Economic burden of malaria and predictors of cost variability to rural households in south-central Ethiopia.
Economic burden of malaria and predictors of cost variability to rural households in south-central Ethiopia.
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DOI：
10.1371/journal.pone.0185315
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Robberstad B
中科院分区：
文献类型：
--
作者：
Hailu A;Lindtjørn B;Deressa W;Gari T;Loha E;Robberstad B
尽管人们认识到最近在全球减少疟疾方面取得的显着成就，但这种疾病仍然是非洲疟疾流行国家面临的挑战。除了疟疾对健康造成的巨大影响之外，政策制定者还需要了解该疾病给家庭带来的经济负担。然而，有关埃塞俄比亚疟疾经济负担的证据却很少。本研究的目的是估计疟疾发作的经济负担并确定农村家庭成本变化的预测因素。采用了从家庭角度出发的前瞻性成本计算方法。 2015 年，埃塞俄比亚中南部阿达米图卢地区的 3 个卫生中心和 9 个卫生站共有 190 名疟疾患者参加了这项研究。收集了有关疟疾支出、因疾病而放弃的工作日、社会经济和人口状况以及家庭资产的主要数据。应用分位数回归来预测与成本变化相关的因素。使用集中指数和集中曲线来衡量与社会经济相关的不平等。每次疟疾给家庭造成的平均费用为 5.06 美元（IQR：2.98-8.10）。直接成本占39%，间接成本占61%。过去六个月的疟疾病史和卫生系统中就诊的设施水平主要影响直接成本。间接成本主要受到卫生机构抗疟药物供应情况的影响。直接成本的集中曲线和集中指数表明存在显着的富人不平等。与间日疟原虫相比，恶性疟原虫对家庭的成本要高得多。疟疾给埃塞俄比亚农村家庭（主要是穷人）带来了巨大的经济负担，这表明减少疟疾负担也有助于减贫。
While recognizing the recent remarkable achievement in the global malaria reduction, the disease remains a challenge to the malaria endemic countries in Africa. Beyond the huge health consequence of malaria, policymakers need to be informed about the economic burden of the disease to the households. However, evidence on the economic burden of malaria in Ethiopia is scanty. The aims of this study were to estimate the economic burden of malaria episode and to identify predictors of cost variability to the rural households. A prospective costing approach from a household perspective was employed. A total of 190 malaria patients were enrolled to the study from three health centers and nine health posts in Adami Tullu district in south-central Ethiopia, in 2015. Primary data were collected on expenditures due to malaria, forgone working days because of illness, socioeconomic and demographic situation, and households’ assets. Quantile regression was applied to predict factors associated with the cost variation. Socioeconomic related inequality was measured using concentration index and concentration curve. The median cost of malaria per episode to the household was USD 5.06 (IQR: 2.98–8.10). The direct cost accounted for 39%, while the indirect counterpart accounted for 61%. The history of malaria in the last six months and the level of the facility visited in the health system predominantly influenced the direct cost. The indirect cost was mainly influenced by the availability of antimalarial drugs in the health facility. The concentration curve and the concentration index for direct cost indicate significant pro-rich inequality. Plasmodium falciparum is significantly more costly for households compared to Plasmodium vivax. The economic burden of malaria to the rural households in Ethiopia was substantial—mainly to the poor—indicating that reducing malaria burden could contribute to the poverty reduction as well.
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影响因子：
3
作者：
Chuma JM;Thiede M;Molyneux CS
通讯作者：
Molyneux CS
影响因子：
3.5
作者：
Filmer, D;Pritchett, LH
通讯作者：
Pritchett, LH
影响因子：
2.6
作者：
Dalaba, Maxwell Ayindenaba;Akweongo, Patricia;Oduro, Abraham
通讯作者：
Oduro, Abraham
影响因子：
3.3
作者：
Deressa, Wakgari;Hailemariam, Damen;Ali, Ahmed
通讯作者：
Ali, Ahmed
影响因子：
5
作者：
Cropper, ML;Haile, M;Whittington, D
通讯作者：
Whittington, D