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Table 3 Observed and potential cost-effectiveness of cases appropriately diagnosed and treated vi vii vii ix

From: Monitoring, characterization and control of chronic, symptomatic malaria infections in rural Zambia through monthly household visits by paid community health workers

  Health facility Community based
Directly observed process indicators over 6 months   Passive Active Total
Covered community based cluster or facility catchment 77754 17543 17543 17543
Diagnostic tests carried out over six months 29897 2652 42556 45208
Diagnostically confirmed and treated cases of malaria infection over 6 months 15568 1260 10149 11409
Diagnostically confirmed and treated malaria case per head population over 6 months 0.20 0.07 0.58 0.65
Diagnostic tests per head of population over 6 months 0.38 0.15 2.43 2.58
Directly observed costs over 6 months     
RDT tests conducted 29,376 2,652 42,556 45,208
Cost per test (US$) 0.31 0.31 0.31 0.31
Total RDT cost (US$) 9,113 823 13,201 14,024
Microscopy tests 521 n/a n/a n/a
Cost per test (US$) 1.30 n/a n/a n/a
Total cost of microscopy (US$) 676 n/a n/a n/a
AL treatments 21,827 1,279 10,684 11,963
Cost per treatment (US$) 1.38 1.38 1.38 1.38
Total cost of AL (US$) 30,069 1,762 14,718 16,480
Total personnel costs (US$) 281,150 18,001 18,001 18,001
Time commitment (% FTE) 30 10 90 100
Personnel costs of malaria testing and treatment 84,345 1,800 16,201 18,001
Sundry maintenance, transport and running costs for six months (US$) 43,201 103 926 1,029
Total cost for Six months (US$) 167,404 4,488 45,046 49,533
Total non-treatment costs over 6 months (US$) 137,335 2,726 30,328 33,053
Projected annual summaries at observed rates of testing & treatment     
Total cost per head of population covered per year (US$) 4.31 0.51 5.14 5.65
Total non-treatment costs per head of population covered per year (US$) 3.53 0.31 3.46 3.77
Total cost per confirmed case treated (US$) 10.75 3.56 4.44 4.34
Projected potential summaries at optimized rates of active testing & treatment    
Total cost per head of population covered per year (US$)    10.68  
Total non-treatment costs per head of population covered per year (US$)    6.25  
Total cost per confirmed case treated (US$)    8.09  
  1. viUS$ 1 = ZMW 4.89, exchange rate has been rebased to fit current Zambian currency.
  2. Source: http://www.boz.zm/(S(keg4bza3j0p4fx2uixtmnibq))/FinanciaMarkestReport.aspx. Accessed 1st October 2013.
  3. viiFTE - Full Time Equivalent.
  4. viiiIn the projected annual summaries, cost per head of population was calculated by dividing the total costs by the catchment population. The cost of non treatment is the cost of only testing such as in an elimination scenario. The cost per confirmed case if the total costs divided by the diagnostically confirmed and treated cases of malaria infection.
  5. ixProjected potential summaries developed from assumptions that the HF and CHW passive will not change even in an optimized environment. Cost/head of population calculated by addition to observed cost of an average 9 missed active visits per person and 2 passive visits per person by the cost of RDTs and Treatment respectively. The cost per confirmed case treated is the total cost per head divided by the mean number of CHW detected infections per year of 1.3.