scholarly journals Economic burden and mental health of primary caregivers of perinatally HIV infected adolescents from Kilifi, Kenya

2019 ◽  
Author(s):  
Patrick V Katana ◽  
Amina Abubakar ◽  
Moses K. Nyongesa ◽  
Derrick Ssewanyana ◽  
Paul Mwangi ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Economic Burden ◽  
Primary Caregivers ◽  
Indirect Costs ◽  
Direct Costs ◽  
Economic Costs ◽  
Direct And Indirect Costs ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background: Eighty per cent of perinatally HIV infected (PHI) adolescents live in sub-Saharan Africa (SSA), a setting also characterized by huge economic disparities. Caregiving is crucial to the management of chronic illness such as HIV/AIDS, but the economic costs and mental disorders borne by caregivers of PHI adolescents often go unnoticed. In this study, we evaluated economic costs, coping strategies and association between economic cost and mental health functioning of caregivers of perinatally HIV infected adolescents in Kilifi, Kenya. Methods: We used a cost of illness descriptive analysis approach and mental health was assessed using the Patient Health Questionnaire (PHQ-9). Cross-sectional data were collected from 121 primary caregivers of PHI adolescents in Kilifi using a structured cost questionnaire. Economic costs (direct costs and indirect costs) were measured from primary caregivers’ perspective. We used descriptive statistics in reporting the results of this study. Results: Average monthly direct and indirect costs per primary caregiver was Ksh 2,784.51 (USD 27.85). Key drivers of direct costs were transportation (66.5%) and medications (13.8%). Total monthly costs represented 28.8% of the reported caregiver monthly earnings. Majority of the caregivers borrowed resources to cope with high economic burden. About 10.7% of primary caregivers reported depressive symptoms. Caregivers with positive depression screen (PHQ-9 score ≥10) had high average monthly direct and indirect costs. However, this was not statistically different compared to costs incurred by caregivers who screened negative for depressive symptoms. Conclusion: Our study indicates that HIV/AIDS is associated with a significant economic burden for caregivers of adolescents living with HIV. These high economic burdens seem to negatively influence the mental health of caregivers of adolescents living with HIV. Results underscore the need for developing economic empowerment and social support programmes that reduce the economic burden of caring for perinatally infected adolescent. These efforts may improve the mental health and quality of life of caregivers of adolescents living with HIV.

scholarly journals Economic burden and mental health of primary caregivers of perinatally HIV infected adolescents from Kilifi, Kenya

2020 ◽  
Author(s):  
Patrick V Katana ◽  
Amina Abubakar ◽  
Moses K. Nyongesa ◽  
Derrick Ssewanyana ◽  
Paul Mwangi ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Economic Burden ◽  
Primary Caregivers ◽  
Indirect Costs ◽  
Sub Saharan Africa ◽  
Economic Costs ◽  
Direct And Indirect Costs ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background: Eighty per cent of perinatally HIV infected (PHI) adolescents live in sub-Saharan Africa (sSA), a setting also characterized by huge economic disparities. Caregiving is crucial to the management of chronic illness such as HIV/AIDS, but the economic costs and mental disorders borne by caregivers of PHI adolescents often go unnoticed. In this study, we evaluated economic costs, coping strategies and association between economic cost and mental health functioning of caregivers of perinatally HIV infected adolescents in Kilifi, Kenya. Methods: We used a cost of illness descriptive analysis approach to determine the economic burden and Patient Health Questionnaire (PHQ-9) to assess the caregivers’ mental health. Cross-sectional data were collected from 121 primary caregivers of PHI adolescents in Kilifi using a structured cost questionnaire. Economic costs (direct and indirect costs) were measured from primary caregivers’ perspective. We used descriptive statistics in reporting the results of this study. Results: Average monthly direct and indirect costs per primary caregiver was Ksh 2,784.51 (USD 27.85). Key drivers of direct costs were transportation (66.5%) and medications (13.8%). Total monthly costs represented 28.8% of the reported caregiver monthly earnings. Majority of the caregivers borrowed resources to cope with high economic burden. About 10.7% of primary caregivers reported depressive symptoms. Caregivers with positive depression screen (PHQ-9 score ≥10) had high average monthly direct and indirect costs. However, this was not statistically different compared to costs incurred by caregivers who screened negative for depressive symptoms. Conclusion: Our study indicates that HIV/AIDS is associated with a significant economic burden for caregivers of adolescents living with HIV. Results underscore the need for developing economic empowerment and social support programmes that reduce the economic burden of caring for perinatally infected adolescent. These efforts may improve the mental health and quality of life of caregivers of adolescents living with HIV.

