1921
Volume 89, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Visceral leishmaniasis (VL) is a neglected parasitic disease that is fatal if left untreated and is endemic in eastern Sudan. We estimated the direct and indirect costs of treatment of VL from the perspective of the provider and the household at three public hospitals in Gedaref State. The median total cost for one VL episode was estimated to be US$450. Despite the free provision of VL drugs at public hospitals, households bore 53% of the total cost of VL with one episode of VL representing 40% of the annual household income. More than 75% of households incurred catastrophic out-of-pocket expenditures. The length of treatment of 30 days led to important costs for both health providers and households. Alternative treatment regimens that reduce the duration of treatment are urgently needed.

[open-access] This is an Open Access article distributed under the terms of the American Society of Tropical Medicine and Hygiene's Re-use License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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2013-12-04
2017-11-19
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References

  1. Murray HW, Berman JD, Davies CR, Saravia NG, , 2005. Advances in leishmaniasis. Lancet 366: 15611577.[Crossref]
  2. Meheus F, Boelaert M, Baltussen R, Sundar S, , 2006. Costs of patient management of visceral leishmaniasis in Muzaffarpur, Bihar, India. Trop Med Int Health 11: 17151724.[Crossref]
  3. Sharma AD, Bern C, Varghese B, Chowdhury R, Haque R, Ali M, Amann J, Ahluwalia IB, Wagatsuma Y, Breiman RF, Maguire JH, McFarland DA, , 2006. The economic impact of visceral leishmaniasis on households in Bangladesh. Trop Med Int Health 11: 757764.[Crossref]
  4. Uranw S, Meheus F, Baltussen R, Rijal S, Boelaert M, , 2013. The economic burden of visceral leishmaniasis on households in eastern Nepal. PLoS Negl Trop Dis 7: e2062.[Crossref]
  5. Central Bureau of Statistics Sudan, 2011. Fifth Population and Housing Census 2008. Available at: http://www.cbs.gov.sd/en/node/6. Accessed July 15, 2012.
  6. Collin SM, Coleman PG, Ritmeijer K, Davidson RN, , 2006. Unseen Kala-azar deaths in south Sudan (1999–2002). Trop Med Int Health 11: 509512.[Crossref]
  7. Desjeux P, , 1996. Leishmaniasis: public health aspects and control. Clin Dermatol 14: 417423.[Crossref]
  8. WHO, 2006. Health System Profile Sudan. Cairo, Egypt: WHO Regional Office for the Eastern Mediterranean.
  9. Malaria Consortium, 2010. Leishmaniasis Control in Eastern Africa: Past and Present Efforts and Future Needs.
  10. Ritmeijer K, Davies C, van Zorge R, Wang SJ, Schorscher J, Dongu’du SI, Davidson RN, , 2007. Evaluation of a mass distribution programme for fine-mesh impregnated bed nets against visceral leishmaniasis in eastern Sudan. Trop Med Int Health 12: 404414.[Crossref]
  11. Federal Ministry of Health Sudan, 2004. Manual for diagnosis and treatment of leishmaniasis. Federal Ministry of Health: Leishmaniasis Administration.
  12. Rijal S, Chappuis F, Singh R, Bovier PA, Acharya P, Karki BM, Das ML, Desjeux P, Loutan L, Koirala S, , 2003. Treatment of visceral leishmaniasis in south-eastern Nepal: decreasing efficacy of sodium stibogluconate and need for a policy to limit further decline. Trans R Soc Trop Med Hyg 97: 350354.[Crossref]
  13. Sundar S, More DK, Singh MK, Singh VP, Sharma S, Makharia A, Kumar PC, Murray HW, , 2000. Failure of pentavalent antimony in visceral leishmaniasis in India: report from the center of the Indian epidemic. Clin Infect Dis 31: 11041107.[Crossref]
  14. Hailu A, Musa A, Wasunna M, Balasegaram M, Yifru S, Mengistu G, Hurissa Z, Hailu W, Weldegebreal T, Tesfaye S, Makonnen E, Khalil E, Ahmed O, Fadlalla A, El-Hassan A, Raheem M, Mueller M, Koummuki Y, Rashid J, Mbui J, Mucee G, Njoroge S, Manduku V, Musibi A, Mutuma G, Kirui F, Lodenyo H, Mutea D, Kirigi G, Edwards T, Smith P, Muthami L, Royce C, Ellis S, Alobo M, Omollo R, Kesusu J, Owiti R, Kinuthia J, , 2010. Geographical variation in the response of visceral leishmaniasis to paromomycin in East Africa: a multicentre, open-label, randomized trial. PLoS Negl Trop Dis 4: e709.[Crossref]
  15. Melaku Y, Collin SM, Keus K, Gatluak F, Ritmeijer K, Davidson RN, , 2007. Treatment of kala-azar in southern Sudan using a 17-day regimen of sodium stibogluconate combined with paromomycin: a retrospective comparison with 30-day sodium stibogluconate monotherapy. Am J Trop Med Hyg 77: 8994.
  16. Musa A, Khalil E, Hailu A, Olobo J, Balasegaram M, Omollo R, Edwards T, Rashid J, Mbui J, Musa B, Abuzaid AA, Ahmed O, Fadlalla A, El-Hassan A, Mueller M, Mucee G, Njoroge S, Manduku V, Mutuma G, Apadet L, Lodenyo H, Mutea D, Kirigi G, Yifru S, Mengistu G, Hurissa Z, Hailu W, Weldegebreal T, Tafes H, Mekonnen Y, Makonnen E, Ndegwa S, Sagaki P, Kimutai R, Kesusu J, Owiti R, Ellis S, Wasunna M, , 2012. Sodium stibogluconate (SSG) & paromomycin combination compared to SSG for visceral leishmaniasis in East Africa: a randomized controlled trial. PLoS Negl Trop Dis 6: e1674.[Crossref]
