Times of India
27 July 2010
By Malathy Iyer
Mumbai, India

Mosquito bites aren’t just sucking out blood–they’re also leaving families poorer by lakhs of rupees. Just ask the family of Kandivli teenager Radhika (name changed). They are struggling to clear soaring bills –over Rs 5 lakh at last count. Radhika has been in the ICU of a posh hospital for over 10 days now, battling sepsis (infection) in a few of her vital organs due to complications arising out of a malarial infection. Her family never imagined that malaria could bring with it such a heavy price.

Only a few realise that malaria, if not caught and treated early, can lead to complications that affect the patient’s brain, lungs, liver and/or kidneys. Serious ICU cases can extract a heavy financial toll. In contrast, doctors say timely treatment in the early stages of the disease would cost barely a few hundred rupees.

The ongoing malaria outbreak, which has already led to over 10,000 patients seeking treatment, is seeing up to 30% of patients being admitted in ICUs, burning a hole in middle–class pockets. Treatment can cost Rs 20,000 to Rs 40,000 per day in the initial stages, and Rs 10,000 to Rs 15,000 a day later on. Bill amounts could touch Rs 1–2 lakh, and even higher in cases with malaria–related complications.

Malaria cases double this yr
Mumbai: The city is witnessing a spurt in malaria cases this year. What is even more worrying, doctors say, is that the number of critical patients suffering from the disease has also gone up dramatically over last year.

“There has been a clear doubling of malaria patients since last year,” said Dr Khusrav Bajan, who heads the intensive care department of Hinduja Hospital. Dr Om Shrivastava, infectious diseases specialist who heads a unit at the civic–run Kasturba Hospital near Chinchpokli and consults at Jaslok Hospital, said,“There are enough malaria patients this year for us to be quite concerned.”

More the number of patients, greater the complications. “The number of critical patients has also shot up this year,” added Bajan,“If only about 10–20% of malaria patients needed the ICU last year, this year the number has shot up to 20 to 30%.”

Doctors stressed the need for timely malaria treatment.

“If malaria causes infection in the lungs or kidneys, or a bleeding disorder, then the patient may need a ventilator, dialysis or blood component therapy. These can make treatment frightfully expensive,” said Shrivasatava. An intensivist with a starred hospital elaborated,“On the first two days, the cost of treatment could go up to Rs 40,000 a day. Costs for the following days could range from Rs 10,000 to 15,000 a day.” Bajan added that a patient with severe sepsis could stay in hospital for three to four weeks.

While most cases of malaria can be treated with inexpensive oral medicines, about a third would need more attention. Dr Harish Bhatt of Nityanand Nursing Home, Vile Parle (east), said,“Many patients have fever of 103–plus. Many of them cannot tolerate oral pills and need intravenous drips to get better.” Here, the treatment could run up to Rs 15,000 for a three–day course in the special bed category.

Malaria Treatment Costs

• if caught early and treated soon, the two–medication course as prescribed by WHO would be Rs 200 to Rs 400
• Intravenous treatment in a nursing home could comprise five injections of Rs 200 each. In the general category, malaria hospitalisation would cost Rs 5,000 to Rs 10,000 in a nursing home. In a special room category, the treatment in even a nursing home could climb to Rs 15,000 to Rs 20,000 for three to four days
• When a patient develops complications and needs ICU treatment, expenses soar. ICU treatment on the first and second days could cost Rs 20,000 to Rs 40,000 depending on the grade of hospital. Thereafter, treatment would cost Rs 10,000 to Rs 15,000 each day. At times, a patient may need up to three weeks of hospitalisation