Dans quelle mesure un traitement de la malaria ciblé sur le moustique vecteur "Anophèle", peut être plus efficace en comparaison d'un traitement direct chez l'homme? Une comparaison coût-efficacité

Abstract

Introduction: Malaria affects 229 million people worldwide. It is a major public health problem, particularly in Africa where 95 % of the cases are found. The appearance of new resistances to current treatments is worrisome, and it is necessary to find alternatives in order to cure the affected population.

Material and Method: This work is divided in three phases: a cross-sectional study, a pre-experimental study, and a cost-effectiveness study. The cross-sectional study consists of a questionnaire sent to Gabon in order to collect the patients' feelings regarding the disease and the side effects of the treatment. The pre-experimental study assesses the effectiveness of the new strategy, i.e. treating mosquitoes rather than patients. The cost-effectiveness study determines if the strategy is more advantageous from an efficiency and financial point of view compared to the current strategies.

Results: The cross-sectional study shows that patients suffer more from numerous side effects due to the treatment than from the disease itself. The most commonly used antimalarial drug is Coartem. The pre-experimental study shows the effectiveness of the new treatment. 95 % of the mosquitoes that came into contact with this formulation died after 24 hours. The cost-effectiveness study shows that the new strategy is more expensive than treatment strategies. However, after 20 years of implementation, the gap is narrowing.

Conclusion: The implementation of the new strategy (i.e. treatment of the vector) is more expensive than the one of the current treatment strategies. However, this cost difference tends to decrease over time. In addition, it should be kept in mind that this strategy eliminates a quantity of mosquitoes each year, which would reduce the incidence of malaria, but also of other diseases transmitted by the same type of vector.