Socioeconomic implications of Buruli ulcer in Ghana: a three-year review.

Abstract

Abstract. This study examines some of the socioeconomic cost of treating 102 cases of Buruli ulcer between 1994 and 1996 at the St. Martin's Catholic Hospital in Agroyesum in the Amansie West district of the Ashanti region of Ghana. Seventy percent of the cases were children (up to 15 years of age). There was no sex difference in the distribution of cases. Hospitalization was prolonged (average ϭ 186 days in 1994, 103 days in 1995, and 102 days in 1996) with no significant age and sex differences. There were 10 limb amputations, 12 patients were left with contracture deformities, one patient lost sight in one eye, and two died of sepsis and tetanus. The average total treatment cost per patient was $966.85 (62% indirect) in 1994, $706.08 (75% indirect) in 1995, and $658.74 (79% indirect) in 1996. With increasing number of cases, high treatment costs, and serious complications, urgent attention should be given to the disease in terms of control and research efforts aimed at early detection and treatment.

The socioeconomic burden of Buruli Ulcer disease in the Ga West District of Ghana

“…Further to this, some studies in Ghana and other countries have found the indirect cost of BU to be high; sometimes, even more than half of its total cost (Asiedu & Etuaful, 1998;Stienstra, van der Graaf, Asamoah & van der Werf, 2002;Drummond, Butler & James, 2004;Kofie, Attua and Nabila, 2008). Asiedu and Etuaful (1998) specified with reference to BU in Ghana, that the indirect cost of the disease was up to 79% of the total cost of the disease per patient per year.…”

“…Specific to Ghana, Mumma, Whitney, Dadzie, Etuaful and Ampadu (2003) documented in their study of BU patients, that the disease caused even the affected households that were not poor before the infection, to drift into poverty. Again, studying the socioeconomic cost of treating BU infection on households in Ghana over three years, Asiedu and Etuaful (1998) specified that the direct cost of treating the disease per patient per year was up to an average of $967. Kofie, Attua and Nabila (2008) acknowledge that the disease makes the patients they studied in the Ga West District poor, while Adamba and Owusu (2011) found in the same Ga West District that the BU households they studied got poorer due to the disease and coped by selling tangible family assets and reduced their farm sizes, among other strategies, all of which plunged the study households into further poverty.…”

“…While there is an appreciable amount of information on the economic burden of the disease in Ghana (Asiedu & Etuaful, 1998), there is very little on the social burden, including the burden of stigma that households have to face. The social burden of any disease is intricately linked to the economic burden, and further compounds how households mobilise resources to cope with the burden of the disease.…”

Economic inequality caused by feedbacks between poverty and the dynamics of a rare tropical disease: the case of Buruli ulcer in sub-Saharan Africa

“…Direct non-medical costs associated with treatment (x i ) such as transportation to the health centre and feeding costs are deducted from income for individuals undergoing treatment [21,22,34]. Importantly, when the individuals in the model are renewed (one individual dies and is replaced by a new born), the offspring 'inherits' the physical capital of the individual they replace (their 'parent').…”

“…For individuals under medical treatment, w i ¼ w T and it is associated with hospitalization or daily visits to the healthcare centre that are responsible for the great indirect costs of the disease [21,22,34]. We attribute disabled individuals a reduced human capital, w i ¼ w D , to account for their reduced ability to work and the impact of functional limitations on school abandon and job loss [27,28], which is reinforced by the strong social stigma and mystical beliefs associated with the disease [35,36].…”