Cirera Laia, Sacoor Charfudin, Meremikwu Martin, Ranaivo Louise, F Manun'Ebo Manu, Arikpo Dachi, Matavele Osvaldo, Rafaralahy Victor, Ndombe Didier, Pons Duran Clara, Ramirez Maximo, Ramponi Francesco, González Raquel, Maly Christina, Roman Elaine, Sicuri Elisa, Pagnoni Franco, Menéndez Clara
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
Manhiça Health Research Center, Manhiça, Mozambique.
Gates Open Res. 2023 May 5;7:47. doi: 10.12688/gatesopenres.14375.2. eCollection 2023.
Background Malaria in pregnancy is a major public health problem in sub-Saharan Africa (SSA), which imposes a significant economic burden. We provide evidence on the costs of malaria care in pregnancy to households and the health system in four high-burden countries in SSA. Methods Household and health system economic costs associated with malaria control in pregnancy were estimated in selected areas of the Democratic Republic of Congo (DRC), Madagascar (MDG), Mozambique (MOZ) and Nigeria (NGA). An exit survey was administered to 2,031 pregnant women when leaving the antenatal care (ANC) clinic from October 2020 to June 2021. Women reported the direct and indirect costs associated to malaria prevention and treatment in pregnancy. To estimate health system costs, we interviewed health workers from 133 randomly selected health facilities. Costs were estimated using an ingredients-based approach. Results Average household costs of malaria prevention per pregnancy were USD6.33 in DRC, USD10.06 in MDG, USD15.03 in MOZ and USD13.33 in NGA. Household costs of treating an episode of uncomplicated/complicated malaria were USD22.78/USD46 in DRC, USD16.65/USD35.65 in MDG, USD30.54/USD61.25 in MOZ and USD18.92/USD44.71 in NGA, respectively. Average health system costs of malaria prevention per pregnancy were USD10.74 in DRC, USD16.95 in MDG, USD11.17 in MOZ and USD15.64 in NGA. Health system costs associated with treating an episode of uncomplicated/complicated malaria were USD4.69/USD101.41 in DRC, USD3.61/USD63.33 in MDG, USD4.68/USD83.70 in MOZ and USD4.09/USD92.64 in NGA. These estimates resulted in societal costs of malaria prevention and treatment per pregnancy of USD31.72 in DRC, USD29.77 in MDG, USD31.98 in MOZ and USD46.16 in NGA. Conclusions Malaria in pregnancy imposes a high economic burden on households and the health system. Findings emphasize the importance of investing in effective strategies that improve access to malaria control and reduce the burden of the infection in pregnancy.
妊娠疟疾是撒哈拉以南非洲（SSA）的一个主要公共卫生问题，带来了巨大的经济负担。我们提供了关于SSA四个高负担国家中妊娠疟疾护理对家庭和卫生系统成本的证据。方法：在刚果民主共和国（DRC）、马达加斯加（MDG）、莫桑比克（MOZ）和尼日利亚（NGA）的选定地区，估计了与妊娠疟疾控制相关的家庭和卫生系统经济成本。2020年10月至2021年6月，在产前护理（ANC）诊所对2031名孕妇进行了出院调查。妇女报告了与妊娠疟疾预防和治疗相关的直接和间接成本。为了估计卫生系统成本，我们采访了133个随机选择的卫生设施的卫生工作者。成本采用基于成分的方法进行估计。结果：DRC每次妊娠疟疾预防的平均家庭成本为6.33美元，MDG为10.06美元，MOZ为15.03美元，NGA为13.33美元。DRC治疗一次单纯性/复杂性疟疾的家庭成本分别为22.78美元/46美元，MDG为16.65美元/35.65美元，MOZ为30.54美元/61.25美元，NGA为18.92美元/44.71美元。DRC每次妊娠疟疾预防的平均卫生系统成本为10.74美元，MDG为16.95美元，MOZ为11.17美元，NGA为15.64美元。与治疗一次单纯性/复杂性疟疾相关的卫生系统成本在DRC为4.69美元/101.41美元，MDG为3.61美元/63.33美元，MOZ为4.68美元/83.70美元，NGA为4.09美元/92.64美元。这些估计得出DRC每次妊娠疟疾预防和治疗的社会成本为31.72美元，MDG为29.77美元，MOZ为31.98美元，NGA为46.16美元。结论：妊娠疟疾给家庭和卫生系统带来了高昂的经济负担。研究结果强调了投资于有效策略的重要性，这些策略可改善疟疾控制的可及性并减轻妊娠感染负担。