scholarly journals Economic Burden of HIV/AIDS Infection in Iran; a Modelling Approach

2020 ◽  
Author(s):  
Hesam Ghiasvand ◽  
Jebreil Shamseddin ◽  
Akbar Biglarian
Keyword(s):  
Economic Burden ◽  
Scale Up ◽  
Indirect Costs ◽  
Direct Costs ◽  
Base Case ◽  
Mortality And Morbidity ◽  
Medical Practitioners ◽  
Poor Countries ◽  
The Government ◽  
Hiv Aids

Abstract Background HIV/AIDS infection is a leading cause of mortality and morbidity in developing and poor countries. It may potentially lead to economic burden on health system. Prevalence of HIV/AIDS infection in is a debatable issue among researchers, and as our best knowledge, there is lack in economic evidence in this regard in Iran. The purpose of this study is calculating the economic burden of HIV/AIDS infection in Iran in 2016. Methods We used a societal perspective to capture the direct and indirect costs attributed to HIV/AIDS infection in until end of 2016. We used a prevalence model based approach to estimate the costs of the infection in Iran. For developing our model, we used the Iran Ministry of Health National Guideline for Managing of the infection of Iran by health and medical practitioners. We analysed the HIV/AIDS Surveillance System in three base case, optimistic and pessimistic approaches as our sensitivity analysis. Results Total direct costs and indirect costs attributed to the HIV/AIDS infection were 7,946,530 and 1,288,586 US$ until end of 2016. In addition, the total cost is 8,785,116. Conclusions Direct costs form approximately 85% of total costs of HIV/AIDS infection in Iran. However, we should consider that these costs are just for about 14.3% of diagnosed people who are under Antiretroviral Therapy, therefor if the government wants to scale up ART to large proportion of the population, it expectedly will raise.

scholarly journals Economic burden of Huntington’s disease in Peru

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gustavo Silva-Paredes ◽  
Rosa M. Urbanos-Garrido ◽  
Miguel Inca-Martinez ◽  
Danielle Rabinowitz ◽  
Mario R. Cornejo-Olivas
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Economic Burden ◽  
Annual Cost ◽  
Healthcare Costs ◽  
Neurodegenerative Disorder ◽  
Indirect Costs ◽  
Direct Costs ◽  
Cross Sectional ◽  
Direct And Indirect Costs

Abstract Background Huntington’s disease (HD) is a devastating and fatal neurodegenerative disorder that leads to progressive disability, and over time to total dependence. The economic impact of HD on patients living in developing countries like Peru is still unknown. This study aims to estimate the economic burden by estimating direct and indirect costs of Huntington’s disease in Peru, as well as the proportion of direct costs borne by patients and their families. Methods Disease-cost cross-sectional study where 97 participants and their primary caregivers were interviewed using a common questionnaire. Prevalence and human capital approaches were used to estimate direct and indirect costs, respectively. Results The average annual cost of HD reached USD 8120 per patient in 2015. Direct non-healthcare costs represented 78.3% of total cost, indirect costs 14.4% and direct healthcare costs the remaining 7.3%. The mean cost of HD increased with the degree of patient dependency: from USD 6572 for Barthel 4 & 5 (slight dependency and total independency, respectively) to USD 23,251 for Barthel 1 (total dependency). Direct costs were primarily financed by patients and their families. Conclusions The estimated annual cost of HD for Peruvian society reached USD 1.2 million in 2015. The cost impact of HD on patients and their families is very high, becoming catastrophic for most dependent patients, and thus making it essential to prioritize full coverage by the State.

