Gaëtan Moukoumbi Lipenguet1,2,3, Edgard Brice Ngoungou4,5,6, Euloge Ibinga4,5, Jean Engohang-Ndong4,5,7, Jérôme Wittwer8. 1. University of Bordeaux, Population Health of Bordeaux, Inserm U1219, EMOS team. ISPED, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France. geatan.moukoumbi-lipenguet@u-bordeaux.fr. 2. Department of Epidemiology-Biostatistics and Medical Informatics (DEBIM), Faculty of Medicine, University of Health Sciences, BP: 4009, Libreville, Gabon. geatan.moukoumbi-lipenguet@u-bordeaux.fr. 3. University of Health Sciences, Research Unit in Epidemiology of Chronic Diseases and Environmental Health (UREMCSE), BP: 11587, Libreville, Gabon. geatan.moukoumbi-lipenguet@u-bordeaux.fr. 4. Department of Epidemiology-Biostatistics and Medical Informatics (DEBIM), Faculty of Medicine, University of Health Sciences, BP: 4009, Libreville, Gabon. 5. University of Health Sciences, Research Unit in Epidemiology of Chronic Diseases and Environmental Health (UREMCSE), BP: 11587, Libreville, Gabon. 6. UMR 1094 Inserm partner IRD-Tropical Neuroepidemiology (NET), Faculty of Medicine of the University of Limoges, 87 025, Limoges, France. 7. Department of Biological Sciences, Kent State University at Tuscarawas, 330 University Dr. NE, New Philadelphia, OH, 44663, USA. 8. University of Bordeaux, Population Health of Bordeaux, Inserm U1219, EMOS team. ISPED, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France.
Abstract
BACKGROUND: Malaria is one of the leading causes of morbidity and mortality in African countries. It is one of the leading causes of hospital visits and hospitalization in pediatric wards for children under 5 years old. Interestingly however, the economic burden of this disease remains unknown in these endemic countries including Gabon. The purpose of this study is to assess the direct hospital cost for the management of malaria in children under 5 years old at the Libreville University Hospital Centre (CHUL, Centre Hospitalier Universitaire de Libreville) in Gabon. METHODS: This research work is a retrospective study using a comprehensive review of medical records of patients seen at the CHUL over a two-year period extending from January 2018 through December 2019. The study focused on children under 5 years old, admitted for malaria in the paediatric ward of the CHUL. The analysis targeted specifically direct hospital costs, which excluded salary and wages of health care workers. The monetary currency used in this study was the CFA francs, as that currency is the one used in Central Africa (as reference, 1 Euro = 656 CFA francs). RESULTS: For the set timeframe, 778 patient records matched the study criteria. Thus, out of 778 admitted patients, 58.4% were male while 41.5% were female. Overall, the average age was 13.2 months (± 13.8 months). The total cost incurred by the hospital for the management of these 778 malaria patients was 94,922,925 CFA francs (144,699.58 €), for an average expense per patient topping at 122,008 CFA francs (185.99 €). The highest expenditure items were hospitalizations (44,200,000 CFA francs, 67,378.1 €), followed by drugs (26,394,425 CFA francs, 40,235.4 €) and biomedical examinations (14,036,000 CFA francs, 21,396.34 €). CONCLUSION: The financial burden for managing malaria in the paediatric ward seems to be very high, not only for the hospital, but also for families in spite of the government medical insurance coverage in some cases. These findings bring new insights as to the urgency to develop policies that foster preventive initiatives over curative approaches in the management of malaria in children in endemic countries.
BACKGROUND:Malaria is one of the leading causes of morbidity and mortality in African countries. It is one of the leading causes of hospital visits and hospitalization in pediatric wards for children under 5 years old. Interestingly however, the economic burden of this disease remains unknown in these endemic countries including Gabon. The purpose of this study is to assess the direct hospital cost for the management of malaria in children under 5 years old at the Libreville University Hospital Centre (CHUL, Centre Hospitalier Universitaire de Libreville) in Gabon. METHODS: This research work is a retrospective study using a comprehensive review of medical records of patients seen at the CHUL over a two-year period extending from January 2018 through December 2019. The study focused on children under 5 years old, admitted for malaria in the paediatric ward of the CHUL. The analysis targeted specifically direct hospital costs, which excluded salary and wages of health care workers. The monetary currency used in this study was the CFA francs, as that currency is the one used in Central Africa (as reference, 1 Euro = 656 CFA francs). RESULTS: For the set timeframe, 778 patient records matched the study criteria. Thus, out of 778 admitted patients, 58.4% were male while 41.5% were female. Overall, the average age was 13.2 months (± 13.8 months). The total cost incurred by the hospital for the management of these 778 malariapatients was 94,922,925 CFA francs (144,699.58 €), for an average expense per patient topping at 122,008 CFA francs (185.99 €). The highest expenditure items were hospitalizations (44,200,000 CFA francs, 67,378.1 €), followed by drugs (26,394,425 CFA francs, 40,235.4 €) and biomedical examinations (14,036,000 CFA francs, 21,396.34 €). CONCLUSION: The financial burden for managing malaria in the paediatric ward seems to be very high, not only for the hospital, but also for families in spite of the government medical insurance coverage in some cases. These findings bring new insights as to the urgency to develop policies that foster preventive initiatives over curative approaches in the management of malaria in children in endemic countries.