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喀麦隆西北地区象皮病和麻风病对患者家庭经济成本的对比分析。

A Comparative Analysis of Economic Cost of Podoconiosis and Leprosy on Affected Households in the Northwest Region of Cameroon.

机构信息

Research Foundation in Tropical Diseases and Environment, Buea, Cameroon.

Epidemiology and Control of Infectious Diseases, Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.

出版信息

Am J Trop Med Hyg. 2018 Apr;98(4):1075-1081. doi: 10.4269/ajtmh.17-0931. Epub 2018 Feb 15.

Abstract

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.

摘要

麻风病和足菌肿(足病)是被忽视的热带病,会导致严重的毁容和残疾,并可能导致灾难性的健康支出,阻碍患者和家庭的经济发展。本研究比较了喀麦隆西北地区(N.W.R.)受影响家庭和未受影响的邻近家庭的这两种疾病的经济成本。采用匹配的对照性横断面设计,从 N.W.R. 的三个卫生区招募了 170 户家庭(43 例足病病例家庭、41 例足病对照家庭、43 例麻风病病例家庭和 43 例麻风病对照家庭)。足病的直接治疗费用平均为 142 美元(USD),而麻风病则为零(<0.001)。这也反映在家庭年收入的消耗比例上(分别为 0.4 和 0.0,<0.001)。这两种疾病都导致了大量的工作日减少(麻风病为 115 天,足病为 135 天,<0.001)。与未受影响的家庭相比,足病患者的家庭平均收入明显较低(410 美元对 913 美元, = 0.01),而麻风病患者的家庭收入与未受影响的家庭相当(329 美元对 399 美元, = 0.23)。麻风病和足病都会给受影响的家庭带来经济负担,但足病患者的家庭负担要大得多。这些负担来自直接的治疗费用和工作能力的降低。改善足病的公共卫生干预措施的获得,包括预防、发病管理和残疾预防,可能会给受影响的家庭带来经济回报。在喀麦隆,一种方法是通过为这些经济弱势群体的家庭提供补贴医疗保险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8180/5928838/ee71a70129ee/tpmd170931f1.jpg

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