Household costs of leprosy reactions (ENL) in rural India.
Erythema nodosum leprosum (ENL) is a common immune-mediated complication of lepromatous (LL) and borderline lepromatous (BL) leprosy. Most patients experience chronic or multiple acute ENL over many years during an economically active period of their lives. Understanding the economic burden of ENL i...
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ftdoajarticles:oai:doaj.org/article:0883848085ab4944bed0f60942744d52 2023-05-15T15:12:13+02:00 Household costs of leprosy reactions (ENL) in rural India. David J Chandler Kristian S Hansen Bhabananda Mahato Joydeepa Darlong Annamma John Diana N J Lockwood 2015-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0003431 https://doaj.org/article/0883848085ab4944bed0f60942744d52 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4295874?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0003431 https://doaj.org/article/0883848085ab4944bed0f60942744d52 PLoS Neglected Tropical Diseases, Vol 9, Iss 1, p e0003431 (2015) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2015 ftdoajarticles https://doi.org/10.1371/journal.pntd.0003431 2022-12-31T15:03:29Z Erythema nodosum leprosum (ENL) is a common immune-mediated complication of lepromatous (LL) and borderline lepromatous (BL) leprosy. Most patients experience chronic or multiple acute ENL over many years during an economically active period of their lives. Understanding the economic burden of ENL is essential to provide effective patient support, yet this area has not been investigated.Ninety-one patients with LL or BL leprosy attending a leprosy hospital in Purulia district of West Bengal, India, were interviewed using a structured questionnaire. Cases (n = 53) were identified as those who had one or more episodes of ENL within the last 3 years. Controls (n = 38) had LL or BL leprosy but no history of ENL. Data were collected on household income, direct and indirect costs, and coping strategies.The total household cost was Rs 1543 per month or 27.9% (IQR 13.2-52.6) of monthly household income for cases, and Rs 237 per month or 4.9% (IQR 1.7-13.4) of monthly household income for controls. Indirect costs accounted for 65% of total household costs for cases. Direct costs accounted for the remaining 35% of household costs, and resulted almost entirely from treatment-seeking in the private sector. Total household costs exceeded 40% of household income for 37.7% of cases (n = 20) and 2.6% of controls (n = 1) [1 USD = 59 INR].Households affected by ENL face significant economic burden and are at risk of being pushed further into poverty. Health policy should acknowledge the importance of private sector provision and the significant contribution to total household costs of lost productivity (indirect cost). Further work is needed to explore this area and identify solutions. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 9 1 e0003431 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 David J Chandler Kristian S Hansen Bhabananda Mahato Joydeepa Darlong Annamma John Diana N J Lockwood Household costs of leprosy reactions (ENL) in rural India. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Erythema nodosum leprosum (ENL) is a common immune-mediated complication of lepromatous (LL) and borderline lepromatous (BL) leprosy. Most patients experience chronic or multiple acute ENL over many years during an economically active period of their lives. Understanding the economic burden of ENL is essential to provide effective patient support, yet this area has not been investigated.Ninety-one patients with LL or BL leprosy attending a leprosy hospital in Purulia district of West Bengal, India, were interviewed using a structured questionnaire. Cases (n = 53) were identified as those who had one or more episodes of ENL within the last 3 years. Controls (n = 38) had LL or BL leprosy but no history of ENL. Data were collected on household income, direct and indirect costs, and coping strategies.The total household cost was Rs 1543 per month or 27.9% (IQR 13.2-52.6) of monthly household income for cases, and Rs 237 per month or 4.9% (IQR 1.7-13.4) of monthly household income for controls. Indirect costs accounted for 65% of total household costs for cases. Direct costs accounted for the remaining 35% of household costs, and resulted almost entirely from treatment-seeking in the private sector. Total household costs exceeded 40% of household income for 37.7% of cases (n = 20) and 2.6% of controls (n = 1) [1 USD = 59 INR].Households affected by ENL face significant economic burden and are at risk of being pushed further into poverty. Health policy should acknowledge the importance of private sector provision and the significant contribution to total household costs of lost productivity (indirect cost). Further work is needed to explore this area and identify solutions. |
format |
Article in Journal/Newspaper |
author |
David J Chandler Kristian S Hansen Bhabananda Mahato Joydeepa Darlong Annamma John Diana N J Lockwood |
author_facet |
David J Chandler Kristian S Hansen Bhabananda Mahato Joydeepa Darlong Annamma John Diana N J Lockwood |
author_sort |
David J Chandler |
title |
Household costs of leprosy reactions (ENL) in rural India. |
title_short |
Household costs of leprosy reactions (ENL) in rural India. |
title_full |
Household costs of leprosy reactions (ENL) in rural India. |
title_fullStr |
Household costs of leprosy reactions (ENL) in rural India. |
title_full_unstemmed |
Household costs of leprosy reactions (ENL) in rural India. |
title_sort |
household costs of leprosy reactions (enl) in rural india. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2015 |
url |
https://doi.org/10.1371/journal.pntd.0003431 https://doaj.org/article/0883848085ab4944bed0f60942744d52 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 9, Iss 1, p e0003431 (2015) |
op_relation |
http://europepmc.org/articles/PMC4295874?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0003431 https://doaj.org/article/0883848085ab4944bed0f60942744d52 |
op_doi |
https://doi.org/10.1371/journal.pntd.0003431 |
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PLOS Neglected Tropical Diseases |
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9 |
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1 |
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e0003431 |
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