02863nas a2200229   4500000000100000008004100001653003900042653001700081653001500098653002300113653001400136653002000150653001000170100001500180700001300195245011700208856008200325300000800407490000700415520219700422022001402619       2013                            d10aNeglected tropical diseases (NTDs)10aBuruli ulcer10aHouseholds10aOutpatient clinics10aIsolation10aCost of Illness10aGhana1 aAmoakoh HB1 aAikins M00aHousehold cost of out-patient treatment of Buruli ulcer in Ghana: a case study of Obom in Ga South Municipality.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029088/pdf/1472-6963-13-507.pdf  a5070 v133 a<p><strong>BACKGROUND: </strong>The economic burden of diseases has become increasingly relevant to policy makers as healthcare expenditure keep rising in the face of limited and competing resources. Buruli ulcer (BU), a neglected but treatable tropical disease caused by Mycobacterium ulcerans, the only known environmental mycobacterium is capable of causing long term disability when left untreated. However, most BU studies have tended to focused on its bacteriology, epidemiology, entomology and other social determinants to the neglect of its economic evaluation. This paper reports estimated the household economic costs of BU and describe the intangible cost suffered by BU patients in an endemic area.</p>

<p><strong>METHODS: </strong>Retrospective one year cost data was used. A total of 63 confirmed BU cases were randomly sampled for the study. Economic cost and cost burden of BU were estimated. Sensitivity analysis was conducted to test the robustness of the cost estimates. Intangible cost measured stigmatization, pain, functional limitation and social isolation of children.</p>

<p><strong>RESULTS: </strong>The annual total household economic cost was US$35,915.98, of which about 65% was cost incurred by children with a mean cost of US$521.04. The mean annual household cost was US$570.09. The direct cost was 96% of the total cost. Non-medical cost accounts for about 97% of the direct cost with a mean cost of US$529.27. The mean medical cost was US$18.94. The main cost drivers of the household costs were transportation (78%) and food (12%). Caregivers and adult patients lost a total of 535 productive days seeking care, which gives an indirect cost valued at US$1,378.67 with a mean of US$21.88. A total of 365 school days (about 1&nbsp;year) were lost by 19 BU patients (mean, 19.2&nbsp;days). Functional loss and pain were low, and stigma rated moderate. Most children suffering from BU (84%) were socially isolated.</p>

<p><strong>CONCLUSION: </strong>Household cost burden of out-patient BU ulcer treatment was high. Household cost of BU is therefore essential in the design of its intervention. BU afflicted children experience social isolation.</p>
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