Abstract
BackgroundThe economic burden of diseases has become increasingly relevant to policy makers as healthcare expenditure keep rising in the face of limited and competing resources. Buruli ulcer (BU), a neglected but treatable tropical disease caused by Mycobacterium ulcerans, the only known environmental mycobacterium is capable of causing long term disability when left untreated. However, most BU studies have tended to focused on its bacteriology, epidemiology, entomology and other social determinants to the neglect of its economic evaluation. This paper reports estimated the household economic costs of BU and describe the intangible cost suffered by BU patients in an endemic area.MethodsRetrospective one year cost data was used. A total of 63 confirmed BU cases were randomly sampled for the study. Economic cost and cost burden of BU were estimated. Sensitivity analysis was conducted to test the robustness of the cost estimates. Intangible cost measured stigmatization, pain, functional limitation and social isolation of children.ResultsThe annual total household economic cost was US$35,915.98, of which about 65% was cost incurred by children with a mean cost of US$521.04. The mean annual household cost was US$570.09. The direct cost was 96% of the total cost. Non-medical cost accounts for about 97% of the direct cost with a mean cost of US$529.27. The mean medical cost was US$18.94. The main cost drivers of the household costs were transportation (78%) and food (12%). Caregivers and adult patients lost a total of 535 productive days seeking care, which gives an indirect cost valued at US$1,378.67 with a mean of US$21.88. A total of 365 school days (about 1 year) were lost by 19 BU patients (mean, 19.2 days). Functional loss and pain were low, and stigma rated moderate. Most children suffering from BU (84%) were socially isolated.ConclusionHousehold cost burden of out-patient BU ulcer treatment was high. Household cost of BU is therefore essential in the design of its intervention. BU afflicted children experience social isolation.
Highlights
The economic burden of diseases has become increasingly relevant to policy makers as healthcare expenditure keep rising in the face of limited and competing resources
Buruli ulcer (BU), is a neglected infectious disease of tropical and subtropical climates caused by Mycobacterium ulcerans, the only known environmental mycobacterium and the third commonest mycobacterium after Mycobacterium tuberculosis and Leprosae
Socio-demographic characteristics of the study population Table 3 shows that 52% of the BU cases were male and about 62% of BU cases were less than 15 years old with a median age of 13 years
Summary
The economic burden of diseases has become increasingly relevant to policy makers as healthcare expenditure keep rising in the face of limited and competing resources. Buruli ulcer (BU), a neglected but treatable tropical disease caused by Mycobacterium ulcerans, the only known environmental mycobacterium is capable of causing long term disability when left untreated. This paper reports estimated the household economic costs of BU and describe the intangible cost suffered by BU patients in an endemic area. Though the indirect cost of BU was estimated at $550 with 265 productive days lost among ulcerative cases of BU in previous Ghanaian studies, the total cost (direct and indirect) and the economic burden of BU to household is unknown [6,17]. The economic burden of diseases has become increasingly important as healthcare expenditure rapidly escalates whilst resources remain limited. This study was conducted to estimate the household economic costs of BU and describe the intangible cost suffered by BU patients in an endemic area.
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