Cost-effectiveness and social outcomes of a community-based treatment for podoconiosis lymphoedema in the East Gojjam zone, Ethiopia.
Background Podoconiosis is a disease of the lymphatic vessels of the lower extremities that is caused by chronic exposure to irritant soils. It results in leg swelling, commonly complicated by acute dermatolymphangioadenitis (ADLA), characterised by severe pain, fever and disability. Methods We cond...
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ftdoajarticles:oai:doaj.org/article:9a21b6319ae4462c8b04a7d406ce9821 2023-05-15T15:14:18+02:00 Cost-effectiveness and social outcomes of a community-based treatment for podoconiosis lymphoedema in the East Gojjam zone, Ethiopia. Natalia Hounsome Meseret Molla Kassahun Moses Ngari James A Berkley Esther Kivaya Patricia Njuguna Greg Fegan Abreham Tamiru Abebe Kelemework Tsige Amberbir Annabelle Clarke Trudie Lang Melanie J Newport Andy McKay Fikre Enquoselassie Gail Davey 2019-10-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0007780 https://doaj.org/article/9a21b6319ae4462c8b04a7d406ce9821 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0007780 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007780 https://doaj.org/article/9a21b6319ae4462c8b04a7d406ce9821 PLoS Neglected Tropical Diseases, Vol 13, Iss 10, p e0007780 (2019) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2019 ftdoajarticles https://doi.org/10.1371/journal.pntd.0007780 2022-12-31T13:50:09Z Background Podoconiosis is a disease of the lymphatic vessels of the lower extremities that is caused by chronic exposure to irritant soils. It results in leg swelling, commonly complicated by acute dermatolymphangioadenitis (ADLA), characterised by severe pain, fever and disability. Methods We conducted cost-effectiveness and social outcome analyses of a pragmatic, randomised controlled trial of a hygiene and foot-care intervention for people with podoconiosis in the East Gojjam zone of northern Ethiopia. Participants were allocated to the immediate intervention group or the delayed intervention group (control). The 12-month intervention included training in foot hygiene, skin care, bandaging, exercises, and use of socks and shoes, and was supported by lay community assistants. The cost-effectiveness analysis was conducted using the cost of productivity loss due to acute dermatolymphangioadenitis. Household costs were not included. Health outcomes in the cost-effectiveness analysis were: the incidence of ADLA episodes, health-related quality of life captured using the Dermatology Life Quality Index (DLQI), and disability scores measured using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Results The cost of the foot hygiene and lymphoedema management supplies was 529 ETB (69 I$, international dollars) per person per year. The cost of delivery of the intervention as part of the trial, including transportation, storage, training of lay community assistants and administering the intervention was 1,890 ETB (246 I$) per person. The intervention was effective in reducing the incidence of acute dermatolymphangioadenitis episodes and improving DLQI scores, while there were no significant improvements in the disability scores measured using WHODAS 2.0. In 75% of estimations, the intervention was less costly than the control. This was due to improved work productivity. Subgroup analyses based on income group showed that the intervention was cost-effective (both less costly and more effective) in reducing the ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 13 10 e0007780 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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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 Natalia Hounsome Meseret Molla Kassahun Moses Ngari James A Berkley Esther Kivaya Patricia Njuguna Greg Fegan Abreham Tamiru Abebe Kelemework Tsige Amberbir Annabelle Clarke Trudie Lang Melanie J Newport Andy McKay Fikre Enquoselassie Gail Davey Cost-effectiveness and social outcomes of a community-based treatment for podoconiosis lymphoedema in the East Gojjam zone, Ethiopia. |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Podoconiosis is a disease of the lymphatic vessels of the lower extremities that is caused by chronic exposure to irritant soils. It results in leg swelling, commonly complicated by acute dermatolymphangioadenitis (ADLA), characterised by severe pain, fever and disability. Methods We conducted cost-effectiveness and social outcome analyses of a pragmatic, randomised controlled trial of a hygiene and foot-care intervention for people with podoconiosis in the East Gojjam zone of northern Ethiopia. Participants were allocated to the immediate intervention group or the delayed intervention group (control). The 12-month intervention included training in foot hygiene, skin care, bandaging, exercises, and use of socks and shoes, and was supported by lay community assistants. The cost-effectiveness analysis was conducted using the cost of productivity loss due to acute dermatolymphangioadenitis. Household costs were not included. Health outcomes in the cost-effectiveness analysis were: the incidence of ADLA episodes, health-related quality of life captured using the Dermatology Life Quality Index (DLQI), and disability scores measured using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Results The cost of the foot hygiene and lymphoedema management supplies was 529 ETB (69 I$, international dollars) per person per year. The cost of delivery of the intervention as part of the trial, including transportation, storage, training of lay community assistants and administering the intervention was 1,890 ETB (246 I$) per person. The intervention was effective in reducing the incidence of acute dermatolymphangioadenitis episodes and improving DLQI scores, while there were no significant improvements in the disability scores measured using WHODAS 2.0. In 75% of estimations, the intervention was less costly than the control. This was due to improved work productivity. Subgroup analyses based on income group showed that the intervention was cost-effective (both less costly and more effective) in reducing the ... |
format |
Article in Journal/Newspaper |
author |
Natalia Hounsome Meseret Molla Kassahun Moses Ngari James A Berkley Esther Kivaya Patricia Njuguna Greg Fegan Abreham Tamiru Abebe Kelemework Tsige Amberbir Annabelle Clarke Trudie Lang Melanie J Newport Andy McKay Fikre Enquoselassie Gail Davey |
author_facet |
Natalia Hounsome Meseret Molla Kassahun Moses Ngari James A Berkley Esther Kivaya Patricia Njuguna Greg Fegan Abreham Tamiru Abebe Kelemework Tsige Amberbir Annabelle Clarke Trudie Lang Melanie J Newport Andy McKay Fikre Enquoselassie Gail Davey |
author_sort |
Natalia Hounsome |
title |
Cost-effectiveness and social outcomes of a community-based treatment for podoconiosis lymphoedema in the East Gojjam zone, Ethiopia. |
title_short |
Cost-effectiveness and social outcomes of a community-based treatment for podoconiosis lymphoedema in the East Gojjam zone, Ethiopia. |
title_full |
Cost-effectiveness and social outcomes of a community-based treatment for podoconiosis lymphoedema in the East Gojjam zone, Ethiopia. |
title_fullStr |
Cost-effectiveness and social outcomes of a community-based treatment for podoconiosis lymphoedema in the East Gojjam zone, Ethiopia. |
title_full_unstemmed |
Cost-effectiveness and social outcomes of a community-based treatment for podoconiosis lymphoedema in the East Gojjam zone, Ethiopia. |
title_sort |
cost-effectiveness and social outcomes of a community-based treatment for podoconiosis lymphoedema in the east gojjam zone, ethiopia. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2019 |
url |
https://doi.org/10.1371/journal.pntd.0007780 https://doaj.org/article/9a21b6319ae4462c8b04a7d406ce9821 |
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Arctic |
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Arctic |
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Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 13, Iss 10, p e0007780 (2019) |
op_relation |
https://doi.org/10.1371/journal.pntd.0007780 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007780 https://doaj.org/article/9a21b6319ae4462c8b04a7d406ce9821 |
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https://doi.org/10.1371/journal.pntd.0007780 |
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PLOS Neglected Tropical Diseases |
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