Evidence map›Paper›PMID 34717637›Full record

ArticleMalaria journal2021

Rethinking the economic costs of hospitalization for malaria: accounting for the comorbidities of malaria patients in western Kenya.

Caroline Watts, Harrysone Atieli, Jason Alacapa, Ming-Chieh Lee, Guofa Zhou, Andrew Githeko, Guiyun Yan, Virginia Wiseman

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Malaria journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
6.3field-weighted citation impact, top 3% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 4 countries.

Caroline WattsThe Kirby Institute, University of New South Wales, Sydney, Australia. cwatts@kirby.unsw.edu.au.ORCID http://orcid.org/0000-0002-3811-4797
Harrysone AtieliSchool of Public Health, Maseno University, Kisumu, Kenya.
Jason AlacapaThe School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
Ming-Chieh LeeProgram in Public Health, University of California, Irvine, California, USA.
Guofa ZhouProgram in Public Health, University of California, Irvine, California, USA.
Andrew GithekoCentre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
Guiyun YanProgram in Public Health, University of California, Irvine, California, USA.
Virginia WisemanThe Kirby Institute, University of New South Wales, Sydney, Australia.
University of California, Irvine · USUNSW Sydney · AUKenya Medical Research Institute · KEMaseno University · KEThe University of Sydney · AU

Funding

Vector Biology of Invasive Anopheles stephensi in Rural to Urban Landscapes in EthiopiaU19AI129326 · NIAID · UNIVERSITY OF CALIFORNIA-IRVINE · PI Guiyun Yan · 2017 to 2026
$19.9M
Ecology of African Highland MalariaR01AI050243 · NIAID · UNIVERSITY OF CALIFORNIA-IRVINE · PI YAN, GUIYUN · 2001 to 2018
$8.8M
Research Training in Mosquito Genomics and Bioinformat*D43TW001505 · FIC · UNIVERSITY OF CALIFORNIA-IRVINE · PI Guiyun Yan · 2000 to 2026
$6.0M
FIC NIH HHS D43 TW001505NIAID NIH HHS R01 AI050243NIAID NIH HHS U19 AI129326
6 · The paper itself

Abstract

backgroundMalaria causes significant mortality and morbidity in sub-Saharan Africa, especially among children under five years of age and places a huge economic burden on individuals and health systems. While this burden has been assessed previously, few studies have explored how malaria comorbidities affect inpatient costs. This study in a malaria endemic area in Western Kenya, assessed the total treatment costs per malaria episode including comorbidities in children and adults.

methodsTotal economic costs of malaria hospitalizations were calculated from a health system and societal perspective. Patient-level data were collected from patients admitted with a malaria diagnosis to a county-level hospital between June 2016 and May 2017. All treatment documented in medical records were included as health system costs. Patient and household costs included direct medical and non-medical expenses, and indirect costs due to productivity losses.

resultsOf the 746 patients admitted with a malaria diagnosis, 64% were female and 36% were male. The mean age was 14 years (median 7 years). The mean length of stay was three days. The mean health system cost per patient was Kenyan Shilling (KSh) 4288 (USD 42.0) (95% confidence interval (CI) 95% CI KSh 4046-4531). The total household cost per patient was KSh 1676 (USD 16.4) (95% CI KSh 1488-1864) and consisted of: KSh 161 (USD1.6) medical costs; KSh 728 (USD 7.1) non-medical costs; and KSh 787 (USD 7.7) indirect costs. The total societal cost (health system and household costs) per patient was KSh 5964 (USD 58.4) (95% CI KSh 5534-6394). Almost a quarter of patients (24%) had a reported comorbidity. The most common malaria comorbidities were chest infections, diarrhoea, and anaemia. The inclusion of comorbidities compared to patients with-out comorbidities led to a 46% increase in societal costs (health system costs increased by 43% and patient and household costs increased by 54%).

conclusionsThe economic burden of malaria is increased by comorbidities which are associated with longer hospital stays and higher medical costs to patients and the health system. Understanding the full economic burden of malaria is critical if future malaria control interventions are to protect access to care, especially by the poor.

Indexed as

Cost of IllnessAdolescentAdultChildChild, PreschoolComorbidityFemaleHealth Care CostsHospitalizationHumansInfantInfant, NewbornKenyaMalariaMaleMiddle AgedAfricaCoinfectionHealthcare costsKenyaMalaria

Identifiers

PMID34717637
PMCPMC8557520
OpenAlexW3168798001

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.