Section for Ethics and Health Economics, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway.
Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.
Malar J. 2024 Nov 9;23(1):334. doi: 10.1186/s12936-024-05173-w.
Malaria is a major cause of ill health and death in children in Africa. The disease also imposes a severe social and economic burden on households and health systems and is strongly associated with poverty. This study summarizes the most up-to-date cost of treating severe malaria in children in Africa.
A systematic search was conducted in PubMed, Embase, Cinahl, and Web of Science databases. Google and Google Scholar were searched for grey literature followed by scanning of the reference lists of the previous systematic reviews. The search was limited to children < 12 years, malaria-endemic countries in Africa, and the English language. All costs were adjusted to the year 2023.
19 studies conducted in 12 countries were identified: 14 reported provider costs, and 11 household costs. Out of the 19 studies found, 11 were published before 2018 while 11 reported data that are currently more than ten years old. Studies varied methodologically and in the scope of resources included to estimate the cost. The provider costs ranged from USD 27 in Uganda to USD 165 per patient in Kenya (median value USD 90), while household costs ranged from USD 13 in Kenya to USD 245 per patient in Gabon (median value USD 50). All identified household malaria treatment costs except one represented catastrophic health expenditure, making out more than 10% of the monthly Gross National Income per capita in the respective countries.
Evidence on the cost of treating severe malaria in children in Africa is scarce. However, the few existing studies show that severe malaria in children imposes a significant economic burden on the providers and households. More studies are needed, particularly in high-burden high-impact countries, to inform resource allocation decisions.
疟疾是非洲儿童健康不良和死亡的主要原因。该疾病也给家庭和卫生系统带来了严重的社会和经济负担，并且与贫困密切相关。本研究总结了目前治疗非洲儿童重症疟疾的最新成本。
在 PubMed、Embase、Cinahl 和 Web of Science 数据库中进行了系统搜索。在 Google 和 Google Scholar 上搜索了灰色文献，然后扫描了之前系统评价的参考文献列表。搜索范围限于儿童<12 岁、非洲疟疾流行国家和英语。所有成本均调整至 2023 年。
确定了 12 个国家的 19 项研究：14 项报告了提供者成本，11 项报告了家庭成本。在 19 项研究中，有 11 项发表于 2018 年之前，有 11 项报告的数据已经超过十年。研究方法和纳入资源的范围各不相同，以估算成本。提供者成本从乌干达的 27 美元到肯尼亚的每个患者 165 美元（中位数为 90 美元）不等，而家庭成本从肯尼亚的 13 美元到加蓬的每个患者 245 美元（中位数为 50 美元）不等。除一项外，所有确定的家庭疟疾治疗费用都代表了灾难性的医疗支出，占各自国家人均国民总收入的 10%以上。
关于非洲儿童重症疟疾治疗成本的证据很少。然而，为数不多的现有研究表明，儿童重症疟疾给提供者和家庭带来了巨大的经济负担。需要更多的研究，特别是在高负担、高影响的国家，以为资源分配决策提供信息。
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