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
. 2017 Oct 11;12(10):e0185315.
doi: 10.1371/journal.pone.0185315. eCollection 2017.

Economic burden of malaria and predictors of cost variability to rural households in south-central Ethiopia

Alemayehu Hailu  1   2 , Bernt Lindtjørn  1 , Wakgari Deressa  3 , Taye Gari  4 , Eskindir Loha  4 , Bjarne Robberstad  1   5
Affiliations

Economic burden of malaria and predictors of cost variability to rural households in south-central Ethiopia

Alemayehu Hailu et al. PLoS One. .

Abstract

Background: While recognizing the recent remarkable achievement in the global malaria reduction, the disease remains a challenge to the malaria endemic countries in Africa. Beyond the huge health consequence of malaria, policymakers need to be informed about the economic burden of the disease to the households. However, evidence on the economic burden of malaria in Ethiopia is scanty. The aims of this study were to estimate the economic burden of malaria episode and to identify predictors of cost variability to the rural households.

Methods: A prospective costing approach from a household perspective was employed. A total of 190 malaria patients were enrolled to the study from three health centers and nine health posts in Adami Tullu district in south-central Ethiopia, in 2015. Primary data were collected on expenditures due to malaria, forgone working days because of illness, socioeconomic and demographic situation, and households' assets. Quantile regression was applied to predict factors associated with the cost variation. Socioeconomic related inequality was measured using concentration index and concentration curve.

Results: The median cost of malaria per episode to the household was USD 5.06 (IQR: 2.98-8.10). The direct cost accounted for 39%, while the indirect counterpart accounted for 61%. The history of malaria in the last six months and the level of the facility visited in the health system predominantly influenced the direct cost. The indirect cost was mainly influenced by the availability of antimalarial drugs in the health facility. The concentration curve and the concentration index for direct cost indicate significant pro-rich inequality. Plasmodium falciparum is significantly more costly for households compared to Plasmodium vivax.

Conclusion: The economic burden of malaria to the rural households in Ethiopia was substantial-mainly to the poor-indicating that reducing malaria burden could contribute to the poverty reduction as well.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Concentrations curves for direct (A), and indirect (B) cost of malaria.
See this image and copyright information in PMC

References

    1. World Health Organization. World malaria report 2016. Geneva: World Health Organization; 2016.
    1. Cibulskis RE, Alonso P, Aponte J, Aregawi M, Barrette A, Bergeron L, et al. Malaria: Global progress 2000–2015 and future challenges. Infect Dis Poverty. 2016;5(1):61 doi: 10.1186/s40249-016-0151-8 . - DOI - PMC - PubMed
    1. Shepard DS, Ettling MB, Brinkmann U, Sauerborn R. The economic cost of malaria in Africa. Trop Med Parasitol. 1991;42(3):199–203. . - PubMed
    1. Gallup JL, Sachs JD. The economic burden of malaria. The American journal of tropical medicine and hygiene. 2001;64(1–2 Suppl):85–96. . - PubMed
    1. Ethiopian Public Health Institute. The 2015 Ethiopia National Malaria Indicator Survey (EMIS). Addis Ababa:2016.