Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Oct;89(4):724-736.
doi: 10.4269/ajtmh.13-0033. Epub 2013 Aug 26.

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

Evelyn K Ansah, Michael Epokor, Christopher J M Whitty, Shunmay Yeung, Kristian Schultz Hansen

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

Evelyn K Ansah et al. Am J Trop Med Hyg. 2013 Oct.

Abstract

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.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Decision tree.
Figure 2.
Figure 2.
Sensitivity of the incremental societal cost-effectiveness ratio to improvements in adherence to rapid diagnostic tests with negative test results in Dangme West District, 2009, Ghana, GHS1 = US$0.68.
Figure 3.
Figure 3.
Sensitivity of the incremental societal cost-effectiveness ratio to different price levels of rapid diagnostic tests in Dangme West District, 2009, Ghana, GHS1 = US$0.68.
Figure 4.
Figure 4.
Sensitivity of the incremental societal cost-effectiveness ratio to changes in the value of opportunity cost of time in Dangme West District, 2009, Ghana, GHS1 = US$0.68.
Figure 5.
Figure 5.
Scatter plot of incremental societal costs in GHS and incremental effects [change in correctly treated patients] resulting from replacing microscopy diagnosis by rapid diagnostic test (RDT) diagnosis in the microscopy setting in Dangme West District, 2009, Ghana, GHS1 = US$0.68.
Figure 6.
Figure 6.
Scatter plot of incremental societal costs in GHS and incremental effects (change in correctly treated patients) resulting from replacing presumptive diagnosis by rapid diagnostic test (RDT) diagnosis in the presumptive diagnosis setting in Dangme West District, 2009, Ghana, GHS1 = US$0.68.
Figure 7.
Figure 7.
Cost-effectiveness acceptability curves for replacing microscopy diagnosis by rapid diagnostic test (RDT) diagnosis in the microscopy setting and for replacing presumptive diagnosis by RDT diagnosis in the presumptive diagnosis setting in Dangme West District, 2009, Ghana, GHS1 = US$0.68.
See this image and copyright information in PMC

References

    1. Amexo M, Tolhurst R, Barnish G, Bates I. Malaria misdiagnosis: effects on the poor and vulnerable. Lancet. 2004;364:1896–1898. - PubMed
    1. Reyburn H, Mbatia R, Drakeley C, Carneiro I, Mwakasungula E, Mwerinde O, Saganda K, Shao J, Kitua A, Olomi R, Greenwood BM, Whitty CJ. Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study. BMJ. 2004;329:1212. - PMC - PubMed
    1. Nankabirwa J, Zurovac D, Njogu JN, Rwakimari JB, Counihan H, Snow RW, Tibenderana JK. Malaria misdiagnosis in Uganda–implications for policy change. Malar J. 2009;8:66. - PMC - PubMed
    1. Chandramohan D, Jaffar S, Greenwood B. Use of clinical algorithms for diagnosing malaria. Trop Med Int Health. 2002;7:45–52. - PubMed
    1. Kallander K, Nsungwa-Sabiiti J, Peterson S. Symptom overlap for malaria and pneumonia–policy implications for home management strategies. Acta Trop. 2004;90:211–214. - PubMed

Publication types