TABLE 2.

Comparative costs for malaria treatment of West African refugees by strategy, 1998–2004^*

Strategy	Artemether-lumefantrine presumptive treatment	Observed U.S. malaria cases	Expected U.S. malaria cases
Presumptive overseas Pre-departure treatment	All†	Actual	None†
Refugees treated	2,332	51	191‡
Cost per treatment course	$14.40	$1,729.50	$1,729.50
Total treatment cost	$33,580	$88.205	$330,335
Relative treatment cost	38%	100%	375%
Malaria prevalence: cost-benefit policy breakpoint§	1.0%	NA	NA

^*NA = not applicable.

^†Theoretical.

^‡If overseas presumptive therapy had not started in 1999, an expected 191 cases of malaria would have occurred among 2,332 refugees. This is derived from the preimplementation refugee malaria rate of 8.2%.

^§Prevalence of malaria above which it is more cost-beneficial to use an overseas presumptive treatment strategy.