Economic cost of malaria: an obstacle to control in rural areas[Coût économique du paludisme un obstacle de lutte en milieu rural]

The World Health Organisation's 2021 report estimates that 95% of malaria cases are borne by the African Region, with 96% of deaths due to the disease. Madagascar recorded 1.4 million cases in 2022. The malaria morbidity rate remains high, and the cost of treatment represents a major burden for rural households. The aim of this study is to assess the economic costs of malaria in rural Madagascar. The study was carried out in Ankaboky-Sakaraha in March 2021; malaria was detected by molecular rapid diagnostic testing (mRDT) and microscopy in patients seen in consultation for fever. Treatment was decided on the basis of the mRDT results. The accounting approach made it possible to assess the cost of the disease and the burden of an emergency response in the event of a pandemic, while willingness to pay gave us the ability to treat. Plasmodium infection was confirmed in 49.27% of the 342 patients suspected of having malaria, and direct medical costs were estimated at MGA 20,000 per patient. In addition, households are willing to pay for prevention and treatment according to their disposable income. These results show that the persistence of malaria entails economic burdens that limit households' ability to combat the disease. he lack of a local health centre results in a monetary burden during an emergency intervention. The economic cost penalises any action to combat malaria.