Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Malaria in pregnancy threatens birth outcomes and the health of women and their newborns. This is also the case in low transmission areas, such as Colombia, where Plasmodium vivax is the dominant parasite species. Within the Colombian health system, which underwent major reforms in the 90s, malaria treatment is provided free of charge to patients. However, patients still incur costs, such as transportation and value of time lost due to the disease. We estimated such costs among 40 pregnant women with clinical malaria (30% Plasmodium falciparum, 70% Plasmodium vivax) in the municipality of Tierralta, Northern Colombia. In a cross-sectional study, women were interviewed after an outpatient or inpatient laboratory confirmed malaria episode. Women were asked to report all types of cost incurred before (including prevention), during and immediately after the contact with the health facility. Median total cost was over 16US$ for an outpatient visit, rising to nearly 30US$ if other treatments were sought before reaching the health facility. Median total inpatient cost was 26US$ or 54US$ depending on whether costs incurred prior to admission were excluded or included. For both outpatients and inpatients, direct costs were largely due to transportation and indirect costs constituted the largest share of total costs. Estimated costs are likely to represent only one of the constraints that women face when seeking treatment in an area characterized, at the time of the study, by armed conflict, displacement, and high vulnerability of indigenous women, the group at highest risk of malaria. Importantly, the Colombian peace process, which culminated with the cease-fire in August 2016, may have a positive impact on achieving universal access to healthcare in conflict areas. The current study can inform malaria elimination initiatives in Colombia.
Date Issued
2018-05-02
Date Acceptance
2018-04-06
Citation
PLoS Neglected Tropical Diseases, 2018, 12 (5)
ISSN
1935-2727
Publisher
Public Library of Science
Journal / Book Title
PLoS Neglected Tropical Diseases
Volume
12
Issue
5
Copyright Statement
© 2018 Sicuri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29718903
PII: PNTD-D-17-02045
Subjects
06 Biological Sciences
11 Medical And Health Sciences
Tropical Medicine
Publication Status
Published
Coverage Spatial
United States
Article Number
e0006431