In 1995 a survey was conducted in a metallurgical company in Cameroon to determine the percentage of health-related costs attributed to malaria. Both direct (consultation, hospitalizations, laboratory tests, and drugs) and indirect (sick pay, overtime, and lost production) costs were included. Total annual health-related expenditures were 4,125,000 FF. The average amount spent was 5,800 FF per family or 900 FF per eligible person. Malaria accounted for 1,272,000 FF or 31% of these expenditures. Thus the average amount spent for malaria was 1780 FF per family and 275 FF per eligible person. These figures indicate that a prevention program based mainly on use of impregnated mosquito nets, would be a highly cost-effective approach especially within the context of a well-organized health care system, a stable local population, a high mosquito biting nuisance, a good awareness of this nuisance, the possibility of social upheaval, and probable company support. Since a malaria-prevention program running at 50% efficiency would only decrease the malaria-related costs by about 12.5% of overall annual health expenditures, careful monitoring of cost-effectiveness would be necessary.
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