University of Bordeaux, Population Health of Bordeaux, Inserm U1219, EMOS team. ISPED, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France.
Department of Epidemiology-Biostatistics and Medical Informatics (DEBIM), Faculty of Medicine, University of Health Sciences, BP: 4009, Libreville, Gabon.
Malar J. 2021 Jul 30;20(1):334. doi: 10.1186/s12936-021-03862-4.
Malaria is one of the leading causes of morbidity and mortality in African countries. It is one of the leading causes of hospital visits and hospitalization in pediatric wards for children under 5 years old. Interestingly however, the economic burden of this disease remains unknown in these endemic countries including Gabon. The purpose of this study is to assess the direct hospital cost for the management of malaria in children under 5 years old at the Libreville University Hospital Centre (CHUL, Centre Hospitalier Universitaire de Libreville) in Gabon.
This research work is a retrospective study using a comprehensive review of medical records of patients seen at the CHUL over a two-year period extending from January 2018 through December 2019. The study focused on children under 5 years old, admitted for malaria in the paediatric ward of the CHUL. The analysis targeted specifically direct hospital costs, which excluded salary and wages of health care workers. The monetary currency used in this study was the CFA francs, as that currency is the one used in Central Africa (as reference, 1 Euro = 656 CFA francs).
For the set timeframe, 778 patient records matched the study criteria. Thus, out of 778 admitted patients, 58.4% were male while 41.5% were female. Overall, the average age was 13.2 months (± 13.8 months). The total cost incurred by the hospital for the management of these 778 malaria patients was 94,922,925 CFA francs (144,699.58 €), for an average expense per patient topping at 122,008 CFA francs (185.99 €). The highest expenditure items were hospitalizations (44,200,000 CFA francs, 67,378.1 €), followed by drugs (26,394,425 CFA francs, 40,235.4 €) and biomedical examinations (14,036,000 CFA francs, 21,396.34 €).
The financial burden for managing malaria in the paediatric ward seems to be very high, not only for the hospital, but also for families in spite of the government medical insurance coverage in some cases. These findings bring new insights as to the urgency to develop policies that foster preventive initiatives over curative approaches in the management of malaria in children in endemic countries.
疟疾是非洲国家发病率和死亡率的主要原因之一。它是导致 5 岁以下儿童住院的主要原因之一。然而，有趣的是，包括加蓬在内的这些疟疾流行国家对这种疾病的经济负担仍不清楚。本研究的目的是评估加蓬利伯维尔大学医院中心（CHUL）儿科病房治疗 5 岁以下儿童疟疾的直接医院费用。
这是一项使用对 2018 年 1 月至 2019 年 12 月期间在 CHUL 就诊的患者病历进行全面回顾的回顾性研究。该研究重点是在 CHUL 儿科病房因疟疾住院的 5 岁以下儿童。分析专门针对直接医院费用，不包括卫生保健工作者的工资和薪水。本研究使用的货币是非洲金融共同体法郎，因为该货币在中部非洲使用（作为参考，1 欧元=656 非洲金融共同体法郎）。
在设定的时间范围内，有 778 份患者记录符合研究标准。因此，在 778 名住院患者中，58.4%为男性，41.5%为女性。总体而言，平均年龄为 13.2 个月（±13.8 个月）。医院为治疗这 778 名疟疾患者所产生的总费用为 94922925 非洲金融共同体法郎（144699.58 欧元），每位患者的平均费用高达 122008 非洲金融共同体法郎（185.99 欧元）。支出最高的项目是住院治疗（44200000 非洲金融共同体法郎，67378.1 欧元），其次是药物治疗（26394425 非洲金融共同体法郎，40235.4 欧元）和生物医学检查（14036000 非洲金融共同体法郎，21396.34 欧元）。
儿科病房治疗疟疾的经济负担似乎非常高，不仅对医院，而且对家庭也是如此，尽管在某些情况下政府提供医疗保险。这些发现为制定政策提供了新的见解，即在疟疾流行国家，管理儿童疟疾应优先采取预防措施，而不是治疗方法。
