247399 Cost-effectiveness of diagnosing and treating malaria symptomatically versus with rapid diagnostic tests in Saraya, southeastern Senegal

Wednesday, November 2, 2011: 11:24 AM

Demetri Blanas, MD-MPH candidate (MSIII) , Senegal-based not-for-profit, Kendeya Community Health Partnership, New York, NY
Youssoupha Ndiaye, MD, MPH, PhD candidate , Health District of Saraya, Senegal Ministry of Health/Kendeya Community Health Partnership, Saraya, Senegal
This presentation discusses the results and implications of an internal cost-effectiveness analysis of a district-wide rapid diagnostic tests (RDT) and artemisinin-based combination therapy (ACT) treatment protocol in Saraya, southeastern Senegal. The data presented consists of a review of data collected over three years through a monitoring system of RDT and ACT use in 6 health posts and 1 health center in the district of Saraya between January 2007 and December 2009. Pharmacy data was used to determine the cost of RDTs (1.20 US$), of treating a child under 13 years (0.58 US$), and of treating an adult (1.22 US$) with ACTs. In the study time period, records were collected for 1,534 patients tested with RDTs, of which 51.6% were positive and were treated with ACTs, and 48.4% were negative. Of the patients with positive RDTs, 64.1% were 13 years or younger, and 35.9% were over 13 years. The cost of screening all patients with RDTs and treating patients with positive results was 261% higher than treating all patients symptomatically ($3,481.92 when RDT screening is used versus $1,334.52 when all symptomatic patients are treated). These results suggest that in areas with a similar age distribution and level of endemicity as Saraya, using RDTs may not be cost effective. This study, however, does not take into account cost externalities of not using RDTs such as the more rapid emergence of resistance, unnecessary numbers of adverse effects, and missed diagnoses.

Learning Areas:
Administer health education strategies, interventions and programs
Biostatistics, economics
Clinical medicine applied in public health
Public health administration or related administration
Public health or related public policy

Learning Objectives:
1. Define cost-effectiveness analysis of rapid diagnostic test and artemisinin-based combination therapy programs. 2. Explain the implications of the increased cost of using rapid-diagnostic tests. 3. Discuss externalities to the marginal cost of rapid diagnostic tests

Keywords: Economic Analysis, Infectious Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently and MD-MPH candidate (MSIII) at the Mount Sinai School of Medicine, with an MPH focus in global health. I have worked in Saraya, Southeastern Senegal since 2006, and have studies rapid diagnostic tests and artemisinin-based combination therapy since 2007. With the chief medical officer of Saraya, Dr Youssoupha Ndiaye MD-MPH, I co-founded not-for-profit organization The Kendeya Community Health Partnership, which is based in Saraya, Senegal.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.