American Journal of Tropical Medicine and Hygiene
Volume 77, Issue 3, 2007, Pages 458-463

Financial implications of refugee malaria: The impact of pre-departure presumptive treatment with anti-malarial drugs (Article)

Collinet-Adler S. , Stauffer W.M. , Boulware D.R. , Larsen K.L. , Rogers T.B. , Williams D.N.
  • a Department of Medicine, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, MN 55415, United States
  • b Departments of Medicine and Pediatrics, University of Minnesota, Mayo Building D407, 420 Delaware Street SE, Minneapolis, MN 55455, United States
  • c Division of Infectious Disease and International Medicine, Departments of Medicine and Pediatrics, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, United States, Departments of Medicine and Pediatrics, University of Minnesota, Mayo Building D407, 420 Delaware Street SE, Minneapolis, MN 55455, United States
  • d Department of Medicine, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, MN 55415, United States
  • e Departments of Medicine and Pediatrics, University of Minnesota, Mayo Building D407, 420 Delaware Street SE, Minneapolis, MN 55455, United States
  • f Department of Medicine, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, MN 55415, United States

Abstract

This study is a cost-benefits analysis of the recommendations of the Centers for Disease Control and Prevention for presumptive anti-malarial treatment among departing West African refugees. We conducted a retrospective chart review of symptomatic, blood smear-positive cases of malaria seen in Minneapolis, Minnesota, from 1996 through 2005. Billing charges of U.S. care were compared with estimates of implementation costs for overseas treatment. Fifty-eight symptomatic malaria infections occurred among West African refugees. After overseas pre-departure presumptive treatment, symptomatic malaria in arriving refugees decreased from 8.2% to 0%. The pre-departure number needed to treat to prevent one case of symptomatic malaria is 13.9 (95% confidence interval = 9.8-24). The average U.S. billing charge for each malaria case is $1,730. Overseas implementation costs for presumptive treatment are estimated to be between $141 and $346 to prevent one U.S. malaria case. Overseas presumptive pre-departure anti-malarial therapy prevents clinical malaria in refugees and results in cost-benefits when the malaria prevalence is > 1%. Overseas presumptive therapy has greater cost-benefits than U.S. based screening and treatment strategies. Copyright © 2007 by The American Society of Tropical Medicine and Hygiene.

Author Keywords

[No Keywords available]

Index Keywords

medical record review atovaquone plus proguanil refugee drug cost Cost benefit analysis economics human Refugees controlled study Malaria Time Factors Minnesota United States health care cost Health Care Costs Humans Adolescent Antimalarials male antimalarial agent female Southeast Asia cost of illness Africa prevalence Article major clinical study artemether plus benflumetol fansidar Asia, Southeastern time Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-35748936456&partnerID=40&md5=ef22d8ef61bf03976de92f486dd8e561
ISSN: 00029637
Cited by: 12
Original Language: English