J Korean Med Sci.
2018 Mar;33(10):e59. 10.3346/jkms.2018.33.e59.
Cost-Benefit Analysis of Malaria Chemoprophylaxis and Early Diagnosis for Korean Soldiers in Malaria Risk Regions
- Affiliations
-
- 1Department of Internal Medicine, Cheongju Medical Center, Cheongju, Korea. gilwon67@chungbuk.ac.kr
- 2Department of Health Informatics and Management, College of Medicine, Chungbuk National University, Cheongju, Korea.
- 3Department of Applied Mathematics, Kyung Hee University, Yongin, Korea.
- 4Armed Forces Medical Command, Seongnam, Korea.
- 5Armed Forces Gangneung Hospital, Gangneung, Korea.
- KMID: 2405006
- DOI: http://doi.org/10.3346/jkms.2018.33.e59
Abstract
- BACKGROUND
Chemoprophylaxis has been used to prevent malaria among soldiers and secondary transmission, as it effectively facilitates a decline in disease occurrence and secondary prevention. However, poor compliance and decreased risk of exposure to malaria necessitate that control strategies be reestablished.
METHODS
To predict the incidence of malaria according to a control strategy, we proposed a mathematical model for its transmission using epidemiological data from 2010 to 2012. The benefit component included in the analyses was the averted cost with each control strategy, and the cost components were the cost of implementing chemoprophylaxis and early diagnosis.
RESULTS
The chemoprophylaxis regimen with hydroxychloroquine sulfate and primaquine was Intervention 1, the regimen with primaquine only was Intervention 2, and diagnosis with a rapid diagnostic test (RDT) kit within 5 days of fever was Intervention 3. The simulation indicated that the combined control program with chemoprophylaxis and early diagnosis would be the most effective strategy, whereas sole early diagnosis would be the least effective strategy. However, the cost-benefit ratio of chemoprophylaxis was less than Intervention 1, irrespective of the varying range of chemoprophylaxis compliance, and that of early diagnosis was more than Intervention 1, regardless of the varying early diagnosis rate and demand for the RDT kit. Although chemoprophylaxis would be more effective at reducing the incidence of malaria than early diagnosis, it is less economical due to the higher cost.
CONCLUSION
Our results support the introduction of early diagnosis with a RDT kit to control malaria in the Republic of Korea Army.
