Determining utility values related to malaria and malaria chemoprophylaxis.
BACKGROUND
Chemoprophylaxis for travellers' malaria is problematic. Decision modeling may help determine optimal prevention strategies for travellers' malaria. Such models can fully assess effect of drug use and disease on quality of life, and help travellers make informed values based decisions. Such models require utility values reflecting societal preferences over different health states of relevance. To date, there are no published utility values relating to clinical malaria or chemoprophylaxis adverse events.


METHODS
Utility estimates for health states related to falciparum malaria, sequelae and drug-related adverse events were obtained using a self-administered visual analogue scale in 20 individuals. Utility values for health states related to clinical malaria were obtained from a survey of 11 malaria experts questioned about length of hospital stay or equivalent disability with simple and severe travellers' malaria.


RESULTS
The general public (potential travellers), were more tolerant of taking prophylaxis if associated with no or mild AEs and least tolerant of mild sequelae from malaria and severe drug related events. The rating value reported for taking no prophylaxis was quite variable. Tropical medicine specialists estimated a mean hospital stay 3.23 days (range 0.5-4.5 days) for simple and 6.36 days (range 4.5-7 days) for severe malaria.


CONCLUSIONS
This study provides a benchmark for important utility value estimates for modeling malaria and drug-related outcomes in non-immune travellers.
McCarthy
Anne E
AE
Tropical Medicine and International Health Clinic, Division of Infectious Diseases Ottawa Hospital General Campus, University of Ottawa, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada. amccarthy@ottawahospital.on.ca
Coyle
Doug
D
D000962:Antimalarials / Q000009:adverse effects* / Q000191:economics; D018890:Chemoprevention / Q000009:adverse effects / Q000592:standards*; D003657:Decision Making; D017723:Drug Utilization Review; D006801:Humans; D007902:Length of Stay; D016778:Malaria, Falciparum / Q000469:parasitology / Q000517:prevention & control*; D012306:Risk; D011795:Surveys and Questionnaires; D014195:Travel; D016896:Treatment Outcome
D000962:Antimalarials