Cost-effectiveness analysis of introducing RDTs for malaria diagnosis as compared to microscopy and presumptive diagnosis in central and peripheral public health facilities in Ghana

TY - JOUR

T1 - Cost-effectiveness analysis of introducing RDTs for malaria diagnosis as compared to microscopy and presumptive diagnosis in central and peripheral public health facilities in Ghana

AU - Ansah, Evelyn K

AU - Epokor, Michael

AU - Whitty, Christopher J M

AU - Yeung, Shunmay

AU - Hansen, Kristian Schultz

PY - 2013/10

Y1 - 2013/10

N2 - Cost-effectiveness information on where malaria rapid diagnostic tests (RDTs) should be introduced is limited. We developed incremental cost-effectiveness analyses with data from rural health facilities in Ghana with and without microscopy. In the latter, where diagnosis had been presumptive, the introduction of RDTs increased the proportion of patients who were correctly treated in relation to treatment with antimalarials, from 42% to 65% at an incremental societal cost of Ghana cedis (GHS)12.2 (US$8.3) per additional correctly treated patients. In the "microscopy setting" there was no advantage to replacing microscopy by RDT as the cost and proportion of correctly treated patients were similar. Results were sensitive to a decrease in the cost of RDTs, which cost GHS1.72 (US$1.17) per test at the time of the study and to improvements in adherence to negative tests that was just above 50% for both RDTs and microscopy.

AB - Cost-effectiveness information on where malaria rapid diagnostic tests (RDTs) should be introduced is limited. We developed incremental cost-effectiveness analyses with data from rural health facilities in Ghana with and without microscopy. In the latter, where diagnosis had been presumptive, the introduction of RDTs increased the proportion of patients who were correctly treated in relation to treatment with antimalarials, from 42% to 65% at an incremental societal cost of Ghana cedis (GHS)12.2 (US$8.3) per additional correctly treated patients. In the "microscopy setting" there was no advantage to replacing microscopy by RDT as the cost and proportion of correctly treated patients were similar. Results were sensitive to a decrease in the cost of RDTs, which cost GHS1.72 (US$1.17) per test at the time of the study and to improvements in adherence to negative tests that was just above 50% for both RDTs and microscopy.

KW - Antimalarials

KW - Cost-Benefit Analysis

KW - Ghana

KW - Health Care Costs

KW - Humans

KW - Malaria

KW - Public Health

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.4269/ajtmh.13-0033

DO - 10.4269/ajtmh.13-0033

M3 - Journal article

C2 - 23980131

SN - 0002-9637

VL - 89

SP - 724

EP - 736

JO - Journal. National Malaria Society

JF - Journal. National Malaria Society

IS - 4

ER -