{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:13:12Z","timestamp":1793229192563,"version":"4.5.0"},"reference-count":83,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015691","name":"Division of Microbiology and Infectious Diseases","doi-asserted-by":"publisher","award":["U19AI089674"],"award-info":[{"award-number":["U19AI089674"]}],"id":[{"id":"10.13039\/100015691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015691","name":"Division of Microbiology and Infectious Diseases","doi-asserted-by":"publisher","award":["U19AI089674"],"award-info":[{"award-number":["U19AI089674"]}],"id":[{"id":"10.13039\/100015691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Case management of malaria in Africa has evolved markedly over the past 20 years and updated cost estimates are needed to guide malaria control policies. We estimated the cost of malaria illness to households and the public health service and assessed the equity of these costs in Uganda. From December 2021 to May 2022, we conducted a costing exercise in eight government-run health centres covering seven sub-regions, collecting health service costs from patient observations, records review and a time-and-motion study. From November 2021 to January 2022, we gathered data on households\u2019 cost of illness from randomly selected households for 614 residents with suspected malaria. Societal costs of illness were estimated and combined with secondary data sources to estimate the total economic burden of malaria in Uganda. We used regression analyses and concentration curves to assess the equity of household costs across age, geographic location and socio-economic status. The mean societal economic cost of treating suspected malaria was $15.12 [95% confidence interval (CI): 12.83\u201317.14] per outpatient and $27.21 (95% CI: 20.43\u201333.99) per inpatient case. Households incurred 81% of outpatient and 72% of inpatient costs. Households bore nearly equal costs of illness, regardless of socio-economic status. A case of malaria cost households in the lowest quintile 26% of per capita monthly consumption, while a malaria case only cost households in the highest quintile 8%. We estimated the societal cost of malaria treatment in Uganda was $577 million (range: $302 million\u20131.09 billion) in 2021. The cost of malaria remains high in Uganda. Households bear the major burden of these costs. Poorer and richer households incur the same costs per case; this distribution is equal, but not equitable. These results can be applied to parameterize future economic evaluations of malaria control interventions and to evaluate the impact of malaria on Ugandan society, informing resource allocations in malaria prevention.<\/jats:p>","DOI":"10.1093\/heapol\/czae093","type":"journal-article","created":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T11:11:23Z","timestamp":1731150683000},"page":"52-65","source":"Crossref","is-referenced-by-count":9,"title":["Who pays to treat malaria and how much? Analysis of the cost of illness, equity and economic burden of malaria in Uganda"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-2720","authenticated-orcid":false,"given":"Katherine","family":"Snyman","sequence":"first","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC) , Plot 2C Nakasero Road, Kampala P.O. Box 7475,","place":["Uganda"]},{"name":"Department of Global Health & Development, London School of Hygiene & Tropical Medicine (LSHTM) , Keppel Street, London WC1E 7HT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Pitt","sequence":"additional","affiliation":[{"name":"Department of Global Health & Development, London School of Hygiene & Tropical Medicine (LSHTM) , Keppel Street, London WC1E 7HT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Aturia","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC) , Plot 2C Nakasero Road, Kampala P.O. Box 7475,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Aber","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC) , Plot 2C Nakasero Road, Kampala P.O. Box 7475,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Gonahasa","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC) , Plot 2C Nakasero Road, Kampala P.O. Box 7475,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane Frances","family":"Namuganga","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC) , Plot 2C Nakasero Road, Kampala P.O. Box 7475,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaniter","family":"Nankabirwa","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC) , Plot 2C Nakasero Road, Kampala P.O. Box 7475,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Arinaitwe","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC) , Plot 2C Nakasero Road, Kampala P.O. Box 7475,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Maiteki-Sebuguzi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC) , Plot 2C Nakasero Road, Kampala P.O. Box 7475,","place":["Uganda"]},{"name":"National Malaria Control Programme, Ministry of Health (MOH\/NMCP) , Plot 6 Lourdel Rd, Nakasero, Kampala,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Katamba","sequence":"additional","affiliation":[{"name":"National Malaria Control Programme, Ministry of Health (MOH\/NMCP) , Plot 6 Lourdel Rd, Nakasero, Kampala,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Opigo","sequence":"additional","affiliation":[{"name":"National Malaria Control Programme, Ministry of Health (MOH\/NMCP) , Plot 6 Lourdel Rd, Nakasero, Kampala,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Matovu","sequence":"additional","affiliation":[{"name":"School of Economics, Makerere University , Plot 51, Pool Road, Kampala,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0740-0317","authenticated-orcid":false,"given":"Grant","family":"Dorsey","sequence":"additional","affiliation":[{"name":"University of California, San Francisco (UCSF) , 1001 Potrero Avenue, San Francisco, CA 94110,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses R","family":"Kamya","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC) , Plot 2C Nakasero Road, Kampala P.O. Box 7475,","place":["Uganda"]},{"name":"Department of Medicine, Makerere University , New Mulago Hill Road, Mulago, Kampala,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Ochieng","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention , 1600 Clifton Rd, Atlanta 30329, ,","place":["Georgia Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah G","family":"Staedke","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC) , Plot 2C Nakasero Road, Kampala P.O. Box 7475,","place":["Uganda"]},{"name":"Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,15]]},"reference":[{"key":"2025011305314166400_R1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-042562","article-title":"Effect of specificity of health expenditure questions in the measurement of out-of-pocket health expenditure: evidence from field experimental study in Ghana","volume":"11","author":"Agorinya","year":"2021","journal-title":"BMJ Open"},{"key":"2025011305314166400_R2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1744-8603-10-21","article-title":"Economic impacts of health shocks on households in low and middle income countries: a review of the literature","volume":"10","author":"Alam","year":"2014","journal-title":"Globalization & Health"},{"key":"2025011305314166400_R3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12936-019-2995-4","article-title":"The economic burden of malaria on households and the health system in a high transmission district of Mozambique","volume":"18","author":"Alonso","year":"2019","journal-title":"Malaria Journal"},{"key":"2025011305314166400_R4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12936-022-04303-6","article-title":"The economic burden of malaria: a systematic review","volume":"21","author":"Andrade","year":"2022","journal-title":"Malaria Journal"},{"key":"2025011305314166400_R5","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/S1473-3099(04)01002-3","article-title":"Vulnerability to malaria, tuberculosis, and HIV\/AIDS infection and disease. 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