The economic costs of malaria in four Kenyan districts: do household costs differ by disease endemicity?
The economic costs of malaria in four Kenyan districts: do household costs differ by disease endemicity?
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DOI：
10.1186/1475-2875-9-149
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发表时间：
2010-06-02
期刊：
影响因子：
3
通讯作者：
Molyneux C
中科院分区：
文献类型：
--
作者：
Chuma J;Okungu V;Molyneux C
疟疾给疟疾流行国家的家庭和经济造成巨大损失。还有证据表明，最贫困人口的经济负担更高，而且雨季和旱季的成本负担差异很大。目前尚不清楚的是，疟疾的经济负担是否以及如何因疾病流行而不同。人们普遍认识到，在估计疟疾的社会和经济负担时需要考虑地理和流行病学差异，但支持这一论点的数据（如果有的话）也是有限的。本研究旨在通过比较肯尼亚四个不同流行地区的疟疾成本负担，为填补这一空白做出贡献。在疟疾传播高峰季节，在疟疾传播模式不同的肯尼亚四个地区最贫困地区进行了一项横断面家庭调查（邦多 179 户；古查 205 户；夸勒 184 户；马库尼 141 户）。发烧持续时间、对发烧严重程度的感知和费用负担存在显着差异。 Gucha 和 Makueni 地区（分别为高地流行地区和低度急性传播地区）成人和儿童五年以上的发烧发作持续时间明显长于 Bondo 和 Kwale 地区（分别为高常年传播和季节性、强烈传播）报告的发烧发作时间。各地区对疾病严重程度的看法也有所不同：古查和马库埃尼地区年龄较大的儿童和成人报告的发烧情况与其他地区报告的情况相比更为严重。各地区之间的间接成本和总成本差异显着，但直接成本差异并不显着。 Makueni 的家庭总成本最高（每月 19.6 美元），Bondo 最低（每月 9.2 美元）。成本负担是社会、经济和流行病学因素之间复杂关系的产物。本研究中提供的成本数据反映了四个地区的传输模式，表明成本负担与传输性质之间可能存在关系，这同样值得研究人员和政策制定者更多关注。
Malaria inflicts significant costs on households and on the economy of malaria endemic countries. There is also evidence that the economic burden is higher among the poorest in a population, and that cost burdens differ significantly between wet and dry seasons. What is not clear is whether, and how, the economic burden of malaria differs by disease endemicity. The need to account for geographical and epidemiological differences in the estimation of the social and economic burden of malaria is well recognized, but there is limited data, if any, to support this argument. This study sought to contribute towards filling this gap by comparing malaria cost burdens in four Kenyan districts of different endemicity. A cross-sectional household survey was conducted during the peak malaria transmission season in the poorest areas in four Kenyan districts with differing malaria transmission patterns (n = 179 households in Bondo; 205 Gucha; 184 Kwale; 141 Makueni). There were significant differences in duration of fever, perception of fever severity and cost burdens. Fever episodes among adults and children over five years in Gucha and Makueni districts (highland endemic and low acute transmission districts respectively) lasted significantly longer than episodes reported in Bondo and Kwale districts (high perennial transmission and seasonal, intense transmission, respectively). Perceptions of illness severity also differed between districts: fevers reported among older children and adults in Gucha and Makueni districts were reported as severe compared to those reported in the other districts. Indirect and total costs differed significantly between districts but differences in direct costs were not significant. Total household costs were highest in Makueni (US$ 19.6 per month) and lowest in Bondo (US$ 9.2 per month). Cost burdens are the product of complex relationships between social, economic and epidemiological factors. The cost data presented in this study reflect transmission patterns in the four districts, suggesting that a relationship between costs burdens and the nature of transmission might exist, and that the same warrants more attention from researchers and policy makers.
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影响因子：
4.8
作者：
Chuma, Jane;Musimbi, Janet;Molyneux, Catherine
通讯作者：
Molyneux, Catherine
影响因子：
3
作者：
Chuma JM;Thiede M;Molyneux CS
通讯作者：
Molyneux CS
影响因子：
3.3
作者：
Attanayake, N;Fox-Rushby, J;Mills, A
通讯作者：
Mills, A
影响因子：
3
作者：
Deressa, Wakgari
通讯作者：
Deressa, Wakgari
影响因子：
15.8
作者：
Guerra, Carlos A.;Gikandi, Priscilla W.;Tatem, Andrew J.;Noor, Abdisalan M.;Smith, Dave L.;Hay, Simon I.;Snow, Robert W.
通讯作者：
Snow, Robert W.