Provider and household costs of Plasmodium vivax malaria episodes: a multicountry comparative analysis of primary trial data.

OBJECTIVE: To determine household and health-care provider costs associated with Plasmodium vivax infection across a range of endemic settings. METHODS: We collected cost data alongside three multicentre clinical trials of P. vivax treatment in Afghanistan, Brazil, Colombia, Ethiopia, Indonesia, Philippines, Peru, Thailand and Viet Nam conducted between April 2014 to December 2017. We derived household costs from trial participant surveys administered at enrolment and again 2 weeks later to determine the costs of treatment and transportation, and the number of days that patients and their household caregivers were unable to undertake their usual activities. We determined costs of routine care by health-care providers by micro-costing the resources used to diagnose and treat P. vivax at the study sites. FINDINGS: The mean total household costs ranged from 8.7 United States dollars (US$; standard deviation, SD: 4.3) in Afghanistan to US$ 254.7 (SD: 148.4) in Colombia. Across all countries, productivity losses were the largest household cost component, resulting in mean indirect costs ranging from US$ 5.3 (SD: 3.0) to US$ 220.8 (SD: 158.40). The range of health-care provider costs for routine care was US$ 3.6-6.6. The cost of administering a glucose-6-phosphate-dehydrogenase rapid diagnostic test, ranged from US$ 0.9 to 13.5, consistently lower than the costs of the widely-used fluorescent spot test (US$ 6.3 to 17.4). CONCLUSION: An episode of P. vivax malaria results in high costs to households. The costs of diagnosing and treating P. vivax are important inputs for future cost-effectiveness analyses to ensure optimal allocation of resources for malaria elimination.

Response of plasmodium falciparum to artemisinin in vivo and in vitro in Phu Rieng ruber plantation (1998 and 2001)

65 patients with uncomplicated Pl.falciparum malaria were monitored during 28 days after 5 -day -course use of artemisinine (year 1998) and 69 patients after 7 day course (year 2001). The mean fever cut time lengthened for 1,5 days in 1998 and 1,8 days in 2001.The mean parasite cut time had lengthened for 1,8 days in1998 and 2,3 days in 2001. The rate of reappearance of parasite accounted for 36,9% within 28 days follow up with 5 -day -course procedure and 7,3 % with 7 days procedure. The rate of repeated infestion was remarkable: 10/21 patients (year1998) and 3/5 (year 2001) had got recurrence. No change of EC50 was reported between the years 1998 and 2001, but an increase by 2 and 4 folds of EC90 and EC99 was reported.EC50,90 and 99% of chloroquine, mefloquine and quinine in the year 2001 decreased by 2 folds vs 1998