Cost of Treatment of Severe Malarial Anemia in Children Living in Western Kenya

Aims: The Western region in Kenya is holoendemic to malaria and experiences stable P. falciparum malaria transmission. Households and healthcare providers in this region incur costs in the management of malaria and malaria related complications. However, information regarding the cost of severe malaria anemia (SMA) management remains almost unknown. The aim of this study was to study the costs incurred by the household and healthcare providers in the management of SMA in children of 10 years and below.

Study Design: Cross-section study.

Place and Duration of Study: Jaramogi Odinga Oginga Teaching and Referral Hospital (JOOTRH) from September 2014 to July 2015.

Methodology: It was open to all children ≤10 years (n=271) admitted and diagnosed with SMA (hemoglobin <5.0 g/dl and any density P. falciparum parasitemia). Data were extracted from the participants’ medical files. Parents/guardians of the participants were interviewed on the costs incurred throughout the management of the disease.

Results: It would cost an overall average of US$ 38.83 per child to treat a case of SMA in Western Kenya. The mean cost of treating a child <5 years and >5 years was nearly the same at US$ 38.95 and US$ 38.44 respectively (p=0.7850). The mean household cost for <5 years old was significantly lower at US$ 18.43 compared to US$ 30.08 in the >5 years old children (p<0.001). The mean provider cost was significantly higher in the <5 years old as (US$ 22.55) compared to US$ 17.22 in the >5 years old (p=0.0027) children.

Conclusion: Mean total cost for SMA treatment was same for children under 5 years and above 5 years of age. The difference was who spent the highest costs. The provider incurred the highest cost for children under 5 and the households incurred the highest cost for children above 5 years. Even though treatment of malaria for the under 5 years old children is considered free of cost, the households still incur costs in the management of SMA.