Research, Policy & Global Development

A Study Evaluates the Economic Cost of Malaria in Pregnancy in the Brazilian Amazon

Plasmodium vivax infections during pregnancy generate considerable costs, even in low transmission areas


 A study led by ISGlobal in collaboration with Brazilian and British scientists, estimates for the first time the economic impact of malaria during pregnancy in the Brazilian Amazon, a low endemic area where Plasmodium vivax predominates. The results have been published in Plos Neglected Tropical Diseases, and provide a solid basis to guide policy decisions for the control and future elimination of malaria in the region.  

Malaria in pregnancy is not only associated to an increase in maternal and foetal morbidity and mortality, but also represents a significant economic burden. However, the few studies on the economics of malaria in pregnancy are limited to Plasmodium falciparum (the dominant species in Africa) in high transmission settings of the sub-Saharan region. Among Latin American countries, where P. vivax predominates, Brazil has the highest reported burden of malaria in pregnancy. Therefore, the authors of the study sought to determine patient and health system costs of malaria in pregnancy in Manaus. Using several sources of information, they estimated an average cost for the patient ranging from 45 USD up to 335 USD in case of multiple infections during pregnancy. The estimated cost for the health system was of 103 USD per malaria episode, with a total cost (diagnosis and treatment) of 17,000 USD for all malaria cases reported in pregnant women in Manaus in 2010. More than 90% of such cost was due to P. vivax infections, and corresponds approximately to 30 times the average national government health expenditure per capita.

The authors conclude that, despite the low risk of transmission, malaria in pregnancy represents a considerable economic burden for Manaus, especially in the case of multiple infections and hospital admission. “The data generated in this study will be of great help for evidence-based decision making aimed at the control of malaria in pregnant women, and its future elimination in the region”, points out Dr. Elisa Sicuri, researcher at ISGlobal and senior author of the study. 


Bôtto-Menezes C, Bardají A, Dos Santos Campos G, et al.Costs Associated with Malaria in Pregnancy in the Brazilian Amazon, a Low Endemic Area Where Plasmodium vivax Predominates. PLoS Negl Trop Dis. 2016 Mar 31;10(3):e0004494.