Household costs associated with zoonotic Plasmodium knowlesi, P. falciparum, P. vivax and P. malariae infections in Sabah, Malaysia

Abstract

Background Malaysia has free universal access to malaria care; however, out-of-pocket costs are unknown. This study estimated and compared household costs of illness during a unique time when four species of malaria were present, due to the emergence of zoonotic Plasmodium knowlesi during the elimination phase of non-zoonotic species in Sabah, Malaysia. Methodology/principal findings Household costs were estimated from patient-level surveys collected from four hospitals between 2013 and 2016. Direct costs including medical and associated travel costs, and indirect costs due to lost productivity were included. One hundred and fifty-two malaria cases were enrolled: P. knowlesi (n=108), P. viva..