Abstract
BackgroundIn 2010, the World Health Organization issued a guideline that calls for a shift from presumptive to test-based treatment. However, test-based treatment is still unpopular in community pharmacies. This could be due to unwillingness of customers to spend extra finance on rapid diagnostic test (RDT). It could also result from lack of interest from community pharmacists since they may perceive no financial gain attached to this service. This study assessed the cost-benefit of test-based malaria treatment to community pharmacists.MethodsThe study was a community pharmacy-based cross sectional survey. Potential benefit of RDT was determined using customers’ willingness-to-pay (WTP) for service. Average WTP was estimated using contingent valuation. Binary logistic regression was used to assess correlates of WTP acceptance while multiple linear regression was used to model the relationship between the independent variables and WTP amount. Cost associated with provision of RDT was estimated from provider’s perspective. Probabilistic sensitivity analysis was used to capture parameter uncertainty. Benefit-cost ratio (BCR) was calculated to determine study objective.ResultsA total of 135 out of 235 participants (57.4%) responded to the WTP question. Of this subset, 111 participants (82.2%) preferred RDT before malaria treatment. Average WTP [minimum–maximum] was US$1.23 [US$0.0–US$5.03]. Educated participants had 1.8 times higher odds of WTP for RDT. Participants that understood RDT as described in the questionnaire had 18.3 times higher odds of WTP for RDT compared to participants that did not understand RDT as described in the questionnaire. Additionally, a unit increase in level of education (e.g. from primary to secondary school) led to US$0.298 increase in WTP amount for RDT. Also, a unit increase in malaria frequency (e.g. from ‘never’ to ‘rarely’) led to US$0.293 decrease in WTP amount for RDT. Average cost [minimum–maximum] of RDT test kit and pharmacist time spent in administering the test were US$0.15 [US$0.13–US$0.17] and US$0.41 [US$0.18–US$0.52], respectively. BCR of test-based malaria treatment was 6.7 (95% CI 6.4–7.0).ConclusionTest-based malaria treatment is cost-beneficial for pharmacy practitioners. This finding could be used as an advocacy tool to increase community pharmacists’ interest and uptake of test-based malaria treatment.
Highlights
In 2010, the World Health Organization issued a guideline that calls for a shift from presumptive to test-based treatment
The problem of misdiagnosis and over treatment of malaria led to the development of a more reliable, field-suitable and cost-effective diagnostic tool–rapid diagnostic test (RDT) [12, 13]
The reason given by majority of the respondents for rejecting RDT and choosing presumptive treatment was majorly due to financial considerations
Summary
In 2010, the World Health Organization issued a guideline that calls for a shift from presumptive to test-based treatment. Test-based treatment is still unpopular in community pharmacies This could be due to unwillingness of customers to spend extra finance on rapid diagnostic test (RDT). Other diagnostic approaches require trained staff, expensive and fragile equipment, and electricity supply among others These requirements and inherent potential for human and technical errors have been shown to result in misdiagnosis and over-diagnosis of malaria [3, 4, 6,7,8,9]. Rapid diagnostic test, based on the detection of Plasmodium antigens in a little drop of the patients’ blood, saves cost and time while giving an almost instant result It generally has high level of sensitivity and specificity, its accuracy varies between brands, location and epidemiological setting [14, 15]. They were shown to be very sensitive (range of about 91–99%) meaning that only 1–9% of people with falciparum malaria would get a negative test result [18]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
