Strict adherence to malaria rapid test results might lead to a neglect of other dangerous diseases: a cost benefit analysis from Burkina Faso
Abstract Background Malaria rapid diagnostic tests (RDTs) have generally been found reliable and cost-effective. In Burkina Faso, the adherence of prescribers to the negative test result was found to be poor. Moreover, the test accuracy for malaria-attributable fever (MAF) is not the same as for mal...
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ftdoajarticles:oai:doaj.org/article:6cdb786eb431420c961a8cb1b2dfa535 2023-05-15T15:17:06+02:00 Strict adherence to malaria rapid test results might lead to a neglect of other dangerous diseases: a cost benefit analysis from Burkina Faso Tinto Halidou Angheben Andrea Gobbi Federico Lodesani Claudia Meheus Filip Sirima Sodiomon B Bisoffi Zeno Neya Bouma Van den Ende Klara Romeo Annalisa Van den Ende Jef 2011-08-01T00:00:00Z https://doi.org/10.1186/1475-2875-10-226 https://doaj.org/article/6cdb786eb431420c961a8cb1b2dfa535 EN eng BMC http://www.malariajournal.com/content/10/1/226 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-10-226 1475-2875 https://doaj.org/article/6cdb786eb431420c961a8cb1b2dfa535 Malaria Journal, Vol 10, Iss 1, p 226 (2011) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2011 ftdoajarticles https://doi.org/10.1186/1475-2875-10-226 2022-12-31T09:10:05Z Abstract Background Malaria rapid diagnostic tests (RDTs) have generally been found reliable and cost-effective. In Burkina Faso, the adherence of prescribers to the negative test result was found to be poor. Moreover, the test accuracy for malaria-attributable fever (MAF) is not the same as for malaria infection. This paper aims at determining the costs and benefits of two competing strategies for the management of MAF: presumptive treatment for all or use of RDTs. Methods A cost benefit analysis was carried out using a decision tree, based on data previously obtained, including a randomized controlled trial (RCT) recruiting 852 febrile patients during the dry season and 1,317 in the rainy season. Cost and benefit were calculated using both the real adherence found by the RCT and assuming an ideal adherence of 90% with the negative result. The main parameters were submitted to sensitivity analysis. Results and discussion At real adherence, the test-based strategy was dominated. Assuming ideal adherence, at the value of 525 € for a death averted, the total cost of managing 1,000 febrile children was 1,747 vs. 1,862 € in the dry season and 1,372 vs. 2,138 in the rainy season for the presumptive vs. the test-based strategy. For adults it was 2,728 vs. 1,983 and 2,604 vs. 2,225, respectively. At the subsidized policy adopted locally, assuming ideal adherence, the RDT would be the winning strategy for adults in both seasons and for children in the dry season. At sensitivity analysis, the factors most influencing the choice of the better strategy were the value assigned to a death averted and the proportion of potentially severe NMFI treated with antibiotics in patients with false positive RDT results. The test-based strategy appears advantageous for adults if a satisfactory adherence could be achieved. For children the presumptive strategy remains the best choice for a wide range of scenarios. Conclusions For RDTs to be preferred, a positive result should not influence the decision to treat a potentially severe NMFI ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 10 1 |
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ftdoajarticles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Tinto Halidou Angheben Andrea Gobbi Federico Lodesani Claudia Meheus Filip Sirima Sodiomon B Bisoffi Zeno Neya Bouma Van den Ende Klara Romeo Annalisa Van den Ende Jef Strict adherence to malaria rapid test results might lead to a neglect of other dangerous diseases: a cost benefit analysis from Burkina Faso |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Malaria rapid diagnostic tests (RDTs) have generally been found reliable and cost-effective. In Burkina Faso, the adherence of prescribers to the negative test result was found to be poor. Moreover, the test accuracy for malaria-attributable fever (MAF) is not the same as for malaria infection. This paper aims at determining the costs and benefits of two competing strategies for the management of MAF: presumptive treatment for all or use of RDTs. Methods A cost benefit analysis was carried out using a decision tree, based on data previously obtained, including a randomized controlled trial (RCT) recruiting 852 febrile patients during the dry season and 1,317 in the rainy season. Cost and benefit were calculated using both the real adherence found by the RCT and assuming an ideal adherence of 90% with the negative result. The main parameters were submitted to sensitivity analysis. Results and discussion At real adherence, the test-based strategy was dominated. Assuming ideal adherence, at the value of 525 € for a death averted, the total cost of managing 1,000 febrile children was 1,747 vs. 1,862 € in the dry season and 1,372 vs. 2,138 in the rainy season for the presumptive vs. the test-based strategy. For adults it was 2,728 vs. 1,983 and 2,604 vs. 2,225, respectively. At the subsidized policy adopted locally, assuming ideal adherence, the RDT would be the winning strategy for adults in both seasons and for children in the dry season. At sensitivity analysis, the factors most influencing the choice of the better strategy were the value assigned to a death averted and the proportion of potentially severe NMFI treated with antibiotics in patients with false positive RDT results. The test-based strategy appears advantageous for adults if a satisfactory adherence could be achieved. For children the presumptive strategy remains the best choice for a wide range of scenarios. Conclusions For RDTs to be preferred, a positive result should not influence the decision to treat a potentially severe NMFI ... |
format |
Article in Journal/Newspaper |
author |
Tinto Halidou Angheben Andrea Gobbi Federico Lodesani Claudia Meheus Filip Sirima Sodiomon B Bisoffi Zeno Neya Bouma Van den Ende Klara Romeo Annalisa Van den Ende Jef |
author_facet |
Tinto Halidou Angheben Andrea Gobbi Federico Lodesani Claudia Meheus Filip Sirima Sodiomon B Bisoffi Zeno Neya Bouma Van den Ende Klara Romeo Annalisa Van den Ende Jef |
author_sort |
Tinto Halidou |
title |
Strict adherence to malaria rapid test results might lead to a neglect of other dangerous diseases: a cost benefit analysis from Burkina Faso |
title_short |
Strict adherence to malaria rapid test results might lead to a neglect of other dangerous diseases: a cost benefit analysis from Burkina Faso |
title_full |
Strict adherence to malaria rapid test results might lead to a neglect of other dangerous diseases: a cost benefit analysis from Burkina Faso |
title_fullStr |
Strict adherence to malaria rapid test results might lead to a neglect of other dangerous diseases: a cost benefit analysis from Burkina Faso |
title_full_unstemmed |
Strict adherence to malaria rapid test results might lead to a neglect of other dangerous diseases: a cost benefit analysis from Burkina Faso |
title_sort |
strict adherence to malaria rapid test results might lead to a neglect of other dangerous diseases: a cost benefit analysis from burkina faso |
publisher |
BMC |
publishDate |
2011 |
url |
https://doi.org/10.1186/1475-2875-10-226 https://doaj.org/article/6cdb786eb431420c961a8cb1b2dfa535 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 10, Iss 1, p 226 (2011) |
op_relation |
http://www.malariajournal.com/content/10/1/226 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-10-226 1475-2875 https://doaj.org/article/6cdb786eb431420c961a8cb1b2dfa535 |
op_doi |
https://doi.org/10.1186/1475-2875-10-226 |
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Malaria Journal |
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10 |
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1766347383893917696 |