Cost-benefit analysis of malaria elimination phase surveillance measures in Fujian Province

Abstract BackgroundMalaria is an insect-borne infectious disease that spreads through bites from infected Anopheles mosquitos or blood transfusions from infected individuals. The disease seriously endangers human life, health, and social and economic development. Against the backdrop of eliminating malaria in Fujian Province, studying the health economics of the surveillance measures for the malaria elimination stage is necessary and essential.MethodsEpidemic data from Fujian Province’s malaria elimination stage from 2005 to 2019 were collected, sorted, and combined with the operation manual and working characteristics of the malaria surveillance program in Fujian Province. The inputs and outputs of malaria surveillance were analyzed by a cost-benefit analysis.ResultsThe cost of the surveillance measures during the 2005–2019 malaria elimination phase was approximately 48.1635 million yuan per year. The cost ratios were as follows: case detection and treatment accounted for 71.53%; health education accounted for 12.28%; epidemic surveillance accounted for 8.84%; supervision and assessment accounted for 4.48%; and training meetings accounted for 2.87%. Fujian Province achieved an average annual total benefit of 7.22 billion yuan at the stage of malaria elimination, of which the economic benefit accounted for 44.26% (about 3.195 billion yuan), and the social benefit accounted for 55.74% (about 4.425 billion yuan). The cost of malaria surveillance per capita was 1.28 yuan and the benefits of malaria surveillance per capita were 192.23 yuan. The net social benefit of malaria surveillance in this stage was 717,200 yuan and the average annual benefit-cost ratio was 149.91:1.ConclusionOver the past 15 years, malaria control work in Fujian Province has achieved excellent economic and social benefits. The work should continue strengthening the surveillance and control of imported malaria cases, increasing health education in high-risk locations (such as those frequented by entry-exit personnel), and enhancing residents’ awareness about prevention and personal protection. The emphasis should also be on improving the cost-benefit ratio for malaria surveillance and consolidating the achievements of eliminating malaria. The framework and results of this study conform to the principles of health economics, and they have a certain reference value for current malaria surveillance practices.