Article (Scientific journals)
Care-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of Congo
Kayiba, N.K.; Yobi, D.M.; Devleesschauwer, B. et al.
2021In Malaria Journal, 20 (1)
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Keywords :
Cost-of-illness; Democratic Republic of Congo; Health-related quality of life; Malaria; National Malaria Control Programme; adolescent; article; body weight; controlled study; Democratic Republic Congo; European Quality of Life 5 Dimensions 3 Level questionnaire; female; health insurance; human; major clinical study; malaria control; male; quality of life; relative; rural area; sensitivity analysis; uncertainty; visual analog scale; adult; aged; child; cost of illness; cross-sectional study; economics; infant; malaria; middle aged; newborn; parasitology; patient attitude; preschool child; psychology; socioeconomics; very elderly; young adult; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Cost of Illness; Cross-Sectional Studies; Democratic Republic of the Congo; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Patient Acceptance of Health Care; Socioeconomic Factors; Young Adult
Abstract :
[en] Background: This study aimed to estimate the socio-economic costs of uncomplicated malaria and to explore health care-seeking behaviours that are likely to influence these costs in the Democratic Republic of Congo (DRC), a country ranked worldwide as the second most affected by malaria. Methods: In 2017, a cross-sectional survey included patients with uncomplicated malaria in 64 healthcare facilities from 10 sentinel sites of the National Malaria Control Programme (NMCP) in the DRC. A standard questionnaire was used to assess health care-seeking behaviours of patients. Health-related quality of life (HRQL) and disutility weights (DW) of illness were evaluated by using the EuroQol Group’s descriptive system (EQ-5D-3L) and its visual analogue scale (EQ VAS). Malaria costs were estimated from a patient’s perspective. Probabilistic sensitivity analyses (PSA) evaluated the uncertainty around the cost estimates. Generalized regression models were fitted to assess the effect of potential predictive factors on the time lost and the DW during illness. Results: In total, 1080 patients (age: 13.1 ± 14 years; M/F ratio: 1.1) were included. The average total costs amounted to US$ 36.3 [95% CI 35.5–37.2] per malaria episode, including US$ 16.7 [95% CI 16.3–17.1] as direct costs and US$ 19.6 [95% CI 18.9–20.3] indirect costs. During care seeking, economically active patients and their relatives lost respectively 3.3 ± 1.8 and 3.4 ± 2.1 working days. This time loss occurred mostly at the pre-hospital stage and was the parameter associated the most with the uncertainty around malaria cost estimates. Patients self-rated an average 0.36 ± 0.2 DW and an average 0.62 ± 0.3 EQ-5D index score per episode. A lack of health insurance coverage (896 out of 1080; 82.9%) incurred substantially higher costs, lower quality of life, and heavier DW while leading to longer time lost during illness. Residing in rural areas incurred a disproportionally higher socioeconomic burden of uncomplicated malaria with longer time lost due to illness and limited access to health insurance mechanisms. Conclusion: Uncomplicated malaria is associated with high economic costs of care in the DRC. Efforts to reduce the cost-of-illness should target time lost at the pre-hospital stage and social disparities in the population, while reinforcing measures for malaria control in the country. © 2021, The Author(s).
Disciplines :
Laboratory medicine & medical technology
Author, co-author :
Kayiba, N.K.;  Research Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium, School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic Congo, School of Public Health, Faculty of Medicine, University of Mbujimayi, Mbujimayi, Democratic Republic Congo
Yobi, D.M.;  Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic Congo
Devleesschauwer, B.;  Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium, Department of Veterinary Public Health and Food Safety, Ghent University, Ghent, Belgium
Mvumbi, D.M.;  Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic Congo, Department of Quality of Laboratories, Sciensano, Brussels, Belgium
Kabututu, P.Z.;  Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic Congo
Likwela, J.L.;  National Malaria Control Programme, Kinshasa, Democratic Republic Congo
Kalindula, L.A.;  National Malaria Control Programme, Kinshasa, Democratic Republic Congo
De Mol, Patrick ;  Université de Liège - ULiège > Département des sciences biomédicales et précliniques
Hayette, Marie-Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de microbiologie clinique
Mvumbi, G.L.;  Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic Congo
Lusamba, P.D.;  School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic Congo
Beutels, P.;  Centre for Health Economics Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
Rosas-Aguirre, A.;  Research Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
Speybroeck, N.;  Research Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
More authors (4 more) Less
Language :
English
Title :
Care-seeking behaviour and socio-economic burden associated with uncomplicated malaria in the Democratic Republic of Congo
Publication date :
2021
Journal title :
Malaria Journal
eISSN :
1475-2875
Publisher :
BioMed Central Ltd
Volume :
20
Issue :
1
Peer reviewed :
Peer Reviewed verified by ORBi
Funding text :
This study was funded by the Belgian Cooperation Agency through the ARES (Académie de Recherche et d’Enseignement Supérieur).
Available on ORBi :
since 21 October 2022

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