper that those made locally. The use of these nets has been shown to reduce the incidence of malaria by up to 60%. If the subsequent savings on treatment were made available for the purchase of bednets, then the total cost of malaria (direct and indirect) would be halved. Patients also seek help from traditional healers, private pharmacists and village health workers. Shortages of essential drugs could be avoided by applying the Bamako Initiative. The use of bednets should be promoted in endemic areas, as communities appear to be more and more willing to contribute to specific measures with proven efficacy.