Year: 2013
Type: dissertation
Abstract: ObjectiveTo provide data about wealth distribution in visceral leishmaniasis (VL)-affected communities compared to that of the general population of Bihar State, India. MethodsAfter extensive disease risk mapping, 16 clusters with high VL transmission were selected inBihar.An exhaustive census of all households in the clusters was conducted and socio-economic household characteristics were documented by questionnaire.Data on the general Bihar population taken from the National Family Health Survey of India were used for comparison.An asset index was developed based on Principal Components Analysis and the distribution of this asset index for the VL communities was compared with that of the general population of Bihar. Results83% of households in communities with high VL attack rates belonged to the two lowest quintiles of the Bihar wealth distribution.All socio-economic indicators showed significantly lower wealth for those households. ConclusionVisceral leishmaniasis clearly affects the poorest of the poor in India.They are most vulnerable, as this vector-born disease is linked to poor housing and unhealthy habitats.The disease leads the affected households to more destitution because of its impact on household income and wealth.Support for the present VL elimination initiative is important in the fight against poverty. Cost of VL patient management in India | 63 ABSTRACT ObjectiveTo identify and quantify the direct and indirect economic cost of treatment for visceral leishmaniasis (VL) with conventional Amphotericin B deoxycholate, currently the first-line treatment in Muzaffarpur. MethodsCosts of patient management for VL were estimated from a societal and household perspective by means of a questionnaire designed for this study, interviews and financial reports. ResultsThe total cost of care per episode of VL from the societal perspective was estimated at US$355, equivalent to 58% of annual household income.The largest cost category was medical costs (55%), followed by indirect costs (36%) and non-medical costs (9%).The cost from the household perspective was equivalent to US$217.The largest cost category was indirect costs (59%), followed by medical costs (27%) and non-medical costs (15%).Loss of income because of illness and hospitalization and expenses for drugs were the largest cost components. ConclusionsThe economic costs related to VL are substantial, both to society and the patient.Public health authorities in Bihar should focus on policies that detect VL in the early stage and implement interventions that minimize the burden to households affected by VL. ABSTRACTVisceral leishmaniasis (VL) is a neglected parasitic disease that is fatal if left untreated and is endemic in eastern Sudan.We estimated the direct and indirect costs of treatment for VL from the perspective of the provider and the household at three public hospitals in Gedaref State.The median total cost for one VL episode was estimated to be US$ 450.Despite the free provision of VL drugs at public hospitals, households bore 53% of the total cost of VL with one episode of VL representing 40% of the annual household income.More than 75% of households incurred catastrophic out-of-pocket expenditures.The length of treatment of 30 days led to important costs for both health providers and households.Alternative treatment regimens that reduce the duration of treatment are urgently needed. ConclusionsCombination treatments are a cost-effective alternative to current monotherapy for VL.Given their expected impact on the emergence of drug resistance, a switch to combination therapy should be considered once final results from clinical trials are available.
Author: Filip Meheus
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2138070618