Relative costs and effectiveness of treating uncomplicated malaria in two rural districts in Zambia: implications for nationwide scale-up of home-based management
Relative costs and effectiveness of treating uncomplicated malaria in two rural districts in Zambia: implications for nationwide scale-up of home-based management
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DOI：
10.1186/1475-2875-10-158
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发表时间：
2011-06-09
期刊：
影响因子：
3
通讯作者：
Pagnoni, Franco
中科院分区：
文献类型：
--
作者：
Chanda, Pascalina;Hamainza, Busiku;Pagnoni, Franco
背景：疟疾病例管理是控制疟疾的关键策略之一。各种研究证明了疟疾家庭管理(HMM)的可行性。然而，关于基于青蒿素的联合疗法(ACT)和通过HMM进行快速诊断测试的成本和有效性的数据有限。方法：从提供者的角度分析了赞比亚两个农村地区家庭管理与基于卫生设施的简单疟疾管理的成本效益。样本包括16名社区卫生工作者(CHW)和15家卫生机构。结果衡量标准是每个病例适当诊断和治疗的成本。根据研究中观察到的CHW使用率，估计了在全国推广HMM的成本。结果：HMM比基于设施的简单疟疾管理更具成本效益。正确诊断和治疗每个病例的费用，HMM为4.22美元，设施水平为6.12美元。HMM的使用率和对诊断和治疗指南的遵守程度高于卫生机构。结论：使用ACT和RDTS的HMM在正确诊断和治疗疟疾方面比卫生机构水平更有效。扩大这种干预需要大量投资。
Background: Malaria case management is one of the key strategies to control malaria. Various studies have demonstrated the feasibility of home management of malaria (HMM). However, data on the costs and effectiveness of artemisinin-based combination therapy (ACT) and rapid diagnostic tests via HMM is limited.Method: Cost-effectiveness of home management versus health facility-based management of uncomplicated malaria in two rural districts in Zambia was analysed from a providers' perspective. The sample included 16 community health workers (CHWs) and 15 health facilities. The outcome measure was the cost per case appropriately diagnosed and treated. Costs of scaling-up HMM nationwide were estimated based on the CHW utilisation rates observed in the study.Results: HMM was more cost effective than facility-based management of uncomplicated malaria. The cost per case correctly diagnosed and treated was USD 4.22 for HMM and USD 6.12 for facility level. Utilization and adherence to diagnostic and treatment guidelines was higher in HMM than at a health facility.Conclusion: HMM using ACT and RDTs was more efficient at appropriately diagnosing and treating malaria than the health facility level. Scaling up this intervention requires significant investments.