  17. Omollo R, Alexander N, Edwards T, Khalil EA, Younis BM, Abuzaid AA, Wasunna M, Njoroge N, Kinoti D, Kirigi G, Dorlo TP, Ellis S, Balasegaram M, Musa AM, , 2011. Safety and efficacy of miltefosine alone and in combination with sodium stibogluconate and liposomal amphotericin B for the treatment of primary visceral leishmaniasis in East Africa: study protocol for a randomized controlled trial. Trials 12: 166.[Crossref]
  18. Zijlstra EE, Ali MS, el-Hassan AM, el-Toum IA, Satti M, Ghalib HW, Kager PA, , 1992. Kala-azar: a comparative study of parasitological methods and the direct agglutination test in diagnosis. Trans R Soc Trop Med Hyg 86: 505507.[Crossref]
  19. Zijlstra EE, el-Hassan AM, , 2001. Leishmaniasis in Sudan. Visceral leishmaniasis. Trans R Soc Trop Med Hyg 95 (Suppl 1): S27S58.[Crossref]
  20. Collin S, Davidson R, Ritmeijer K, Keus K, Melaku Y, Kipngetich S, Davies C, , 2004. Conflict and kala-azar: determinants of adverse outcomes of kala-azar among patients in southern Sudan. Clin Infect Dis 38: 612619.[Crossref]
  21. Hansen K, Chapman G, Chitsike I, Kasilo O, Mwaluko G, , 2000. The costs of HIV/AIDS care at government hospitals in Zimbabwe. Health Policy Plan 15: 432440.[Crossref]
  22. McPake B, Hongoro C, Russo G, , 2011. Two-tier charging in Maputo Central Hospital: costs, revenues and effects on equity of access to hospital services. BMC Health Serv Res 11: 143.[Crossref]
  23. Van der Plaetse B, Hlatiwayo G, Van EL, Meessen B, Criel B, , 2005. Costs and revenue of health care in a rural Zimbabwean district. Health Policy Plan 20: 243251.[Crossref]
  24. Creese A, Parker D, , 1994. Cost Analysis in Primary Health Care: A Training Manual for Programme Managers. Geneva: World Health Organization.
  25. WHO, 2010. Control of the Leishmaniasis: Report of a Meeting of the WHO Expert Committee on the Control of Leishmaniasis. Geneva: WHO.
  26. WHO-CHOICE. Country-specific unit costs. Available at: http://www.who.int/choice/country/country_specific/en/index.html. Accessed July 15, 2012.
  27. Drummond M, Sculpher MJ, Torrance GW, O'Bien BJ, Stoddart GL, , 2005. Methods for the Economic Evaluation of Health Care Programmes. Third edition. Oxford: Oxford University Press.
  28. Gold MR, Russell LB, Siegel JE, Weinstein MC, , 1996. Cost-Effectiveness in Health and Medicine. New York: Oxford University Press.
  29. Conteh L, Walker D, , 2004. Cost and unit cost calculations using step-down accounting. Health Policy Plan 19: 127135.[Crossref]
  30. O'Donnell O, van Doorslaer E, Wagstaf A, Lindelow M, , 2008. Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation. Washington, DC: The World Bank.
  31. Ranson MK, , 2002. Reduction of catastrophic health care expenditures by a community-based health insurance scheme in Gujarat, India: current experiences and challenges. Bull World Health Organ 80: 613621.
  32. World Bank. World databank: World development indicators & Global development finance. Available at: http://data.worldbank.org/indicator/FP.CPI.TOTL. Accessed July 15, 2012.
  33. Rijal S, Koirala S, Van der Stuyft P, Boelaert M, , 2006. The economic burden of visceral leishmaniasis for households in Nepal. Trans R Soc Trop Med Hyg 100: 838841.[Crossref]
  34. Sarnoff R, Desai J, Desjeux P, Mittal A, Topno R, Siddiqui NA, Pandey A, Sur D, Das P, , 2010. The economic impact of visceral leishmaniasis on rural households in one endemic district of Bihar, India. Trop Med Int Health 15 (Suppl 2): 4249.[Crossref]
  35. Sundar S, Arora R, Singh SP, Boelaert M, Varghese B, , 2010. Household cost-of-illness of visceral leishmaniasis in Bihar, India. Trop Med Int Health 15 (Suppl 2): 5054.[Crossref]
  36. Harhay MO, Olliaro PL, Vaillant M, Chappuis F, Lima MA, Ritmeijer K, Costa CH, Costa DL, Rijal S, Sundar S, Balasegaram M, , 2011. Who is a typical patient with visceral leishmaniasis? Characterizing the demographic and nutritional profile of patients in Brazil, East Africa, and South Asia. Am J Trop Med Hyg 84: 543550.[Crossref]
  37. Gerstl S, Amsalu R, Ritmeijer K, , 2006. Accessibility of diagnostic and treatment centres for visceral leishmaniasis in Gedaref State, northern Sudan. Trop Med Int Health 11: 167175.[Crossref]
  38. Edwards T, Omollo R, Khalil EA, Yifru S, Musa B, Musa A, Wasunna M, Smith PG, Royce C, Ellis S, Balasegaram M, Hailu A, , 2011. Single-dose liposomal amphotericin B (AmBisome(R)) for the treatment of visceral leishmaniasis in East Africa: study protocol for a randomized controlled trial. Trials 12: 66.[Crossref]
  39. Burki T, , 2012. Drug donated for treatment of visceral leishmaniasis. Lancet Infect Dis 12: 106107.
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Supplementary Data

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  • Received : 19 Sep 2012
  • Accepted : 10 Aug 2013

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