Tigist Mekonnen
College of Medicine and Health Sciences, University of Gondar, Ethiopia
Title: Cost of Illness of Visceral Leishmaniasis and Associated Factors in Northwest Ethiopia
Biography:
Abstract:
Background: Visceral Leishmaniasis is an important public health problem in Ethiopia, affecting poor rural communities. The most commonly affected people are mainly migrant daily laborers and settlers to the Visceral Leishmaniasis endemic regions. Although management of Visceral Leishmaniasis in Ethiopia is free of charge, patients are likely to face a lot of direct and indirect expenses during their illness.
Objective: The aim of this study was to assess the cost of illness of Visceral Leishmaniasis patients and associated factors in Northwest Ethiopia.
Methods: Institution based cross-sectional study was conducted amongst Visceral Leishmaniasis treated adult patients. The data were collected between September and December 2015 from the three main Visceral Leishmaniasis treatment centers in Northwest Ethiopia (University of Gondar hospital, Abdurafi Health Center and Metema Hospital) using a structured questionnaire. Data included direct and indirect costs. Data were collected separately for the period before and after Visceral Leishmaniasis diagnosis. Data were entered into Epi-Info version 3.5.4 and transferred to SPSS version 20 for analysis. The population characteristics and cost of illness was presented in a descriptive statistics using frequency, mean, median, range, standard deviation. Factors associated with high cost were identified using logistic regression model. A p-value of <0.05 was considered statistically significant.
Results: The median total cost of care per episode of Visceral Leishmaniasis from patients’ perspective was 3855 ETB. The largest cost category was indirect costs (70.4%) followed by medical (19.8%), and non-medical (9.8%) direct costs. The median days elapsed for consultation at alternative care providers and a public health facility prior to Visceral Leishmaniasis diagnosis was 60 days (40-80 days). The median total cost spent during the period of first presentation to a health care center until Visceral Leishmaniasis diagnosed was 1141 ETB per patient. Low monthly income (AOR=8.19; 95%CI: 4.9-13.5), HIV co-infection (AOR=6.67; 95% CI: 2.1-20.4) and superimposed pneumonia (AOR=1.93; 95%CI: 1.0-3.4) were associated with high direct cost. Similarly, patients with HIV (OR=0.12 CI :( 0.1, 0.8)) low monthly income (AOR=2.321; CI: 2.2, 14.7) and pneumonia co-infection (AOR=1.44; CI: 1.3, 3.4) were factors associated high indirect cost of illness.
Conclusion: Despite the fact that Visceral Leishmaniasis treatment and care is given for free in the health care system of Ethiopia, the cost of illness for the patients was still found to be high.