scholarly journals POS0530 HOW DOES MULTIMORBIDITY IMPACT ON THE DIRECT AND INDIRECT COSTS IN PATIENTS WITH RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 498.3-499
Author(s):  
P. H. Hsieh ◽  
C. Geue ◽  
O. Wu ◽  
E. McIntosh
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Rheumatoid Arthritis ◽  
Employment Status ◽  
Functional Disability ◽  
Hospital Admissions ◽  
Information Service ◽  
Indirect Costs ◽  
Direct Costs ◽  
Direct And Indirect Costs ◽  
The Impact

Background:Comorbidities are prevalent in patients with rheumatoid arthritis (RA) and associated with worse outcomes as well as higher economic burden. Little is known about the impact of multimorbidity on the direct and indirect costs of RA. Evidence of the incremental scale of these multimorbidity costs will usefully inform RA interventions and policies.Objectives:The aim of this study was to describe how multimorbidity impacts on the cost-of-illness, including direct and indirect costs, in patients with RA.Methods:The Scottish Early Rheumatoid Arthritis (SERA) is a registry of patients newly presenting with RA since 2011. It contains data on patient characteristics, clinical outcomes, health-related quality of life, and employment status data. These data were linked to routinely recorded hospital admissions and primary care prescribing data. Direct costs were estimated by applying relevant unit costs to healthcare resource use quantities. Indirect cost estimates were obtained from information on employment status and hospital admissions, valued by age and sex specific wages. Two-part models (probit followed by generalized linear model) were used to estimate direct and indirect costs, adjusting for age, gender, and functional disability. The Charlson Comorbidity Index (CCI) score was calculated using patient ICD-10 diagnoses from hospital records. The number of comorbidities was categorized into “RA alone”, “single comorbidity” and “multimorbidity (>1 comorbidity)”.Results:Data were available for 1,150 patients, 65.7% were female and a mean age of 57.5±14 years. The majority of patients only had RA (54.1%), followed by a single comorbidity (23.4%) and multimorbidity (22.5%). Annual total costs were significantly higher for patients with multimorbidity (£6,669 95% CI £4,871-£8,466; OR 11.3 95% CI 8.14-15.87) and for patients with a single comorbidity (£2,075 95% CI £1,559-£2,591; OR 3.52 95% CI 2.61-4.79), when compared with RA alone (£590). The excess costs were mainly driven by direct costs (£6,281 versus £1,875 versus £556). Although the difference in indirect costs between patients with multimorbidity and a single comorbidity were not statistically significant (£1,218 versus £914, p=0.11), patients with multimorbidity were associated with significantly higher costs than those with RA only (£594, p<0.01).Conclusion:The presence of comorbidity contributes significant excess to both direct and indirect costs among RA patients. In particular, patients with multimorbidity incurred substantially higher direct costs than those with a single comorbidity or RA only.Acknowledgements:The study analysed the data from the Scottish Early Rheumatoid Arthritis (SERA) study with a linkage to routinely recorded health data from Information Service Division, National Service Scotland. We would like to thank all the patients, clinical and nursing colleagues who have contributed their time and support to the study, the SERA steering committee for the approval, and Allen Tervit from the Robertson Centre for Biostatistics, University of Glasgow for the timely technical supports.Disclosure of Interests:Ping-Hsuan Hsieh: None declared, Claudia Geue: None declared, Olivia Wu Consultant of: OW has received consultancy fees from Bayer, Lupin and Takeda outside the submitted work., Emma McIntosh: None declared

scholarly journals Cultural and linguistic adaptation of the multi-dimensional OXCAP-MH for outcome measurement of mental health among people living with HIV/AIDS in Uganda: the Luganda version

