Department of Health Care Management, Technische Universität Berlin, Berlin, Germany.
Policy and Economic Research, International Vaccine Institute, Seoul, The Republic of Korea.
BMJ Open. 2022 Jun 1;12(6):e052337. doi: 10.1136/bmjopen-2021-052337.
Cholera remains a significant contributor to diarrhoeal illness, especially in sub-Saharan Africa. Few studies have estimated the cost of illness (COI) of cholera in Malawi, a cholera-endemic country. The present study estimated the COI of cholera in Nsanje, southern Malawi, as part of the Cholera Surveillance in Malawi (CSIMA) programme following a mass cholera vaccination campaign in 2015.
Patients ≥12 months of age who were recruited as part of CSIMA were invited to participate in the COI survey. The COI tool captured household components of economic burden, including direct medical and non-medical costs, and indirect lost productivity costs.
Between April 2016 and March 2020, 40 cholera cases were enrolled in the study, all of whom participated in the COI survey. Only two patients had any direct medical costs and five patients reported lost wages due to illness. The COI per patient was US$14.34 (in 2020), more than half of which was from direct non-medical costs from food, water, and transportation to the health centre.
For the majority of Malawians who struggle to subsist on less than US$2 a day, the COI of cholera represents a significant cost burden to families. While cholera treatment is provided for free in government-run health centres, additional investments in cholera control and prevention at the community level and financial support beyond direct medical costs may be necessary to alleviate the economic burden of cholera on households in southern Malawi.
霍乱仍然是腹泻病的一个重要病因，尤其是在撒哈拉以南非洲地区。在霍乱流行的马拉维，很少有研究估计过霍乱的疾病负担（COI）。本研究是在 2015 年大规模霍乱疫苗接种运动之后，作为马拉维霍乱监测（CSIMA）计划的一部分，在南桑杰地区估计了霍乱的 COI。
作为 CSIMA 的一部分招募的年龄≥12 个月的患者被邀请参加 COI 调查。COI 工具记录了家庭经济负担的组成部分，包括直接医疗和非医疗费用以及间接生产力损失费用。
在 2016 年 4 月至 2020 年 3 月期间，研究共纳入了 40 例霍乱病例，所有患者均参加了 COI 调查。只有两名患者有任何直接医疗费用，五名患者因疾病而报告了工资损失。每位患者的 COI 为 14.34 美元（2020 年），其中超过一半来自食品、水和前往医疗中心的交通等直接非医疗费用。
对于那些每天生活费不足 2 美元的马拉维人来说，霍乱的 COI 给家庭带来了巨大的经济负担。虽然政府运营的医疗中心免费提供霍乱治疗，但可能需要在社区层面进一步投资于霍乱控制和预防，并提供直接医疗费用以外的经济支持，以减轻马拉维南部家庭的霍乱经济负担。
