Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests?
Abstract Background Within the context of increasing antimalarial costs and or decreasing malaria transmission, the importance of limiting antimalarial treatment to only those confirmed as having malaria parasites becomes paramount. This motivates for this assessment of the cost-effectiveness of rou...
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ftdoajarticles:oai:doaj.org/article:aaa92c8590834977b472142e6416a085 2023-05-15T15:17:34+02:00 Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests? Barnes Karen I McIntyre Diane Zikusooka Charlotte M 2008-09-01T00:00:00Z https://doi.org/10.1186/1475-2875-7-176 https://doaj.org/article/aaa92c8590834977b472142e6416a085 EN eng BMC http://www.malariajournal.com/content/7/1/176 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-7-176 1475-2875 https://doaj.org/article/aaa92c8590834977b472142e6416a085 Malaria Journal, Vol 7, Iss 1, p 176 (2008) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2008 ftdoajarticles https://doi.org/10.1186/1475-2875-7-176 2022-12-31T11:57:02Z Abstract Background Within the context of increasing antimalarial costs and or decreasing malaria transmission, the importance of limiting antimalarial treatment to only those confirmed as having malaria parasites becomes paramount. This motivates for this assessment of the cost-effectiveness of routine use of rapid diagnostic tests (RDTs) as an integral part of deploying artemisinin-based combination therapies (ACTs). Methods The costs and cost-effectiveness of using RDTs to limit the use of ACTs to those who actually have Plasmodium falciparum parasitaemia in two districts in southern Mozambique were assessed. To evaluate the potential impact of introducing definitive diagnosis using RDTs (costing $0.95), five scenarios were considered, assuming that the use of definitive diagnosis would find that between 25% and 75% of the clinically diagnosed malaria patients are confirmed to be parasitaemic. The base analysis compared two ACTs, artesunate plus sulfadoxine/pyrimethamine (AS+SP) costing $1.77 per adult treatment and artemether-lumefantrine (AL) costing $2.40 per adult treatment, as well as the option of restricting RDT use to only those older than six years. Sensitivity analyses considered lower cost ACTs and RDTs and different population age distributions. Results Compared to treating patients on the basis of clinical diagnosis, the use of RDTs in all clinically diagnosed malaria cases results in cost savings only when 29% and 52% or less of all suspected malaria cases test positive for malaria and are treated with AS+SP and AL, respectively. These cut-off points increase to 41.5% (for AS+SP) and to 74% (for AL) when the use of RDTs is restricted to only those older than six years of age. When 25% of clinically diagnosed patients are RDT positive and treated using AL, there are cost savings per malaria positive patient treated of up to $2.12. When more than 29% of clinically diagnosed cases are malaria test positive, the incremental cost per malaria positive patient treated is less than US$ 1. When ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 7 1 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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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 Barnes Karen I McIntyre Diane Zikusooka Charlotte M Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests? |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Within the context of increasing antimalarial costs and or decreasing malaria transmission, the importance of limiting antimalarial treatment to only those confirmed as having malaria parasites becomes paramount. This motivates for this assessment of the cost-effectiveness of routine use of rapid diagnostic tests (RDTs) as an integral part of deploying artemisinin-based combination therapies (ACTs). Methods The costs and cost-effectiveness of using RDTs to limit the use of ACTs to those who actually have Plasmodium falciparum parasitaemia in two districts in southern Mozambique were assessed. To evaluate the potential impact of introducing definitive diagnosis using RDTs (costing $0.95), five scenarios were considered, assuming that the use of definitive diagnosis would find that between 25% and 75% of the clinically diagnosed malaria patients are confirmed to be parasitaemic. The base analysis compared two ACTs, artesunate plus sulfadoxine/pyrimethamine (AS+SP) costing $1.77 per adult treatment and artemether-lumefantrine (AL) costing $2.40 per adult treatment, as well as the option of restricting RDT use to only those older than six years. Sensitivity analyses considered lower cost ACTs and RDTs and different population age distributions. Results Compared to treating patients on the basis of clinical diagnosis, the use of RDTs in all clinically diagnosed malaria cases results in cost savings only when 29% and 52% or less of all suspected malaria cases test positive for malaria and are treated with AS+SP and AL, respectively. These cut-off points increase to 41.5% (for AS+SP) and to 74% (for AL) when the use of RDTs is restricted to only those older than six years of age. When 25% of clinically diagnosed patients are RDT positive and treated using AL, there are cost savings per malaria positive patient treated of up to $2.12. When more than 29% of clinically diagnosed cases are malaria test positive, the incremental cost per malaria positive patient treated is less than US$ 1. When ... |
format |
Article in Journal/Newspaper |
author |
Barnes Karen I McIntyre Diane Zikusooka Charlotte M |
author_facet |
Barnes Karen I McIntyre Diane Zikusooka Charlotte M |
author_sort |
Barnes Karen I |
title |
Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests? |
title_short |
Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests? |
title_full |
Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests? |
title_fullStr |
Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests? |
title_full_unstemmed |
Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests? |
title_sort |
should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests? |
publisher |
BMC |
publishDate |
2008 |
url |
https://doi.org/10.1186/1475-2875-7-176 https://doaj.org/article/aaa92c8590834977b472142e6416a085 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 7, Iss 1, p 176 (2008) |
op_relation |
http://www.malariajournal.com/content/7/1/176 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-7-176 1475-2875 https://doaj.org/article/aaa92c8590834977b472142e6416a085 |
op_doi |
https://doi.org/10.1186/1475-2875-7-176 |
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Malaria Journal |
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7 |
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