02558nas a2200421   4500000000100000008004100001653001700042653002000059653002100079653001800100653002700118653001200145100001400157700001100171700001300182700001200195700001500207700001200222700001300234700001500247700001300262700001600275700001200291700001500303700001700318700001400335700001400349700001500363700001200378700001300390700001400403245010100417856006200518300001200580490000600592520152400598022001402122       2017                            d10aBuruli ulcer10aCost of Illness10aHealth economics10aIllness costs10aMycobacterium ulcerans10aNigeria1 aChukwu JN1 aMeka A1 aNWAFOR C1 aOshi DC1 aMADICHIE N1 aEkeke N1 aAnyim MC1 aChukwuka A1 aObinna M1 aAdegbesan J1 aNjoku M1 aSoyinka FO1 aAdelokiki AO1 aEnemuoh I1 aOkolie PI1 aEdochie JE1 aOffor J1 aUshaka J1 aUkwaja KN00aFinancial burden of health care for Buruli ulcer patients in Nigeria: the patients' perspective.  uhttps://academic.oup.com/inthealth/article/9/1/36/2701616  a36–430 v93 a<p><strong>BACKGROUND: </strong>The economic burden of Buruli ulcer for patients has not been well-documented. This study assessed the costs of Buruli ulcer care to patients from the onset of illness to diagnosis and to the end of treatment.</p>

<p><strong>METHODS: </strong>This was a cross-sectional cost of illness study conducted among patients with Buruli ulcer in four States in Nigeria between July and September 2015. A structured questionnaire was used to collect data on the patients' characteristics, household income and out-of-pocket costs of care.</p>

<p><strong>RESULTS: </strong>Of 92 patients surveyed, 54 (59%) were older than 15years, 49 (53%) were males, and 86 (93%) resided in a rural area. The median (IQR) direct medical and non-medical cost per patient was US$124 (50-282) and US$3 (3-6); corresponding to 149% and 4% of the patients' median monthly household income, respectively. The overall direct costs per patient was US$135 (58-327), which corresponded to 162% of median monthly household income, with pre-diagnosis costs accounting for 94.8% of the total costs. The direct costs of Buruli ulcer care were catastrophic for 50% of all patients/households - the rates of catastrophic costs for Buruli ulcer care was 66% and 19% for patients belonging to the lowest and highest income quartiles, respectively.</p>

<p><strong>CONCLUSIONS: </strong>Direct costs of Buruli ulcer diagnosis and treatment are catastrophic to a substantial proportion of patients and their families.</p>
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