TY - JOUR
T1 - Cost of illness for severe and non-severe diarrhea borne by households in a low-income urban community of bangladesh
T2 - A cross-sectional study
AU - Sultana, Rebeca
AU - Luby, Stephen P.
AU - Gurley, Emily S.
AU - Rimi, Nadia Ali
AU - Swarna, Sayeda Tasnuva
AU - Khan, Jahangir A.M.
AU - Nahar, Nazmun
AU - Ghosh, Probir Kumar
AU - Howlader, Sushil Ranjan
AU - Kabir, Humayun
AU - Khan, Shifat
AU - Jensen, Peter Kjær Mackie
N1 - Funding Information:
This study was solely funded by the Danish Ministry of Foreign Affairs (MFA)-Consultative Research Committee for Development Research (FFU) grant 12-040KU. URL: https://dfcentre.com/research/general-conditions-and-forms-for-research-projects. PKMJ was the Principal Investigator and RS participated in developing the grant proposal. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2021 Sultana et al.
PY - 2021/6
Y1 - 2021/6
N2 - The illness cost borne by households, known as out-of-pocket expenditure, was 74% of the total health expenditure in Bangladesh in 2017. Calculating economic burden of diarrhea of low-income urban community is important to identify potential cost savings strategies and prioritize policy decision to improve the quality of life of this population. This study aimed to estimate cost of illness and monthly percent expenditure borne by households due diarrhea in a low-income urban settlement of Dhaka, Bangladesh. We conducted this study in East Arichpur area of Tongi township in Dhaka, Bangladesh from September 17, 2015 to July 26, 2016. We used the World Health Organization (WHO) definition of three or more loose stool in 24 hours to enroll patients and enrolled 106 severe patients and 158 non-severe patients from Tongi General Hospital, local pharmacy and study community. The team enrolled patients between the first to third day of the illness (≤ 72 hours) and continued daily follow-up by phone until recovery. We considered direct and indirect costs to calculate cost-per-episode. We applied the published incidence rate to estimate the annual cost of diarrhea. The estimated average cost of illness for patient with severe diarrhea was US$ 27.39 [95% CI: 24.55, 30.23] (2,147 BDT), 17% of the average monthly income of the households. The average cost of illness for patient with non-severe diarrhea was US$ 6.36 [95% CI: 5.19, 7.55] (499 BDT), 4% of the average monthly income of households. A single diarrheal episode substantially affects financial condition of low-income urban community residents: a severe episode can cost almost equivalent to 4.35 days (17%) and a non-severe episode can cost almost equivalent to 1 day (4%) of household’s income. Preventing diarrhea pre-serves health and supports financial livelihoods.
AB - The illness cost borne by households, known as out-of-pocket expenditure, was 74% of the total health expenditure in Bangladesh in 2017. Calculating economic burden of diarrhea of low-income urban community is important to identify potential cost savings strategies and prioritize policy decision to improve the quality of life of this population. This study aimed to estimate cost of illness and monthly percent expenditure borne by households due diarrhea in a low-income urban settlement of Dhaka, Bangladesh. We conducted this study in East Arichpur area of Tongi township in Dhaka, Bangladesh from September 17, 2015 to July 26, 2016. We used the World Health Organization (WHO) definition of three or more loose stool in 24 hours to enroll patients and enrolled 106 severe patients and 158 non-severe patients from Tongi General Hospital, local pharmacy and study community. The team enrolled patients between the first to third day of the illness (≤ 72 hours) and continued daily follow-up by phone until recovery. We considered direct and indirect costs to calculate cost-per-episode. We applied the published incidence rate to estimate the annual cost of diarrhea. The estimated average cost of illness for patient with severe diarrhea was US$ 27.39 [95% CI: 24.55, 30.23] (2,147 BDT), 17% of the average monthly income of the households. The average cost of illness for patient with non-severe diarrhea was US$ 6.36 [95% CI: 5.19, 7.55] (499 BDT), 4% of the average monthly income of households. A single diarrheal episode substantially affects financial condition of low-income urban community residents: a severe episode can cost almost equivalent to 4.35 days (17%) and a non-severe episode can cost almost equivalent to 1 day (4%) of household’s income. Preventing diarrhea pre-serves health and supports financial livelihoods.
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U2 - 10.1371/journal.pntd.0009439
DO - 10.1371/journal.pntd.0009439
M3 - Article
C2 - 34115764
AN - SCOPUS:85109354561
SN - 1935-2727
VL - 15
JO - PLoS neglected tropical diseases
JF - PLoS neglected tropical diseases
IS - 6
M1 - e0009439
ER -