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Cost of Pediatric Visceral Leishmaniasis Care in Morocco

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BACKGROUND: Visceral leishmaniasis (VL) is a neglected parasitic
                disease that is fatal if left untreated. VL is endemic in
                Morocco and other countries in North Africa were it mainly
                affects children from rural areas. In Morocco, the direct
                observation of Leishmania parasites in bone marrow aspirates and
                serological tests are used to diagnose VL. Glucantime is the
                first line of treatment. The objective of this study was to
                report the costs associated to standard clinical management of
                pediatric VL from the provider perspective in Morocco. As a
                secondary objective we described the current clinical practices
                and the epidemiological characteristics of pediatric VL
                patients. METHODS: From March to June 2014 we conducted a survey
                in eight hospitals treating pediatric VL patients in Morocco. A
                pro-forma was used to collect demographic, clinical and
                management data from medical records. We specifically collected
                data on VL diagnosis and treatment. We also estimated the days
                of hospitalization and the time to start VL treatment. Costs
                were estimated by multiplying the use of resources in terms of
                number of days in hospital, tests performed and drugs provided
                by the official prices. For patients receiving part of their
                treatment at Primary Health Centers (PHC) we estimated the cost
                of administering the Glucantime as outpatient. We calculated the
                median cost per VL patient. We also estimated the cost of
                managing a VL case when different treatment strategies were
                applied: inpatient and outpatient. RESULTS: We obtained data
                from 127 VL patients. The median total cost per pediatric VL
                case in Morocco is 520 US$. The cost in hospitals applying an
                outpatient strategy is significantly lower (307 US$) than
                hospitals keeping the patients for the whole treatment (636
                US$). However the outpatient strategy is not yet recommended as
                VL treatment for children in the Moroccan guidelines. VL
                diagnosis and treatment regimens should be standardized
                following the current guidelines in Morocco.

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Reproducció del document publicat a:
                http://dx.doi.org/10.1371/journal.pone.0155482

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Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Cost of Pediatric Visceral Leishmaniasis Care in Morocco