The household costs of visceral leishmaniasis care in south-eastern Nepal.
BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is an important public health problem in south-eastern Nepal affecting very poor rural communities. Since 2005, Nepal is involved in a regional initiative to eliminate VL. This study assessed the economic impact of VL on households and examined...
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ftdoajarticles:oai:doaj.org/article:448f54d3b6de4986abdab6c183cd7d80 2023-05-15T15:11:45+02:00 The household costs of visceral leishmaniasis care in south-eastern Nepal. Surendra Uranw Filip Meheus Rob Baltussen Suman Rijal Marleen Boelaert 2013-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0002062 https://doaj.org/article/448f54d3b6de4986abdab6c183cd7d80 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3585119?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002062 https://doaj.org/article/448f54d3b6de4986abdab6c183cd7d80 PLoS Neglected Tropical Diseases, Vol 7, Iss 2, p e2062 (2013) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2013 ftdoajarticles https://doi.org/10.1371/journal.pntd.0002062 2022-12-31T08:13:46Z BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is an important public health problem in south-eastern Nepal affecting very poor rural communities. Since 2005, Nepal is involved in a regional initiative to eliminate VL. This study assessed the economic impact of VL on households and examined whether the intensified VL control efforts induced by the government resulted in a decrease in household costs. METHODS: Between August and September 2010, a household survey was conducted among 168 patients that had been treated for VL within 12 months prior to the survey in five districts in south-eastern Nepal. We collected data on health-seeking behaviour, direct and indirect costs and coping strategies. RESULTS: The median total cost of one episode of VL was US$ 165 or 11% of annual household income. The median delay between the onset of symptoms and presentation to a qualified provider was 25 days. Once the patient presented to a qualified provider, the delay to correct diagnosis was minimal (median 3 days). Direct and indirect costs (income losses) represented 47% and 53% of total costs respectively. Households used multiple strategies to cope with the cost of illness, mainly mobilizing cash/savings (71%) or taking a loan (56%). CONCLUSIONS: The provision of free VL diagnosis and drugs by the Nepalese control programme has been an important policy measure to reduce the cost of VL to households. But despite the free VL drugs, the economic burden is still important for households. More effort should be put into reducing indirect costs, in particular the length of treatment, and preventing the transmission of VL through vector control. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 7 2 e2062 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
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 Surendra Uranw Filip Meheus Rob Baltussen Suman Rijal Marleen Boelaert The household costs of visceral leishmaniasis care in south-eastern Nepal. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is an important public health problem in south-eastern Nepal affecting very poor rural communities. Since 2005, Nepal is involved in a regional initiative to eliminate VL. This study assessed the economic impact of VL on households and examined whether the intensified VL control efforts induced by the government resulted in a decrease in household costs. METHODS: Between August and September 2010, a household survey was conducted among 168 patients that had been treated for VL within 12 months prior to the survey in five districts in south-eastern Nepal. We collected data on health-seeking behaviour, direct and indirect costs and coping strategies. RESULTS: The median total cost of one episode of VL was US$ 165 or 11% of annual household income. The median delay between the onset of symptoms and presentation to a qualified provider was 25 days. Once the patient presented to a qualified provider, the delay to correct diagnosis was minimal (median 3 days). Direct and indirect costs (income losses) represented 47% and 53% of total costs respectively. Households used multiple strategies to cope with the cost of illness, mainly mobilizing cash/savings (71%) or taking a loan (56%). CONCLUSIONS: The provision of free VL diagnosis and drugs by the Nepalese control programme has been an important policy measure to reduce the cost of VL to households. But despite the free VL drugs, the economic burden is still important for households. More effort should be put into reducing indirect costs, in particular the length of treatment, and preventing the transmission of VL through vector control. |
format |
Article in Journal/Newspaper |
author |
Surendra Uranw Filip Meheus Rob Baltussen Suman Rijal Marleen Boelaert |
author_facet |
Surendra Uranw Filip Meheus Rob Baltussen Suman Rijal Marleen Boelaert |
author_sort |
Surendra Uranw |
title |
The household costs of visceral leishmaniasis care in south-eastern Nepal. |
title_short |
The household costs of visceral leishmaniasis care in south-eastern Nepal. |
title_full |
The household costs of visceral leishmaniasis care in south-eastern Nepal. |
title_fullStr |
The household costs of visceral leishmaniasis care in south-eastern Nepal. |
title_full_unstemmed |
The household costs of visceral leishmaniasis care in south-eastern Nepal. |
title_sort |
household costs of visceral leishmaniasis care in south-eastern nepal. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2013 |
url |
https://doi.org/10.1371/journal.pntd.0002062 https://doaj.org/article/448f54d3b6de4986abdab6c183cd7d80 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 7, Iss 2, p e2062 (2013) |
op_relation |
http://europepmc.org/articles/PMC3585119?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002062 https://doaj.org/article/448f54d3b6de4986abdab6c183cd7d80 |
op_doi |
https://doi.org/10.1371/journal.pntd.0002062 |
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PLoS Neglected Tropical Diseases |
container_volume |
7 |
container_issue |
2 |
container_start_page |
e2062 |
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