Care-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of Congo
Abstract Background This study aimed to estimate the socio-economic costs of uncomplicated malaria and to explore health care-seeking behaviours that are likely to influence these costs in the Democratic Republic of Congo (DRC), a country ranked worldwide as the second most affected by malaria. Meth...
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| Format: | Article |
| Language: | English |
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BMC
2021-06-01
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| Series: | Malaria Journal |
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| Online Access: | https://doi.org/10.1186/s12936-021-03789-w |
| _version_ | 1818668858793263104 |
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| author | Nadine Kalenda Kayiba Doudou Malekita Yobi Brecht Devleesschauwer Dieudonné Makaba Mvumbi Pius Zakayi Kabututu Joris Losimba Likwela Lydie Azama Kalindula Patrick DeMol Marie-Pierre Hayette Georges Lelo Mvumbi Paul Dikassa Lusamba Philippe Beutels Angel Rosas-Aguirre Niko Speybroeck |
| author_facet | Nadine Kalenda Kayiba Doudou Malekita Yobi Brecht Devleesschauwer Dieudonné Makaba Mvumbi Pius Zakayi Kabututu Joris Losimba Likwela Lydie Azama Kalindula Patrick DeMol Marie-Pierre Hayette Georges Lelo Mvumbi Paul Dikassa Lusamba Philippe Beutels Angel Rosas-Aguirre Niko Speybroeck |
| author_sort | Nadine Kalenda Kayiba |
| collection | DOAJ |
| description | Abstract Background This study aimed to estimate the socio-economic costs of uncomplicated malaria and to explore health care-seeking behaviours that are likely to influence these costs in the Democratic Republic of Congo (DRC), a country ranked worldwide as the second most affected by malaria. Methods In 2017, a cross-sectional survey included patients with uncomplicated malaria in 64 healthcare facilities from 10 sentinel sites of the National Malaria Control Programme (NMCP) in the DRC. A standard questionnaire was used to assess health care-seeking behaviours of patients. Health-related quality of life (HRQL) and disutility weights (DW) of illness were evaluated by using the EuroQol Group’s descriptive system (EQ-5D-3L) and its visual analogue scale (EQ VAS). Malaria costs were estimated from a patient’s perspective. Probabilistic sensitivity analyses (PSA) evaluated the uncertainty around the cost estimates. Generalized regression models were fitted to assess the effect of potential predictive factors on the time lost and the DW during illness. Results In total, 1080 patients (age: 13.1 ± 14 years; M/F ratio: 1.1) were included. The average total costs amounted to US$ 36.3 [95% CI 35.5–37.2] per malaria episode, including US$ 16.7 [95% CI 16.3–17.1] as direct costs and US$ 19.6 [95% CI 18.9–20.3] indirect costs. During care seeking, economically active patients and their relatives lost respectively 3.3 ± 1.8 and 3.4 ± 2.1 working days. This time loss occurred mostly at the pre-hospital stage and was the parameter associated the most with the uncertainty around malaria cost estimates. Patients self-rated an average 0.36 ± 0.2 DW and an average 0.62 ± 0.3 EQ-5D index score per episode. A lack of health insurance coverage (896 out of 1080; 82.9%) incurred substantially higher costs, lower quality of life, and heavier DW while leading to longer time lost during illness. Residing in rural areas incurred a disproportionally higher socioeconomic burden of uncomplicated malaria with longer time lost due to illness and limited access to health insurance mechanisms. Conclusion Uncomplicated malaria is associated with high economic costs of care in the DRC. Efforts to reduce the cost-of-illness should target time lost at the pre-hospital stage and social disparities in the population, while reinforcing measures for malaria control in the country. |
| first_indexed | 2024-12-17T06:43:00Z |
| format | Article |
| id | doaj.art-d92afda46bbd436da87813ec94ae7b5a |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-17T06:43:00Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-d92afda46bbd436da87813ec94ae7b5a2022-12-21T21:59:48ZengBMCMalaria Journal1475-28752021-06-0120111510.1186/s12936-021-03789-wCare-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of CongoNadine Kalenda Kayiba0Doudou Malekita Yobi1Brecht Devleesschauwer2Dieudonné Makaba Mvumbi3Pius Zakayi Kabututu4Joris Losimba Likwela5Lydie Azama Kalindula6Patrick DeMol7Marie-Pierre Hayette8Georges Lelo Mvumbi9Paul Dikassa Lusamba10Philippe Beutels11Angel Rosas-Aguirre12Niko Speybroeck13Research Institute of Health and Society (IRSS), Université Catholique de LouvainDepartment of Basic Sciences, Faculty of Medicine, University of