Exploring Household Economic Impacts of Childhood Diarrheal Illnesses in 3 African Settings

Department of Environmental and Global Health, University of Florida, Gainesville.
Clinical Infectious Diseases (Impact Factor: 8.89). 12/2012; 55 Suppl 4(Suppl 4):S317-26. DOI: 10.1093/cid/cis763
Source: PubMed


Beyond the morbidity and mortality burden of childhood diarrhea in sub-Saharan African are significant economic costs to affected
households. Using survey data from 3 of the 4 sites in sub-Saharan Africa (Gambia, Kenya, Mali) participating in the Global
Enteric Multicenter Study (GEMS), we estimated the direct medical, direct nonmedical, and indirect (productivity losses) costs
borne by households due to diarrhea in young children. Mean cost per episode was $2.63 in Gambia, $6.24 in Kenya, and $4.11
in Mali. Direct medical costs accounted for less than half of these costs. Mean costs understate the distribution of costs,
with 10% of cases exceeding $6.50, $11.05, and $13.84 in Gambia, Kenya, and Mali. In all countries there was a trend toward
lower costs among poorer households and in 2 of the countries for diarrheal illness affecting girls. For poor children and
girls, this may reflect reduced household investment in care, which may result in increased risks of mortality.

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Available from: Richard D Rheingans
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    • "These high levels of disease burden can also be translated into economic costs, which affect healthcare systems and also represent a relevant household economic burden, which is of special relevance in developing areas in which access to inexpensive treatments is difficult (Patil et al., 2002; Rheingans et al., 2012). These costs are also reflected in social inequities, with a trend towards lower expenditure related to diarrhoea in poorer households, which in some countries may often more frequently affect girls, and subsequently result in an increased risk of death (Rheingans et al., 2012). "
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    • "The present study in combination with our related study on household costs for diarrhea treatment in African settings provides helps identify similarities and differences among countries and regions [26]. Across the 6 countries, mean total household costs fell within a fairly wide range, from $1.82 in Bangladesh to $6.47 in Pakistan. "
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    ABSTRACT: In addition to being a major cause of mortality in South Asia, childhood diarrhea creates economic burden for affected households. We used survey data from sites in Bangladesh, India, and Pakistan to estimate the costs borne by households due to childhood diarrhea, including direct medical costs, direct nonmedical costs, and productivity losses. Mean cost per episode was $1.82 in Bangladesh, $3.33 in India, and $6.47 in Pakistan. The majority of costs for households were associated with direct medical costs from treatment. Mean costs understate the distribution of costs, with 10% of cases exceeding $6.61, $8.07, and $10.11 in Bangladesh, India, and Pakistan, respectively. In all countries there was a trend toward lower costs among poorer households and in India and Pakistan there were lower costs for episodes among girls. For both poor children and girls this may reflect rationing of care, which may result in increased risks of mortality.
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