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Kenneth R. Katumba ◽  
Yoko V. Laurence ◽  
Patrick Tenywa ◽  
Joshua Ssebunnya ◽  
Agata Laszewska ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Care Providers ◽  
English Version ◽  
Validation Process ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background It is rare to find HIV/AIDS care providers in sub-Saharan Africa routinely providing mental health services, yet 8–30% of the people living with HIV have depression. In an ongoing trial to assess integration of collaborative care of depression into routine HIV services in Uganda, we will assess quality of life using the standard EQ-5D-5L, and the capability-based OxCAP-MH which has never been adapted nor used in a low-income setting. We present the results of the translation and validation process for cultural and linguistic appropriateness of the OxCAP-MH tool for people living with HIV/AIDS and depression in Uganda. Methods The translation process used the Concept Elaboration document, the source English version of OxCAP-MH, and the Back-Translation Review template as provided during the user registration process of the OxCAP-MH, and adhered to the Translation and Linguistic Validation process of the OxCAP-MH, which was developed following the international principles of good practice for translation as per the International Society for Pharmacoeconomics and Outcomes Research’s standards. Results The final official Luganda version of the OxCAP-MH was obtained following a systematic iterative process, and is equivalent to the English version in content, but key concepts were translated to ensure cultural acceptability, feasibility and comprehension by Luganda-speaking people. Conclusion The newly developed Luganda version of the OxCAP-MH can be used both as an alternative or as an addition to health-related quality of life patient-reported outcome measures in research about people living with HIV with comorbid depression, as well as more broadly for mental health research.

scholarly journals Mapping evidence on the distribution of the costs associated with cancer of prostate, cervix, and female breast in the sub-Saharan Africa: protocol for a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Cebisile Ngcamphalala ◽  
Ellinor Ostensson ◽  
Mbuzeleni Hlongwa ◽  
Themba G. Ginindza
Keyword(s):  
Systematic Reviews ◽  
Scoping Review ◽  
Economic Burden ◽  
Indirect Costs ◽  
Economic Consequences ◽  
Sub Saharan Africa ◽  
Breast Cancers ◽  
Direct And Indirect Costs ◽  
Female Breast ◽  
Sub Saharan

Abstract Background Despite the well-documented information on cancer prevention and management, among noncommunicable diseases (NCDs), globally, cancer continues to be the second leading cause of morbidity and mortality with devastating economic consequences. The burden is disproportionately more among developing countries and the extent of evidence available on the economic consequences (direct and indirect costs) of cancer remains unknown in low-income countries particularly in the sub-Saharan region. Understanding the costs of illness is important to inform decision-making on setting up health care policies and informing economic evaluation of interventions. This study aims to map evidence on the distribution of the economic burden (direct and indirect costs) associated with prevention, diagnosis, and treatment of three predominant cancers: prostate, cervix, and female breast in the sub-Saharan Africa. Methods This scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR), and will be conducted following Arksey and O’Malley’s framework. We will search PubMed/MEDLINE, Web of Science, CINHAL (via EBSCOhost platform), Science Direct, Cochrane Database of Systematic Reviews, Africa-Wide Information, Google Scholar, and WHO Library. We will perform hand-searching of the reference lists of included studies and other relevant documents. Two reviewers will independently screen all citations, full-text articles, and abstract data. We will include primary studies from all study designs reporting costs associated with prevention, diagnosis and treatment of prostate, cervical, and breast cancers in the sub-Saharan region. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., thematic analysis) methods. A narrative summary of findings will be presented. Discussion This review will map the extent of information available on the economic burden (direct and indirect costs) of prostate, cervical, and breast cancers in the sub-Saharan region. Further guidance for future research in the subject area will be discussed. Systematic review registration Open Science Framework

