Authors : Prosper Andriatsilanisoa Christian; Dr. Tsimangataka Andriamampiandra Tsimiovalaza; Prosper Hery Chrystopher

Volume/Issue : Volume 11 - 2026, Issue 5 - May

Google Scholar : https://tinyurl.com/yc4ejrpp

Scribd : https://tinyurl.com/2v6mc2xf

DOI : https://doi.org/10.38124/ijisrt/26May1076

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Abstract : Stroke is a major public health issue in Madagascar. This study evaluates and compares the clinical effectiveness and economic impact of three treatment strategies in Toamasina: hospital care (CHUAT, CHUM), traditional medicine (MTR), and no structured care (NRF). A retrospective analytical study included 480 patients. The analysis relies on health economics tools (costeffectiveness, ICER, QALY, DALY), Markov models, Monte Carlo simulations, survival analyses (Kaplan-Meier, Cox), and multivariate regressions (Logit, Probit). The results show that MTR offers the best 5-year survival rate (71.5%), the highest QALY (5.15), and the lowest costs (1,760,000 MGA), with a cost per QALY of 341,748 MGA, compared to 934,562 MGA for CHUAT. MTR reduces the risk of death by 48% (HR = 0.52, p < 0.001). Integrating MTR into the healthcare system would generate estimated annual savings of 4.7 billion MGA.  Conclusion: Traditional medicine is a clinically effective and cost-efficient strategy in the Toamasina context. Its structured integration is recommended to optimize stroke care in Madagascar.

Keywords : Stroke, Health Economics, Cost-Effectiveness, Traditional Medicine, Madagascar, QALY, DALY

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