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Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/98676
Costs Associated with Malaria in Pregnancy in the Brazilian Amazon, a Low Endemic Area Where Plasmodium vivax Predominates
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BACKGROUND: Information on costs associated with malaria in
pregnancy (MiP) in low transmission areas where Plasmodium vivax
predominates is so far missing. This study estimates health
system and patient costs of MiP in the Brazilian Amazon.
METHODS/PRINCIPAL FINDINGS: Between January 2011 and March 2012
patient costs for the treatment of MiP were collected through an
exit survey at a tertiary referral hospital and at a primary
health care centre in the Manaus metropolitan area, Amazonas
state. Pregnant and post-partum women diagnosed with malaria
were interviewed after an outpatient consultation or at
discharge after admission. Seventy-three interviews were
included in the analysis. Ninety-six percent of episodes were
due to P. vivax and 4% to Plasmodium falciparum. In 2010, the
total median costs from the patient perspective were estimated
at US $45.91 and US $216.29 for an outpatient consultation and
an admission, respectively. When multiple P. vivax infections
during the same pregnancy were considered, patient costs
increased up to US $335.85, representing the costs of an
admission plus an outpatient consultation. Provider direct and
overhead cost data were obtained from several sources. The
provider cost associated with an outpatient case, which includes
several consultations at the tertiary hospital was US $103.51
for a P. vivax malaria episode and US $83.59 for a P. falciparum
malaria episode. The cost of an inpatient day and average
admission of 3 days was US $118.51 and US $355.53, respectively.
Total provider costs for the diagnosis and treatment of all
malaria cases reported in pregnant women in Manaus in 2010 (N =
364) were US $17,038.50, of which 92.4% (US$ 15,741.14) due to
P. vivax infection. CONCLUSION: Despite being an area of low
risk malaria transmission, MiP is responsible for a significant
economic burden in Manaus. Especially when multiple infections
are considered, costs associated with P. vivax are higher than
costs associated with P. falciparum. The information generated
may help health policy decisions for the current control and
future elimination of malaria in the area.
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BOTTO MENEZES, Camila, et al. Costs Associated with Malaria in Pregnancy in the Brazilian
Amazon, a Low Endemic Area Where Plasmodium vivax Predominates. PLoS Neglected Tropical Diseases. 2016. Vol. 10, num. 3, pags. e0004494. ISSN 1935-2727. [consulted: 14 of August of 2026]. Available at: https://hdl.handle.net/2445/98676