OBJECTIVES: Assess the economic cost borne by households in the Comé District Health (CDH) in south-western Benin for the treatment of a malaria episode and its effect on their well-being. Malaria indicators in the CDH remain worrying despite the health policies implemented by the health authority to reduce prevalence, burden of disease and mortality related to this disease. Like the other 33 Health Districts in Benin, the CDH is characterized by a lack of knowledge and information on the cost of malaria treatment for households.

METHODS: A cross-sectional survey, both retrospective and prospective, was conducted at the CDH Hospital discharge from November 13, 2017 to July 27, 2018. The 246 patients selected in situ were followed for the entire duration of treatment until all information on costs incurred for the treatment of the disease was obtained. Direct costs were assessed by the bottom-up costing approach and indirect costs by the human capital approach. The effect of the economic cost of treating a malaria episode on household welfare is analyzed using Wagstaff's basic catastrophic health expenditure approach.

RESULTS: On average, households spent XOF 21,933.53 to treat an episode of uncomplicated malaria, of which XOF 17,557.06 was for direct costs and XOF 4,376.47 for indirect costs. For complicated cases, households spent an average of XOF 84,214.13, divided into XOF 60,782.47 for direct costs and XOF 23,431.66 for indirect costs. In terms of effect, the average household experiences a decline in utility due to the cost of treating an episode of malaria. The decrease in utility recorded is amplified with severe malaria.

CONCLUSIONS: The results are consistent with economic valuation studies of the costs of malaria to households in low- and middle-income endemic countries. Not only does malaria induce catastrophic treatment costs for households in the CDH in Southwest Benin, but it also impoverishes them