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[Management of severe malaria in children in developing countries. A protocol for economic evaluation]
1Département de Parasitologie, Université Cheikh Anta Diop, Faculté de Médecine et de Pharmacie, Dakar, Sénégal.
Insights
This study on severe malaria management in Senegal found a 12.2% mortality rate and identified key areas for improvement, including nurse workload and cost-effectiveness, to enhance patient care.
Area of Science:
- Public Health
- Infectious Diseases
- Health Economics
Background:
- Severe malaria poses a significant public health challenge, particularly in resource-limited settings.
- Effective management protocols are crucial for reducing mortality and morbidity.
- Economic appraisal provides valuable data for optimizing healthcare resource allocation.
Purpose of the Study:
- To conduct a preliminary economic appraisal of severe malaria management.
- To establish a framework for evaluating management strategies based on key performance indicators.
- To inform institutional decision-making for improving severe malaria care.
Main Methods:
- Prospective one-year study at Albert Royer Children's Hospital, Dakar, Senegal.
- Routine data collection using standardized checklists.
- Analysis of four key indicators: nurse workload, care adequacy, direct cost, and mortality rate.
Main Results:
- Mean daily nurse workload: 27.2 minutes per patient.
- Adequate care provided to 54.5% of patients based on 5 criteria.
- Estimated direct cost of severe malaria treatment: 45,963 CFA francs.
- Mortality rate: 12.2%, indicating limited improvement over previous years.
Conclusions:
- Findings provide objective, measurable data for institutional decision-making.
- Identified areas for improvement include nurse workload, care adequacy, cost reduction, and mortality rate.
- Recommendations for integrating these indicators into quality control programs to enhance severe malaria management.
Abstract:
This prospective one-year study was conducted as a preliminary phase to setting up a protocol for economic appraisal of management of severe malaria at Albert Royer Children's Hospital in Dakar, Senegal. Data was routinely collected using a standardized checklist. The four key indicators chosen for this study were nurse workload, adequacy of care (number of patients receiving adequate care), direct cost, and mortality rate. The mean daily care workload was estimated to be 27.2 minutes. This indicator assesses the relationship between supply and demand. Based on 5 criteria, care was considered as adequate in 54.5 p. 100 of patients. This indicator is helpful in judging the effectiveness of the therapeutic modalities used. The direct cost of treating severe malaria was estimated to be 45963 CFA francs. This indicator will be useful in establishing controls to reduce costs. The mortality rate was 12.2 p. 100. Comparison of this rate with previous years suggests little improvement in the outcome of malaria management at the institution. This indicator must be taken into account in the ongoing quality control program. Overall these findings should enable institutional decision-making to improve management of severe malaria based on objective measurable data.