Cost risk benefit analysis to support chemoprophylaxis policy for travellers to malaria endemic countries
2011

Cost-Effectiveness of Malaria Chemoprophylaxis for Travelers

publication Evidence: moderate

Author Information

Author(s): Massad Eduardo, Behrens Ben C, Coutinho Francisco AB, Behrens Ronald H

Primary Institution: School of Medicine, University of São Paulo

Hypothesis

Is the current malaria chemoprophylactic policy for travelers cost-effective when adjusted for endemic transmission risk and duration of exposure?

Conclusion

Chemoprophylaxis is not cost-effective for travelers to Thailand or the Amazon region of Brazil, but is cost-effective for travel to West Africa and for those staying longer than 45 days in India and Indonesia.

Supporting Evidence

  • The threshold incidence for cost-effective chemoprophylaxis is 1.13%.
  • Travelers to Brazil and Thailand never achieve the minimal threshold for cost-effectiveness.
  • The analysis incorporates both direct and indirect costs of using malaria prophylaxis.

Takeaway

This study looks at whether taking malaria prevention medicine is worth the money for travelers, and finds it's not always a good idea depending on where you go and how long you stay.

Methodology

A three-component model combining probability, cost, and malaria risk components was used to estimate health costs avoided through chemoprophylaxis and costs of disease prevention.

Potential Biases

The malaria probability may be subject to reporting bias and does not account for chemoprophylaxis usage or the number of truly exposed travelers.

Limitations

The model does not include intangible costs like pain and suffering and relies on the accuracy of malaria incidence data.

Participant Demographics

UK travelers to malaria endemic regions.

Statistical Information

Confidence Interval

95% C.I.

Digital Object Identifier (DOI)

10.1186/1475-2875-10-130

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