Economic impact of cholera in households in rural southern Malawi: a prospective study
Introduction Cholera remains a significant contributor to diarrhoeal illness, especially in sub-Saharan Africa. Few studies have estimated the cost of illness (COI) of cholera in Malawi, a cholera-endemic country. The present study estimated the COI of cholera in Nsanje, southern Malawi, as part of...
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
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| author | Florian Marks Wilm Quentin Vittal Mogasale Amber Hsiao Enusa Ramani Hye-Jin Seo GiDeok Pak Dan Vuntade Maurice M’bang’ombe Bagrey Ngwira |
| author_facet | Florian Marks Wilm Quentin Vittal Mogasale Amber Hsiao Enusa Ramani Hye-Jin Seo GiDeok Pak Dan Vuntade Maurice M’bang’ombe Bagrey Ngwira |
| author_sort | Florian Marks |
| collection | DOAJ |
| description | Introduction Cholera remains a significant contributor to diarrhoeal illness, especially in sub-Saharan Africa. Few studies have estimated the cost of illness (COI) of cholera in Malawi, a cholera-endemic country. The present study estimated the COI of cholera in Nsanje, southern Malawi, as part of the Cholera Surveillance in Malawi (CSIMA) programme following a mass cholera vaccination campaign in 2015.Methods Patients ≥12 months of age who were recruited as part of CSIMA were invited to participate in the COI survey. The COI tool captured household components of economic burden, including direct medical and non-medical costs, and indirect lost productivity costs.Results Between April 2016 and March 2020, 40 cholera cases were enrolled in the study, all of whom participated in the COI survey. Only two patients had any direct medical costs and five patients reported lost wages due to illness. The COI per patient was US$14.34 (in 2020), more than half of which was from direct non-medical costs from food, water, and transportation to the health centre.Conclusion For the majority of Malawians who struggle to subsist on less than US$2 a day, the COI of cholera represents a significant cost burden to families. While cholera treatment is provided for free in government-run health centres, additional investments in cholera control and prevention at the community level and financial support beyond direct medical costs may be necessary to alleviate the economic burden of cholera on households in southern Malawi. |
| format | Article |
| id | doaj-art-23f2f0ad444246afaa7f4452a139d51d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
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| spelling | doaj-art-23f2f0ad444246afaa7f4452a139d51d2025-02-01T12:40:09ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-052337Economic impact of cholera in households in rural southern Malawi: a prospective studyFlorian Marks0Wilm Quentin1Vittal Mogasale2Amber Hsiao3Enusa Ramani4Hye-Jin Seo5GiDeok Pak6Dan Vuntade7Maurice M’bang’ombe8Bagrey Ngwira9Department of Medicine, University of Cambridge, Cambridge, UKDepartment of Planetary & Public Health, University of Bayreuth, Bayreuth, GermanyPolicy and Economic Research, International Vaccine Institute, Seoul, The Republic of KoreaDepartment of Health Care Management, Technische Universität Berlin, Berlin, GermanyDepartment of Health Care Management, Technische Universität Berlin, Berlin, GermanyEpidemiology, Public Health, Impact, International Vaccine Institute, Seoul, The Republic of KoreaEpidemiology, Public Health, and Impact Unit, International Vaccine Institute, Gwanak-gu, The Republic of KoreaDepartment of Environmental Health, University of Malawi the Polytechnic, Blantyre, MalawiMinistry of Health Malawi, Lilongwe, MalawiDepartment of Environmental Health, University of Malawi the Polytechnic, Blantyre, MalawiIntroduction Cholera remains a significant contributor to diarrhoeal illness, especially in sub-Saharan Africa. Few studies have estimated the cost of illness (COI) of cholera in Malawi, a cholera-endemic country. The present study estimated the COI of cholera in Nsanje, southern Malawi, as part of the Cholera Surveillance in Malawi (CSIMA) programme following a mass cholera vaccination campaign in 2015.Methods Patients ≥12 months of age who were recruited as part of CSIMA were invited to participate in the COI survey. The COI tool captured household components of economic burden, including direct medical and non-medical costs, and indirect lost productivity costs.Results Between April 2016 and March 2020, 40 cholera cases were enrolled in the study, all of whom participated in the COI survey. Only two patients had any direct medical costs and five patients reported lost wages due to illness. The COI per patient was US$14.34 (in 2020), more than half of which was from direct non-medical costs from food, water, and transportation to the health centre.Conclusion For the majority of Malawians who struggle to subsist on less than US$2 a day, the COI of cholera represents a significant cost burden to families. While cholera treatment is provided for free in government-run health centres, additional investments in cholera control and prevention at the community level and financial support beyond direct medical costs may be necessary to alleviate the economic burden of cholera on households in southern Malawi.https://bmjopen.bmj.com/content/12/6/e052337.full |
| spellingShingle | Florian Marks Wilm Quentin Vittal Mogasale Amber Hsiao Enusa Ramani Hye-Jin Seo GiDeok Pak Dan Vuntade Maurice M’bang’ombe Bagrey Ngwira Economic impact of cholera in households in rural southern Malawi: a prospective study BMJ Open |
| title | Economic impact of cholera in households in rural southern Malawi: a prospective study |
| title_full | Economic impact of cholera in households in rural southern Malawi: a prospective study |
| title_fullStr | Economic impact of cholera in households in rural southern Malawi: a prospective study |
| title_full_unstemmed | Economic impact of cholera in households in rural southern Malawi: a prospective study |
| title_short | Economic impact of cholera in households in rural southern Malawi: a prospective study |
| title_sort | economic impact of cholera in households in rural southern malawi a prospective study |
| url | https://bmjopen.bmj.com/content/12/6/e052337.full |
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