ArticleBulletin of the World Health Organization2011
Cost-effectiveness of parenteral artesunate for treating children with severe malaria in sub-Saharan Africa.
Article in Bulletin of the World Health Organization, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01828333 (Treatment of Severe Malaria - An Operational Comparative Study Between Quinine and Artesunate for the Treatment of Severe Malaria in Hospitals and Health Centers of Kinshasa and Lower Congo), which is not on this map. Cited by 33 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Treatment of Severe Malaria - An Operational Comparative Study Between Quinine and Artesunate for the Treatment of Severe Malaria in Hospitals and Health Centers of Kinshasa and Lower Congo
Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Systematic review of methodological approaches in economic evaluations of maternal and neonatal sepsis interventions in low- and middle-income countries.BMC health services research · 2025Pooled it
- Health-related quality of life due to malaria: a systematic review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Pooled it
- Cost of treating severe malaria in children in Africa: a systematic literature review.Malaria journal · 2024Pooled it
- Artesunate versus quinine for treating severe malaria.The Cochrane database of systematic reviews · 2012Pooled it
- Economic evaluation of artesunate and three quinine regimens in the treatment of severe malaria in children at the Ebolowa Regional Hospital-Cameroon: a cost analysis.Malaria journal · 2016Trial
- An operational comparative study of quinine and artesunate for the treatment of severe malaria in hospitals and health centres in the Democratic Republic of Congo: the MATIAS study.Malaria journal · 2015Trial
- Costs and cost-effectiveness of a large-scale mass testing and treatment intervention for malaria in Southern Province, Zambia.Malaria journal · 2015Trial
- Economic evaluation of severe malaria in children under 14 years in Zambia.Cost effectiveness and resource allocation : C/E · 2022Article
- High impact health service interventions for attainment of UHC in Africa: A systematic review.PLOS global public health · 2022Article
- Ten-Year Molecular Surveillance of Drug-ResistantFrontiers in cellular and infection microbiology · 2021Article
- Impact of substandard and falsified antimalarials in Zambia: application of the SAFARI model.BMC public health · 2020Article
- Modelling the cost-effectiveness of introducing subsidised malaria rapid diagnostic tests in the private retail sector in sub-Saharan Africa.BMJ global health · 2020Article
- Projected impact and cost-effectiveness of community-based versus targeted azithromycin administration strategies for reducing child mortality in sub-Saharan Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Poor-quality antimalarials further health inequities in Uganda.Health policy and planning · 2019Article
- Development of an agent-based model to assess the impact of substandard and falsified anti-malarials: Uganda case study.Malaria journal · 2019Article
- Geographic Resource Allocation Based on Cost Effectiveness: An Application to Malaria Policy.Applied health economics and health policy · 2017Article
- The Economic Value of Long-Lasting Insecticidal Nets and Indoor Residual Spraying Implementation in Mozambique.The American journal of tropical medicine and hygiene · 2017Article
- Malaria and Economic Evaluation Methods: Challenges and Opportunities.Applied health economics and health policy · 2017Article
- Cost-effectiveness analysis of malaria interventions using disability adjusted life years: a systematic review.Cost effectiveness and resource allocation : C/E · 2017Review
- Budget Impact Analysis of Using Dihydroartemisinin-Piperaquine to Treat Uncomplicated Malaria in Children in Tanzania.PharmacoEconomics · 2016Article
Corrections and comments
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Authors and funding
16 authors at 9 institutions in 7 countries.
Funding
Abstract
objectiveTo explore the cost-effectiveness of parenteral artesunate for the treatment of severe malaria in children and its potential impact on hospital budgets.
methodsThe costs of inpatient care of children with severe malaria were assessed in four of the 11 sites included in the African Quinine Artesunate Malaria Treatment trial, conducted with over 5400 children. The drugs, laboratory tests and intravenous fluids provided to 2300 patients from admission to discharge were recorded, as was the length of inpatient stay, to calculate the cost of inpatient care. The data were matched with pooled clinical outcomes and entered into a decision model to calculate the cost per disability-adjusted life year (DALY) averted and the cost per death averted.
findingsThe mean cost of treating severe malaria patients was similar in the two study groups: 63.5 United States dollars (US$) (95% confidence interval, CI: 61.7-65.2) in the quinine arm and US$ 66.5 (95% CI: 63.7-69.2) in the artesunate arm. Children treated with artesunate had 22.5% lower mortality than those treated with quinine and the same rate of neurological sequelae: (artesunate arm: 2.3 DALYs per patient; quinine arm: 3.0 DALYs per patient). Compared with quinine as a baseline, artesunate showed an incremental cost per DALY averted and an incremental cost per death averted of US$ 3.8 and US$ 123, respectively.
conclusionArtesunate is a highly cost-effective and affordable alternative to quinine for treating children with severe malaria. The budgetary implications of adopting artesunate for routine use in hospital-based care are negligible.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.