Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia

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...

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Authors: Sicuri, Elisa, Bardají, Azucena, Sanz, Sergi, Alonso, Sergi, Fernandes, Silke, Hanson, Kara, Arévalo-Herrera, Myriam, Menéndez, Clara
Format: article
Status:Published version
Publication Date:2018
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/123527
Online Access:https://hdl.handle.net/2445/123527
Access Level:Open access
Keyword:Malària
Embaràs
Malaria
Pregnancy
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spelling Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of ColombiaSicuri, ElisaBardají, AzucenaSanz, SergiAlonso, SergiFernandes, SilkeHanson, KaraArévalo-Herrera, MyriamMenéndez, ClaraMalàriaEmbaràsMalariaPregnancyMalaria 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.Public Library of Science (PLoS)2018201820182018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion13 p.application/pdfapplication/pdfhttps://hdl.handle.net/2445/123527Articles publicats en revistes (ISGlobal)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: http://dx.doi.org/10.1371/journal.pntd.0006431PLoS Neglected Tropical Diseases, 2018, vol. 12, num. 5, p. e0006431http://dx.doi.org/10.1371/journal.pntd.0006431info:eu-repo/grantAgreement/EC/FP7/201588cc by (c) Sicuri et al., 2018http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1235272026-05-29T05:05:01Z
dc.title.none.fl_str_mv Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia
title Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia
spellingShingle Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia
Sicuri, Elisa
Malària
Embaràs
Malaria
Pregnancy
title_short Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia
title_full Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia
title_fullStr Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia
title_full_unstemmed Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia
title_sort Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia
dc.creator.none.fl_str_mv Sicuri, Elisa
Bardají, Azucena
Sanz, Sergi
Alonso, Sergi
Fernandes, Silke
Hanson, Kara
Arévalo-Herrera, Myriam
Menéndez, Clara
author Sicuri, Elisa
author_facet Sicuri, Elisa
Bardají, Azucena
Sanz, Sergi
Alonso, Sergi
Fernandes, Silke
Hanson, Kara
Arévalo-Herrera, Myriam
Menéndez, Clara
author_role author
author2 Bardají, Azucena
Sanz, Sergi
Alonso, Sergi
Fernandes, Silke
Hanson, Kara
Arévalo-Herrera, Myriam
Menéndez, Clara
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Malària
Embaràs
Malaria
Pregnancy
topic Malària
Embaràs
Malaria
Pregnancy
description 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.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018
2018
2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/123527
url https://hdl.handle.net/2445/123527
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pntd.0006431
PLoS Neglected Tropical Diseases, 2018, vol. 12, num. 5, p. e0006431
http://dx.doi.org/10.1371/journal.pntd.0006431
info:eu-repo/grantAgreement/EC/FP7/201588
dc.rights.none.fl_str_mv cc by (c) Sicuri et al., 2018
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Sicuri et al., 2018
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 13 p.
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (ISGlobal)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.81155

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