Health-Related Quality of Life due to malaria in the Brazilian Amazon using EQ-5D-3L

Malaria is a mosquito-borne infectious disease caused by protozoa of the genus Plasmodium. Despite of the progress in malaria control in the last decades, malaria remains a major public health problem, contributing to increased morbidity and mortality in tropical and subtropical countries. Among American countries, Bolivia, Venezuela, and Brazil account for 73% of the cases. In Brazil, the majority of malaria cases is concentrated in Amazon region. This study estimated health-related quality of life (HRQoL) losses due to malaria in endemic areas of the Brazilian Amazon using the EQ-5D-3L instrument. We collected data from a convenience sample of 1,179 individuals aged 18 years or older. To measure the HRQoL loss, we matched individuals from the treatment group (with recent malaria) to those from the control group (without recent malaria) using Propensity Score Matching (PSM) and compared the difference in mean health utility between the groups. The results show a significant loss of HRQoL due to malaria. The mean utility was 0.69 and 0.83 for the treatment and control groups, respectively, representing a loss of quality of life of approximately 16.3% for individuals with recent malaria episodes. These findings underscore the importance of effective malaria prevention and treatment strategies, especially in areas where adverse socioeconomic conditions and a challenging epidemiological context exacerbate the impact of the disease. Continued investment in malaria control programs and improved access to health services are essential to mitigate the negative impact of this disease on the quality of life of affected populations.Author summary: Malaria is an infectious disease transmitted by mosquitoes, primarily affecting tropical and subtropical regions worldwide. Despite significant efforts to control malaria, the rates of illness and death are still important. In the Americas, Brazil, Venezuela, and Bolivia account for more than 50% of the cases. This study focuses on the Brazilian Amazon, where malaria is most prevalent, accounting for 99.5% of all reported cases in the country. We aimed to understand how malaria affects individuals’ health-related quality of life (HRQoL) in these endemic areas. Using the EQ-5D-3L instrument, we collected data from over 1,100 adults in endemic municipalities of the Brazilian Amazon. We compare the EQ-5D-3L utility scores for those who recently had malaria with those who did not by means of Propensity Score Matching. Our findings revealed that individuals who recently had malaria experienced a significant reduction in HRQoL. Specifically, there was a 16.3% decrease in EQ-5D-3L utility for those affected by recent malaria episodes. These results highlight the urgent need for malaria prevention and treatment programs. Effective strategies and better access to healthcare are key in reducing the disease’s impact on individuals’ lives, especially in regions with challenging health environments, and poor socioeconomic conditions and infrastructure.