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Cost-utility of a tertiary facility. P5 inpatient case fatality rate for severe malaria (with no pre-referral interventions)
Source publication
Background
In 2013, 78% of malaria deaths occurred in children aged 5 years and below, in sub-Saharan Africa. Treatment of severe malaria requires a health facility with inpatient care. However, in most sub-Sahara African countries, access to health facilities is a major problem. Pre-referral antimalarial treatments aim to delay the progress of sev...
Citations
... Consequently, malaria places a staggering economic burden on the already strained African economy. The disease has been estimated to cost many SSA countries billions of dollars every year in gross domestic product (Malaria, 2005;Carrasco-Escobar et al., 2021;Rakuomi et al., 2017). Moreover, the incidence of malaria in the past decades has increased. ...
It is expected that diseases are likely to spread to newer areas, and high-income countries may experience some illnesses that may have been restricted to low or middle-income countries. In addition, following the Intergovernmental Panel on Climate Change, the present study noted that climate change is likely to have many effects on the spatial and temporal distribution of malaria in many Sub-Saharan African countries. This study examines climate change effects on the geographical distribution of malaria occurrence and how extreme climatic events may perhaps be determining factors in the range of vectors for human diseases in SSA in the nearest future. Here, the study appraisals the symbiotic connection of (1) malaria transmission and association with the changes in temperature, rainfall, and humidity as well as their extremes in SSA and (2) the relationship between climate and malaria with the role of climate change in determining upsurge in malaria and meningitis occurrences in the SSA. The study concludes that major drivers of malaria occurrence are climatic elements such as precipitation and temperature. Therefore, we call for a better early Warning System on a proposed roadmap solution for Sub-Saharan Africa.
... In this context, one of the main problems for malaria patients in remote Sub-Saharan African settings is the difficulty of timely access to health-care facilities and to receive appropriate treatment due to long and difficult travels, distance to clinics, and costs. In seriously ill young children, a few hours delay in start of antimalarial treatment may increase the risk of death [17]. Parenteral drug administration (intravenous or intramuscular) to treat severe malaria must be given by trained personnel in a health care facility and commonly cannot be provided in remote areas [18]. ...
Introduction:
Plasmodium falciparum, the deadliest malaria parasite, kills hundreds of thousands of people per year, mainly young children in Sub-Saharan Africa. Artesunate suppositories are recommended as pre-referral malaria treatment in remote endemic areas for severely ill children to prevent progression of the disease and to provide extra time for patients until the definitive severe malaria treatment can be administered.
Areas covered:
The authors provide an overview of the discovery of artesunate and its different formulations focusing on rectal administration, summarizing key studies concerning the pharmacokinetic, pharmacodynamic, safety, tolerability and efficacy of rectal artesunate leading to WHO recommendation and market authorization in Africa. In addition, studies on acceptance and adherence to rectal artesunate administration and the post-launch status are also covered.
Expert opinion:
Efforts by ministries of health in malaria endemic countries together with international health organizations should establish and enforce guidelines to ensure the correct use of artesunate suppositories only as pre-referral medication in presumed severe malaria cases to minimize the risk of abuse as a monotherapy for treatment of uncomplicated malaria. The priority is to not jeopardize the efficacy of artesunate and to prevent resistance development against this valuable drug class in Africa.
... Estimates of , shown in (2), were based on country-specific average of all health conditions from . 9 We extracted estimates of malaria inpatient unit costs for 22 country-years from 13 peer-reviewed articles, as shown in Table 2. [10][11][12][13][14][15][16][17][18][19][20][21][22] Only 11 country-years from these studies reported inpatient unit costs without spending on drugs and diagnostics. Therefore, we took the median share of non-drug, non-diagnostic spending and applied it were from the same source but focused on all treatment-seeking among children under five with a fever in the last two weeks. ...
