Measuring the economic cost of malaria to households in Sri Lanka.

The economic cost at the household level of labor days lost due to malaria and other illnesses was estimated in a rural community in Sri Lanka. Over a one-year period, 223 episodes of malaria were recorded from the 298 inhabitants of the village. Based on daily activity records, the economically active age group was defined as 14-60 years. In this age group, 1.8% of working days were lost due to malaria and 5.2% due to all other illnesses. The value of a labor day lost was based on the actual rural wage rate for children, women, and men, with weeks during periods of high labor demand weighting more than weeks during lean agricultural periods. In this way the annual economic loss per household amounted to US $15.56 for malaria and US $47.46 for all other illnesses. This corresponded to a loss of 6% and 18% of annual household net income, respectively. Although the overall economic impact was limited, malaria cases were concentrated in an important agricultural season. During this season, 5.6% of working days were lost due to malaria. In addition, children, who were not part of the economically active population, lost 10% of school days due to malaria during the high transmission season. In estimating the socioeconomic impact of malaria and in measuring cost-benefits of malaria control interventions, these costs have to be considered together with direct expenditures incurred by households such as on treatment and travel and with costs for the service providers.