Volume 98, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Leprosy and podoconiosis (podo) are neglected tropical diseases that cause severe disfigurement and disability, and may lead to catastrophic health expenditure and hinder economic development of affected persons and households. This study compared economic costs of both diseases on affected households with unaffected neighboring households in the Northwest Region (N.W.R.) of Cameroon. A matched comparative cross-sectional design was used enrolling 170 households (43 podo case households, 41 podo control households, 43 leprosy case households, and 43 leprosy control households) from three health districts in the N.W.R. Direct treatment costs for podo averaged 142 United State dollar (USD), compared with zero for leprosy ( < 0.001). This was also reflected in the proportion of annual household income consumed (0.4 versus 0.0, respectively, < 0.001). Both diseases caused considerable reductions in working days (leprosy 115 versus podo 135 days. for comparison < 0.001). The average household income was considerably lower in podo-affected households than unaffected households (410 versus 913 USD, = 0.01), whereas income of leprosy-affected households was comparable to unaffected households (329 versus 399 USD, = 0.23). Both leprosy and podo cause financial burdens on affected households, but those on podo-affected families are much greater. These burdens occur through direct treatment costs and reduced ability to work. Improved access to public health interventions for podo including prevention, morbidity management and disability prevention are likely to result in economic returns to affected families. In Cameroon, one approach to this would be through subsidized health insurance for these economically vulnerable households.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  1. Hotez PJ, Kamath A, 2009. Neglected tropical diseases in sub-Saharan Africa: review of their prevalence, distribution and disease burden. PLoS Negl Trop Dis 3: e412.
    [Google Scholar]
  2. Chen S, Ravallion M, 2010. The developing world is poorer than we thought, but no less successful in the fight against poverty. Q J Econ 125: 15771625.
    [Google Scholar]
  3. Davey G, Burridge E, 2009. Community-based control of a neglected tropical disease: the mossy foot treatment and prevention association. PLoS Negl Trop Dis 3: e424.
    [Google Scholar]
  4. Wanji S, Tendongfor N, Esum M, Che JN, Mand S, Tanga Mbi C, Enyong P, Hoerauf A, 2008. Elephantiasis of non-filarial origin (podoconiosis) in the highlands of north-western Cameroon. Ann Trop Med Parasitol 102: 529540.
    [Google Scholar]
  5. Price EW, Henderson WJ, 1981. Endemic elephantiasis of the lower legs in the United Cameroon Republic. Trop Geogr Med 33: 2329.
    [Google Scholar]
  6. Deribe K, Tomczyk S, Mousley E, Abreham T, Davey G, 2013. Stigma towards a neglected tropical disease: felt and enacted stigma scores among podoconiosis patients in northern Ethiopia. BMC Public Health 13: 1178.
    [Google Scholar]
  7. Tekola F, Haile MD, Davey G, 2006. Economic costs of endemic non-filarial elephantiasis in Wolaita zone, Ethiopia. Trop Med Int Health 11: 11361144.
    [Google Scholar]
  8. Chandler DJ, Hansen KS, Mahato B, Darlong J, John A, Lockwood DN, 2015. Household costs of leprosy reactions (ENL) in rural India. PLoS Negl Trop Dis 9: e0003431.
    [Google Scholar]
  9. World Health Organization, 2017. Weekly Epidemiological Record: Global Leprosy Update, 2016: Accelerating Reduction of Disease Burden No 35, Vol. 92, 501520. Available at: http://www.who.int/wer. Accessed December 16, 2017.
  10. Nsagha DS, Bamgboye EA, Salimonu L, Jules Clement NA, Earnest NT, Anne-Cécile B, Longdoh AN, Kamga H, Marcelin Ngowe MN, Kongnyu AN, 2014. Epidemiological surveillance of leprosy in Cameroon using the ELISA test with D-BSA and Tris-HCl as buffer. Am J Epid Inf Dis 2: 6673.
    [Google Scholar]
  11. Lastória JC, Abreu MA, 2014. Leprosy: review of the epidemiological, clinical, and etiopathogenic aspects—part 1. An Bras Dermatol 89: 205218.
    [Google Scholar]
  12. WHO, 2009. World Health Organization Guide to Identifying the Economic Consequences of Disease and Injury. Geneva, Switzerland: World Health Organization.
  13. Deribe K, Meribo K, Gebre T, Hailu A, Ali A, Aseffa A, Davey G, 2012. The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination. Parasit Vectors 5: 240.
    [Google Scholar]
  14. Koen PG, Um Boock A, Peeters H, Susanna H-M, Elizabeth T, Joan MR, 2008. “It is me who endures but my family that suffers”: social isolation as a consequence of the household cost burden of Buruli ulcer free of charge hospital treatment. PLoS Negl Trop Dis 2: e321.
    [Google Scholar]
  15. Kengne-Ouafo JA, Nji TM, Tantoh WF, Nyoh DN, Tendongfor N, Enyong PA, Newport MJ, Davey G, Wanji S, 2014. Perceptions of consent, permission structures and approaches to the community: a rapid ethical assessment performed in north west Cameroon. BMC Public Health 14: 1026.
    [Google Scholar]
  16. O’Donnell OA, Wagstaff A, 2008. Catastrophic payments in health care. Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation. Washington, DC: World Bank.

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  • Received : 30 Nov 2017
  • Accepted : 25 Dec 2017
  • Published online : 19 Feb 2018
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