Economic burden of childhood asthma in children attending a follow-up clinic in a resource-poor setting of Southeast Nigeria

Ughasoro, Maduka Donatus; Eze, Joy N.; Ayuk, Adaeze C; Obumneme-Anyim, Ijeoma; Akubuilo, Uzoamaka C; Oguonu, Tagbo

doi:10.1016/j.prrv.2020.01.001

Cited by 13 publications

(16 citation statements)

References 25 publications

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“…A wealth index based on the household items was used to group the participants into quartiles of lowest, second, third, and highest using a principal component analysis. Catastrophic health expenditure (CHE) was calculated based on health expenditure being more than 40% of non-food expenditure incurred monthly [36,37].…”

Section: Discussionmentioning

confidence: 99%

Direct and Indirect Costs of Non-surgical Treatment for Acute Tonsillitis in Children in Southeast Nigeria

Ughasoro

Akpeh

Echendu

et al. 2021

PharmacoEconomics Open

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Background Acute tonsillitis has become one of the main reasons why children visit healthcare facilities in Nigeria. Presently, there is no information on the costs of its treatment, and this study aimed at determining these costs. Methods The study was conducted in two hospitals located in southeast Nigeria. The information was obtained in two ways: (1) retrospectively from the medical records of children treated for acute tonsillitis over a period of 5 years and (2) cross-sectionally from children who presented with complaints of acute tonsillitis over a period of 7 months. The information obtained was the costs of self-medication and hospital treatment, and the payment mechanisms used to settle these costs. The human capital method approach was used to estimate the indirect cost (loss in productivity) from the caregivers' absenteeism from work. Results The mean costs of self-medication and hospital treatment for acute tonsillitis in children were €3.85 and €13.48, respectively. The indirect cost was €11.31. The mean total cost of treatment of acute tonsillitis was €23.80. The proportion of households that suffered catastrophic health expenditure (CHE) from the treatment of acute tonsillitis was 55 (55%). CHE was highest [22 (91.7%)] in the lowest socio-economic quartile compared to households in the highest quartile [4 (16.7%)], and the difference was statistically significant (p = 0.02). Of the 72 participants whose payment mechanisms were documented, the proportion who paid out of pocket was 53 (73.6%), and 19 (26.4%) used the National Health Insurance Scheme. Conclusion The costs of treatment for children with acute tonsillitis were high, and most of these costs were settled out-ofpocket. The costs for laboratory investigations, drugs, and productivity loss contributed to these high costs. There is a need to cover the costs of non-surgical treatment of acute tonsillitis in social health insurance and improve efforts to increase the coverage of the health insurance scheme.

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Section: Discussionmentioning

confidence: 99%

Direct and Indirect Costs of Non-surgical Treatment for Acute Tonsillitis in Children in Southeast Nigeria

Ughasoro

Akpeh

Echendu

et al. 2021

PharmacoEconomics Open

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“…Remarkably, the cost of childhood bronchial asthma care was catastrophic in 18.2% of the households studied. [54] The high cost of managing childhood bronchial asthma was also reported from developed countries. [55] These costs coupled with indirect and intangible cost (which are often not estimated and not accounted for), make the optimal management of childhood bronchial asthma beyond the reach of the average Nigerian family, if unsubsidised.…”

Section: Childhood Bronchial Asthma and School Absenteeismmentioning

confidence: 96%

“…A recent report of the cost implications of childhood asthma in Nigeria estimated the annual cost of asthma treatment to be USD162.49, with a cumulative national cost of USD 0.16 billion, which makes up 0.002% of the national GDP. [54] The direct cost was estimated to account for 50-80% of the total cost of childhood asthma care. Remarkably, the cost of childhood bronchial asthma care was catastrophic in 18.2% of the households studied.…”

Section: Childhood Bronchial Asthma and School Absenteeismmentioning

confidence: 99%

“…These, coupled with other direct costs of purchase of controller and reliever medications and indirect cost of transportation including intangible cost, make the total cost of adequate management of childhood asthma unaffordable to an average family in Nigeria, if unsubsidised. [54] Stigma and aversion to using of inhalation devices Caregivers often have lots of misconceptions about the nature, diagnosis and management of childhood asthma. [ 60] Parents and caregivers believe their children/wards may be unduly stigmatised, particularly if they are seen with any form of inhalation devices at home and in school.…”

Section: Povertymentioning

confidence: 99%

“…[87,88] This often leads to health financing catastrophe in a bid to meet health demands. [54,88] The management of childhood asthma often impose a huge financial burden on the family particularly if the payment has to be done out-of-pocket and this often leads to seeking alternative medical care in unorthodox and substandard settings. [88] Possible solutions to the challenges…”

Section: Unavailability Of Child-friendly Inhalational Devices and Spmentioning

confidence: 99%

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Childhood Asthma in Nigeria: A Review of the Burden and Challenges of Management

Kuti¹

2020

Ann Health Res

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Bronchial asthma care professionals all over the world are faced with many challenges in managing children with asthma. This narrative review highlights the burden and specific challenges encountered by Nigerian health care professionals in the care of children with bronchial asthma and attempts to suggest ways of overcoming some of these challenges for optimal bronchial asthma care. Electronic search of relevant published articles from year 2000 to date was carried out using appropriate search engines for the following search words and phrases: “asthma in Nigerian children”, “childhood asthma in Nigeria”, “burden of asthma”, “challenges,” “prevalence” and “cost of bronchial asthma care.” The findings revealed that childhood bronchial asthma was reported in all the geo-political zones of the country with evidence of increasing prevalence and male preponderance. Higher prevalence rates were reported in urban settings compared to rural settings and intermittent asthma was the most frequently reported form of the disease in Nigeria. Allergic rhinitis, with or without conjunctivitis were the most common co-morbidities, while respiratory tract infections, exposure to dust and physical exercise were the common triggers. Bronchial asthma was reported to affect school attendance, family finances and the quality of life of children and their caregivers. Reported challenges of childhood bronchial asthma in Nigeria included ignorance, poverty, stigma and poor adherence to medications by affected children and caregivers; inadequate work force and suboptimal knowledge of various cadres of health workers and poor health system as well as little or no availability of standard asthma care facilities at all levels of health care in Nigeria. Awareness creation, routine training and re-training of all cadres of health workers, provision of basic asthma care facilities and revamping of the health system may assist in overcoming the challenges.

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The availability, cost, and affordability of essential medicines for asthma and COPD in low-income and middle-income countries: a systematic review

Stolbrink

Thomson

Hadfield

et al. 2022

The Lancet Global Health

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Economic burden of childhood asthma in children attending a follow-up clinic in a resource-poor setting of Southeast Nigeria

Cited by 13 publications

References 25 publications

Direct and Indirect Costs of Non-surgical Treatment for Acute Tonsillitis in Children in Southeast Nigeria

Direct and Indirect Costs of Non-surgical Treatment for Acute Tonsillitis in Children in Southeast Nigeria

Childhood Asthma in Nigeria: A Review of the Burden and Challenges of Management

The availability, cost, and affordability of essential medicines for asthma and COPD in low-income and middle-income countries: a systematic review

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