Xiong Mingzhou, Li Ming, Zheng Daocheng, Wang Xiaohua, Su Ting, Chen Yongfeng, Yang Bin
Leprosy Control Department, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, China.
Leprosy Control Department, Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, Guangdong Province, China.
BMC Infect Dis. 2017 Dec 11;17(1):760. doi: 10.1186/s12879-017-2869-8.
A lot of time and money was needed during the diagnosis and treatment process of leprosy, the delayed leprosy would also impair the labor capability of patients as well, and these put a heavy burden for the leprosy patients. The migrant leprosy patient is a special group and need more concern. Our goal was to assess the economic burden of leprosy on migrant and resident patient populations in Guangdong province, China.
We conducted a population-based cross-sectional survey from February to July of 2016. A self-designed questionnaire was administered to leprosy patients who: (1) had registered in Leprosy Management Information System in China (LEPMIS) by the end of February 2016, (2) had received multiple drug treatment (MDT) drugs at a local leprosy control institution for three consecutive months or had had at least one physical check in the past half year, and (3) were willing to take part in the investigation and give informed written consent. Demographic characteristics, Financial and disease information, and costs before and after leprosy diagnosis were collected and compared using t-test and χ2 test.
A total of 254 participants completed the questionnaires, including 168 males and 86 females. Migrants and residents accounted for 33.9% and 66.1% of patients, respectively. Among migrant patients, the median cost before diagnosis was $131.6 (39.2-450.9), the median yearly cost of leprosy treatment after diagnosis was $300.6 (158.4-868.5), and the median yearly cost of leprosy complications was $69.5 (11-178.4). In comparison, among residents the median yearly costs were $152.4 (30.7-770.9) pre-diagnosis, $309.7 (103.2-1016.7) after diagnosis, and $91.9 (32.6-303.1) for leprosy complications. Base on this, we determined that the median yearly total expense after diagnosis amounted to 15% of migrant and 38% of resident patients' annual income.
Leprosy places a heavy economic burden on both migrant and resident leprosy patients and governmental policies and programs could substantially alleviate this. Measures to implement more active surveillance and early diagnosis would benefit both populations, while labor protection and medical insurance are urgently needed for migrant patients and easier access to medical services and social aids could substantially decrease the burden of leprosy for resident patients.
麻风病的诊断和治疗过程需要耗费大量时间和金钱,延误治疗还会损害患者的劳动能力,给麻风病患者带来沉重负担。流动麻风病患者是一个特殊群体,需要更多关注。我们的目标是评估麻风病给中国广东省流动和常住患者群体带来的经济负担。
我们于2016年2月至7月开展了一项基于人群的横断面调查。向符合以下条件的麻风病患者发放自行设计的问卷:(1)截至2016年2月底已在中国麻风病管理信息系统(LEPMIS)中登记;(2)在当地麻风病防治机构连续三个月接受了联合化疗药物治疗或在过去半年内至少进行过一次体检;(3)愿意参与调查并签署知情同意书。收集人口统计学特征、财务和疾病信息,以及麻风病诊断前后的费用,并采用t检验和χ²检验进行比较。
共有254名参与者完成了问卷,其中男性168名,女性86名。流动患者和常住患者分别占患者总数的33.9%和66.1%。在流动患者中,诊断前的费用中位数为131.6美元(39.2 - 450.9美元),诊断后麻风病治疗的年费用中位数为300.6美元(158.4 - 868.5美元),麻风病并发症的年费用中位数为69.5美元(11 - 178.4美元)。相比之下,常住患者诊断前的年费用中位数为152.4美元(30.7 - 770.9美元),诊断后的年费用中位数为309.7美元(103.2 - 1016.7美元),麻风病并发症的年费用中位数为91.9美元(32.6 - 303.1美元)。基于此,我们确定诊断后的年总费用中位数分别占流动患者年收入的15%和常住患者年收入的38%。
麻风病给流动和常住麻风病患者都带来了沉重的经济负担,政府的政策和项目可以大幅减轻这种负担。实施更积极的监测和早期诊断措施将使这两类人群都受益,而流动患者迫切需要劳动保护和医疗保险,为常住患者提供更便捷的医疗服务和社会救助可以大幅减轻麻风病负担。