Households’ incidence on malaria and expenditures to treat malaria in Sudan: what role does use of different vector control tools play in rural and urban locations?

Abstract

BACKGROUND: Malaria is the major health problem in Sudan and accounts for more than 40% of health facility visits and 35,000 deaths in Sudan. Although treatable, it affects people from different socio-economic status (SES), causing suffering and poor socio-economic development.
OBJECTIVES: To explore the relationship between use of different malaria control tools and household expenditure for malaria treatment especially in children under five.
METHODS: The study was undertaken in 6 localities in Gezira and Khartoum states in Sudan. 720 randomly selected households were interviewed using a pre-tested interviewer - administered questionnaire. Household incidence and expenditure for malaria in different age groups was used to compare the use of different malaria control tools for malaria treatment in rural and urban communities.
RESULTS: The highest incidence of malaria elicited from respondents was 29.0% and mean expenditure was 3235.5 Dinars (US$12). It was found that there was high incidence of malaria and large expenditure on treatment on households with insecticide treated-bed net (ITN) and in-door residual house spraying (IRHS).
CONCLUSION: The relationship between expenditure and use of different vector control depends on the geographic location of respondents. People living in the rural areas spend more to have access to malaria control tools. Location of respondent has a positive effect on expenditures and use of malaria control tools. The National Malaria Administration (NMA) and (SMA) State Malaria Administration should continually determine the access that the poorest and high risk households have to IRHS and ITNs. Financial riak protection mechanism are needed to ameliorate the expenditures on malaria control tool, which mostly paid from out of pocket.

Key words: Malaria, expenditure, vector control tools, households.