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乌干达北部受点头综合征影响家庭中照顾者持续性发病的经济负担。

Economic burden of the persistent morbidity of nodding syndrome on caregivers in affected households in Northern Uganda.

机构信息

School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.

Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan.

出版信息

PLoS One. 2020 Sep 29;15(9):e0238643. doi: 10.1371/journal.pone.0238643. eCollection 2020.

Abstract

BACKGROUND

Nodding syndrome (NS), is an unexplained form of epilepsy which leads to stunted growth, cognitive decline, and a characteristic nodding of the head. Current data about its impact on households in Uganda is scarce. Therefore, this study aims to assess the economic burden of the persistent morbidity of NS on caregivers in affected households in Northern Uganda.

METHODS

A cross-sectional cost-of-care study was conducted from January 2019 to February 2019 in Lakwela village-Northern Uganda in 14 households, who are members of a community-based organization (CBO) established in the village with the support of a Japanese research team, (Uganda-Japan Nodding Syndrome Network). Data was collected through questionnaires. Both direct (medical and non-medical) and indirect (informal care) costs of caregiving were assessed. Indirect costs were valued using the human-capital method as loss of production.

RESULTS

Direct costs constituted a higher proportion of costs for NS households, accounting for on average 7.7% of household expenditure. The annual weighted mean cost per NS patient was estimated at 27.6 USD (26.4 USD direct costs, 96.2% and 1.2 USD indirect cost, 3.8%). Average time spent on informal caregiving was 4.4 ±1.7 (standard deviation) hours/week with an estimated annual informal caregiving cost of 24.85 USD and gross domestic product (GDP) loss of 412.40 USD.

CONCLUSION

Direct costs due to NS are still high among households in this study. More studies are needed to investigate measures that could help bring down these costs and equally reduce the day-to-day disruption of caregiver's activities; consequently, improving the lives of these affected households and communities.

摘要

背景

点头综合征(NS)是一种不明原因的癫痫形式,导致生长迟缓、认知能力下降和特征性点头。目前,关于它对乌干达家庭的影响的数据很少。因此,本研究旨在评估 NS 持续发病对乌干达北部受影响家庭照顾者的经济负担。

方法

2019 年 1 月至 2 月,在乌干达北部的 Lakwela 村进行了一项横断面成本关怀研究,该村是一个社区组织(CBO)的成员,该组织在日本研究团队(乌干达-日本点头综合征网络)的支持下在该村成立。通过问卷调查收集数据。评估了直接(医疗和非医疗)和间接(非正式护理)护理成本。间接成本使用人力资本法进行评估,作为生产损失。

结果

直接成本构成 NS 家庭成本的较高比例,占家庭支出的平均 7.7%。估计每位 NS 患者的年加权平均成本为 27.6 美元(直接成本 26.4 美元,占 96.2%,间接成本 1.2 美元,占 3.8%)。平均每周用于非正式护理的时间为 4.4±1.7 小时(标准差),估计每年的非正式护理成本为 24.85 美元,国内生产总值(GDP)损失为 412.40 美元。

结论

本研究中,NS 引起的直接成本仍然很高。需要更多的研究来调查可以帮助降低这些成本并同样减少照顾者日常活动中断的措施;从而改善这些受影响家庭和社区的生活。

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