Abstract
BackgroundMalaria is one of the leading causes of morbidity and mortality in African countries. It is one of the leading causes of hospital visits and hospitalization in pediatric wards for children under 5 years old. Interestingly however, the economic burden of this disease remains unknown in these endemic countries including Gabon. The purpose of this study is to assess the direct hospital cost for the management of malaria in children under 5 years old at the Libreville University Hospital Centre (CHUL, Centre Hospitalier Universitaire de Libreville) in Gabon.MethodsThis research work is a retrospective study using a comprehensive review of medical records of patients seen at the CHUL over a two-year period extending from January 2018 through December 2019. The study focused on children under 5 years old, admitted for malaria in the paediatric ward of the CHUL. The analysis targeted specifically direct hospital costs, which excluded salary and wages of health care workers. The monetary currency used in this study was the CFA francs, as that currency is the one used in Central Africa (as reference, 1 Euro = 656 CFA francs).ResultsFor the set timeframe, 778 patient records matched the study criteria. Thus, out of 778 admitted patients, 58.4% were male while 41.5% were female. Overall, the average age was 13.2 months (± 13.8 months). The total cost incurred by the hospital for the management of these 778 malaria patients was 94,922,925 CFA francs (144,699.58 €), for an average expense per patient topping at 122,008 CFA francs (185.99 €). The highest expenditure items were hospitalizations (44,200,000 CFA francs, 67,378.1 €), followed by drugs (26,394,425 CFA francs, 40,235.4 €) and biomedical examinations (14,036,000 CFA francs, 21,396.34 €).ConclusionThe financial burden for managing malaria in the paediatric ward seems to be very high, not only for the hospital, but also for families in spite of the government medical insurance coverage in some cases. These findings bring new insights as to the urgency to develop policies that foster preventive initiatives over curative approaches in the management of malaria in children in endemic countries.
Highlights
Malaria is one of the leading causes of morbidity and mortality in African countries
In Gabon, the Centre Hospitalier Universitaire de Libreville (CHUL) was a hospital of choice to conduct this study because in one hand, that hospital has the largest paediatric ward in the country, on another hand, the facility is adequately equipped to care for children and very importantly, to keep accurate records of medical procedures of patients admitted in the facility
The screening of patient files showed that more than half of them (58.5%) had an age range that varied between 1 month and 12 months old and that 51.7% (402) of patients did not have any health insurance coverage. 488 patients exhibited complications among which 28% suffered of anaemia and 16% had prostration
Summary
Malaria is one of the leading causes of morbidity and mortality in African countries. It is one of the leading causes of hospital visits and hospitalization in pediatric wards for children under 5 years old. The World Health Organization [1], in its 2018 malaria progress report, estimated the number of cases at 219 million, 92% of which were in African countries. 2019, this number increased to 229 million of the malaria cases, for an estimated total of 409,000 deaths, according to the WHO statement [2]. The number of cases of children aged 0–5 years was estimated at 41,087 cases in health care facilities. In spite of the fact that deaths are underreported, 120 deaths were recorded for the year 2019 in the main health care facilities in the country [2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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 call
