Title
Care-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of Congo
Date Issued
01 December 2021
Access level
open access
Resource Type
journal article
Author(s)
Kayiba N.K.
Yobi D.M.
Devleesschauwer B.
Mvumbi D.M.
Kabututu P.Z.
Likwela J.L.
Kalindula L.A.
DeMol P.
Hayette M.P.
Mvumbi G.L.
Lusamba P.D.
Beutels P.
Speybroeck N.
Université Catholique de Louvain
Publisher(s)
BioMed Central Ltd
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.
Volume
20
Issue
1
Language
English
OCDE Knowledge area
Salud pública, Salud ambiental
Epidemiología
Subjects
Scopus EID
2-s2.0-85107429457
PubMed ID
Source
Malaria Journal
ISSN of the container
14752875
Sponsor(s)
This study was funded by the Belgian Cooperation Agency through the ARES (Académie de Recherche et d’Enseignement Supérieur).
Sources of information:
Directorio de Producción Científica
Scopus