DSpace Repository

Operational response to malaria epidemics: are rapid diagnostic tests cost-effective?

Show simple item record

dc.contributor Epicentre, Paris, France.
dc.creator Rolland, E
dc.creator Checchi, F
dc.creator Pinoges, L
dc.creator Balkan, S
dc.creator Guthmann, J P
dc.creator Guerin, P J
dc.date 2006-04
dc.date.accessioned 2017-01-31T07:09:35Z
dc.date.available 2017-01-31T07:09:35Z
dc.identifier Operational response to malaria epidemics: are rapid diagnostic tests cost-effective? 2006, 11 (4):398-408 Trop. Med. Int. Health
dc.identifier 1360-2276
dc.identifier 16553923
dc.identifier 10.1111/j.1365-3156.2006.01580.x
dc.identifier http://hdl.handle.net/10144/17723
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/17723
dc.identifier Tropical Medicine & International Health
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/17723
dc.description OBJECTIVE: To compare the cost-effectiveness of malaria treatment based on presumptive diagnosis with that of malaria treatment based on rapid diagnostic tests (RDTs). METHODS: We calculated direct costs (based on experience from Ethiopia and southern Sudan) and effectiveness (in terms of reduced over-treatment) of a free, decentralised treatment programme using artesunate plus amodiaquine (AS + AQ) or artemether-lumefantrine (ART-LUM) in a Plasmodium falciparum epidemic. Our main cost-effectiveness measure was the incremental cost per false positive treatment averted by RDTs. RESULTS: As malaria prevalence increases, the difference in cost between presumptive and RDT-based treatment rises. The threshold prevalence above which the RDT-based strategy becomes more expensive is 21% in the AS + AQ scenario and 55% in the ART-LUM scenario, but these thresholds increase to 58 and 70%, respectively, if the financing body tolerates an incremental cost of 1 euro per false positive averted. However, even at a high (90%) prevalence of malaria consistent with an epidemic peak, an RDT-based strategy would only cost moderately more than the presumptive strategy: +29.9% in the AS + AQ scenario and +19.4% in the ART-LUM scenario. The treatment comparison is insensitive to the age and pregnancy distribution of febrile cases, but is strongly affected by variation in non-biomedical costs. If their unit price were halved, RDTs would be more cost-effective at a malaria prevalence up to 45% in case of AS + AQ treatment and at a prevalence up to 68% in case of ART-LUM treatment. CONCLUSION: In most epidemic prevalence scenarios, RDTs would considerably reduce over-treatment for only a moderate increase in costs over presumptive diagnosis. A substantial decrease in RDT unit price would greatly increase their cost-effectiveness, and should thus be advocated. A tolerated incremental cost of 1 euro is probably justified given overall public health and financial benefits. The RDTs should be considered for malaria epidemics if logistics and human resources allow.
dc.language en
dc.publisher Wiley-Blackwell
dc.relation http://www.blackwell-synergy.com/loi/tmi
dc.rights Archived on this site with the kind permission of Wiley-Blackwell
dc.title Operational response to malaria epidemics: are rapid diagnostic tests cost-effective?

Files in this item

Files Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record

Search DSpace

Advanced Search


My Account