KinshasaDepartment of Epidemiology and Public Health, SciensanoDepartment of Basic Sciences, Faculty of Medicine, University of KinshasaDepartment of Basic Sciences, Faculty of Medicine, University of KinshasaNational Malaria Control ProgrammeNational Malaria Control ProgrammeLaboratory of Clinical Microbiology, Center for Interdisciplinary Research on Medicines (CIRM), University of LiègeLaboratory of Clinical Microbiology, Center for Interdisciplinary Research on Medicines (CIRM), University of LiègeDepartment of Basic Sciences, Faculty of Medicine, University of KinshasaSchool of Public Health, Faculty of Medicine, University of KinshasaCentre for Health Economics Research and Modelling Infectious Diseases, University of AntwerpResearch Institute of Health and Society (IRSS), Université Catholique de LouvainResearch Institute of Health and Society (IRSS), Université Catholique de LouvainAbstract Background This study aimed to estimate the socio-economic costs of uncomplicated malaria and to explore health care-seeking behaviours that are likely to influence these costs in the Democratic Republic of Congo (DRC), a country ranked worldwide as the second most affected by malaria. Methods In 2017, a cross-sectional survey included patients with uncomplicated malaria in 64 healthcare facilities from 10 sentinel sites of the National Malaria Control Programme (NMCP) in the DRC. A standard questionnaire was used to assess health care-seeking behaviours of patients. Health-related quality of life (HRQL) and disutility weights (DW) of illness were evaluated by using the EuroQol Group’s descriptive system (EQ-5D-3L) and its visual analogue scale (EQ VAS). Malaria costs were estimated from a patient’s perspective. Probabilistic sensitivity analyses (PSA) evaluated the uncertainty around the cost estimates. Generalized regression models were fitted to assess the effect of potential predictive factors on the time lost and the DW during illness. Results In total, 1080 patients (age: 13.1 ± 14 years; M/F ratio: 1.1) were included. The average total costs amounted to US$ 36.3 [95% CI 35.5–37.2] per malaria episode, including US$ 16.7 [95% CI 16.3–17.1] as direct costs and US$ 19.6 [95% CI 18.9–20.3] indirect costs. During care seeking, economically active patients and their relatives lost respectively 3.3 ± 1.8 and 3.4 ± 2.1 working days. This time loss occurred mostly at the pre-hospital stage and was the parameter associated the most with the uncertainty around malaria cost estimates. Patients self-rated an average 0.36 ± 0.2 DW and an average 0.62 ± 0.3 EQ-5D index score per episode. A lack of health insurance coverage (896 out of 1080; 82.9%) incurred substantially higher costs, lower quality of life, and heavier DW while leading to longer time lost during illness. Residing in rural areas incurred a disproportionally higher socioeconomic burden of uncomplicated malaria with longer time lost due to illness and limited access to health insurance mechanisms. Conclusion Uncomplicated malaria is associated with high economic costs of care in the DRC. Efforts to reduce the cost-of-illness should target time lost at the pre-hospital stage and social disparities in the population, while reinforcing measures for malaria control in the country.https://doi.org/10.1186/s12936-021-03789-wMalariaCost-of-illnessHealth-related quality of lifeNational Malaria Control ProgrammeDemocratic Republic of Congo |
| spellingShingle | Nadine Kalenda Kayiba Doudou Malekita Yobi Brecht Devleesschauwer Dieudonné Makaba Mvumbi Pius Zakayi Kabututu Joris Losimba Likwela Lydie Azama Kalindula Patrick DeMol Marie-Pierre Hayette Georges Lelo Mvumbi Paul Dikassa Lusamba Philippe Beutels Angel Rosas-Aguirre Niko Speybroeck Care-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of Congo Malaria Journal Malaria Cost-of-illness Health-related quality of life National Malaria Control Programme Democratic Republic of Congo |
| title | Care-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of Congo |
| title_full | Care-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of Congo |
| title_fullStr | Care-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of Congo |
| title_full_unstemmed | Care-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of Congo |
| title_short | Care-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of Congo |
| title_sort | care seeking behaviour and socio economic burden associated with uncomplicated malaria in the democratic republic of congo |
| topic | Malaria Cost-of-illness Health-related quality of life National Malaria Control Programme Democratic Republic of Congo |
| url | https://doi.org/10.1186/s12936-021-03789-w |
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