Comparative analysis of the economic costs of treating patients with non-infectious diseases of internal osteosynthesis

2020 ◽  
Vol 22 (4) ◽  
pp. 156-160
Author(s):  
V. V. Khominets ◽  
V. Yu. Tegza ◽  
I. V. Foos ◽  
E. M. Pugaev
Keyword(s):  
Comparative Analysis ◽  
Indirect Costs ◽  
Infectious Complications ◽  
Long Bones ◽  
Economic Costs ◽  
Direct And Indirect Costs ◽  
Military Medical Academy ◽  
Limb Fractures ◽  
Primary Osteosynthesis ◽  
The Military

A comparative analysis of the economic costs of revision surgical treatment of 121 patients with non-infectious complications of internal osteosynthesis and 59 patients who underwent primary osteosynthesis for fractures of the long bones of the limbs with an uncomplicated course was carried out. General economic costs include direct and indirect costs. It was found that the total costs for the treatment of patients suffering from non-infectious complications of internal osteosynthesis of the long bones of the extremities, who are in the clinic of military traumatology and orthopedics. G.I. Turner of the Military Medical Academy in the period from 2007 to 2018 revision surgery was performed, amounted to 279637238 rubles, which corresponds to 2311051,55 rubles per patient. At the same time, the total costs for the treatment of patients with fractures of the long bones of the extremities without complications amounted to 44960873 rubles (762048,69 rubles per patient). The total cost per patient with a non-infectious complication of internal osteosynthesis of the femur was 2540499,54 rubles (483824,85 straight, 2056674,69 indirect), of the leg bones 2333762,17 rubles (474501,47 straight, 1859260,70 indirect), the humerus 1830362,75 rubles (399942 straight, 1430420,75 indirect), the bones of the forearm 1804664,6 rubles (339700 straight, 1464964,6 indirect). It was revealed that due to failures after primary osteosynthesis of limb fractures and complications, the costs associated with the direct and indirect costs of their treatment increase. In this regard, further research is needed to improve the treatment of complications of internal osteosynthesis and to develop a set of measures for their prevention. This is important both for the patient and for the health care system as a whole.

scholarly journals Economic Burden Associated with Head Louse (Pediculus humanus capitis) Infestation in Iran

2020 ◽  
Author(s):  
Mojtaba SALIMI ◽  
Abedin SAGHAFIPOUR ◽  
Hadi HAMIDI PARSA ◽  
Majid KHOSRAVI
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Economic Burden ◽  
Head Louse ◽  
Indirect Costs ◽  
Head Lice ◽  
Louse Infestation ◽  
Direct And Indirect Costs ◽  
Head Louse Infestation ◽  
Care System

Background: The head louse infestation is a public health issue in the world especially, affecting most people who live in camps, school-aged children and their families. Head lice treatment has economic ramifications that often under calculated. The aim of this study was evaluation of economic burden associated with head louse infestation in Iran. Methods: In a cross-sectional study, 500,002 infestations were diagnosed among suspected head lice infested people who referred to health care system in all provinces of Iran during 2017. Direct and indirect costs related to paid by patients and government systems were extracted by referring to accounting documents and interviews with patients and experts and were recorded in researcher-made forms. Microsoft Excel 2010 software was used for economic burden calculation. Results: The incidence rate of head lice infestation in Iran was 500,002/79,926,270 (625.5 per 100,000 populations). Economic burden of head lice in the country was calculated at 5,790,143$. Direct and indirect costs, governmental cost, out of pocket and total costs of head lice were included 3.14$, 2.84$, 5.98$, 5.60$ and 11.58$ per case respectively. Conclusion: The direct and indirect costs associated with treatment of infestations were relatively high. Therefore, the creation of medical facilities such as availability of diagnostic and treatment strategies can be effective in the control of infestation. The adoption of infestation prevention methods, such as health education to people at risk of infestation, reduces the incidence of head lice and imposition of related treatment costs on governmental health care system and head lice cases.

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