Cost-Effectiveness Analysis of Introducing RDTs for Malaria Diagnosis as Compared to Microscopy and Presumptive Diagnosis in Central and Peripheral Public Health Facilities in Ghana

Abstract. Cost-effectiveness information on where malaria rapid diagnostic tests (RDTs) should be introduced is limited. We developed incremental cost-effectiveness analyses with data from rural health facilities in Ghana with and without microscopy. In the latter, where diagnosis had been presumptive, the introduction of RDTs increased the propor-tion of patients who were correctly treated in relation to treatment with antimalarials, from 42 % to 65 % at an incremental societal cost of Ghana cedis (GHS)12.2 (US$8.3) per additional correctly treated patients. In the “microscopy setting ” there was no advantage to replacing microscopy by RDT as the cost and proportion of correctly treated patients were similar. Results were sensitive to a decrease in the cost of RDTs, which cost GHS1.72 (US$1.17) per test at the time of the study and to improvements in adherence to negative tests that was just above 50 % for both RDTs and microscopy