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ECONOMIC COST OF TREATMENT OF CHILDHOOD EPILEPSY IN ENUGU, SOUTHEAST NIGERIA

Published online by Cambridge University Press:  26 November 2014

Maduka D. Ughasoro ,
Obinna E. Onwujekwe  and
Ngozika C. Ojinnaka
Maduka D. Ughasoro
Affiliation:
Department of Paediatrics, University of Nigeria Enugu Campus, Nigeria & Health Policy Research Group, University of Nigeria Enugu Campusmaduka.ughasoro@unn.edu.ng
Obinna E. Onwujekwe
Affiliation:
Health Policy Research Group, Department of Pharmacology and Therapeutics, University of Nigeria Enugu Campus Department of Health Administration and Management, University of Nigeria Enugu Campus
Ngozika C. Ojinnaka
Affiliation:
Department of Paediatrics, University of Nigeria Enugu Campus
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Abstract

Objectives: The aim of this study was to determine the economic costs and the level of catastrophic health expenditure (CHE) due to childhood epilepsy.

Methods: The study was conducted at the Paediatric Neurology Clinic of the University of Nigeria Teaching Hospital, Enugu. Data were collected using pre-tested questionnaires that were administered to caregivers of the children. The indirect and direct expenditure due to childhood epilepsy were computed. A 40 percent of monthly non-food expenditure was used to estimate CHE.

Results: The average annual direct and indirect expenditures were USD 162.6 and USD 82.3, respectively. Most of direct costs were drugs (25.4 percent versus 35.3 percent) and investigations (48.7 percent versus 61.3 percent) for out-patient and in-patient, respectively. CHE was 34.1 percent and 63.6 percent for out-patient and in-patient care, respectively. The total annual costs: (direct and indirect), for childhood epilepsy of USD244.9. Considering the estimated 190,000 epileptic children in Nigeria, it will amount to USD46.53 million annually, approximately 0.018 percent of Nigeria Gross Domestic Product (GDP). All payments were made out-of-pocket with no health insurance for financial risk protection.

Conclusions: The cost of treatment of childhood epilepsy is high and catastrophic for many households. There was lack of usage of health financial risk mechanisms. Scale-up use of health financial risk protection mechanisms such as health insurance can reduce the economic burden.

Keywords

Economic costChildhood epilepsyCatastrophic health expenditure
Type
Policies
Information
International Journal of Technology Assessment in Health Care , Volume 30 , Issue 4 , October 2014 , pp. 469 - 474
Copyright
Copyright © Cambridge University Press 2014 

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References

REFERENCES

1. Shinnar, S, Berg, AT, O’Dell, C, et al. Predictors of multiple seizures in a cohort of children prospectively followed from the time of their first unprovoked seizure. Ann Neurol, 2001;48:140–147. doi: 10.1002/1531-8249.3.0.CO;2-Y>CrossRefGoogle Scholar
2. Fisher, RS, van Emde Boas, W, Blume, W, et al. Epileptic seizures and epilepsy: Definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005;46:470–472. doi/ 10.1111/j.0013-9580.2005.66104.x.CrossRefGoogle ScholarPubMed
3. Breman, JG, Campbell, CC. Combating severe malaria in African children. Bull World Health Org. 1988;66:611–620.Google ScholarPubMed
4. The Global Campaign Against Epilepsy. 2000. Information Pack for the launch of the Global Campaign's Second Phase, 12–13 February 2001. Geneva: World Health Organization; 2000.Google Scholar
5. World Health Organization. Epilepsy in the WHO African region: Bridging the gap. Geneva: World Health Organization; 2004.Google Scholar
6. Lagarde, M, Palmer, N. The impact of user fees on health service utilization in low and middle income countries: How strong is the evidence. Bull World Health Org. 2008;86:839–848.CrossRefGoogle ScholarPubMed
7. Onwujekwe, OE, Uzochukwu, BSC. Socio-economic and geographic differentials in costs and payment strategies for primary health care services in Southeast Nigeria. Health Policy. 2005;71:383–397.CrossRefGoogle ScholarPubMed
8. Lagunju, IA, Imam, ZO, Adedokun, BO. Cost of epilepsy in children attending a tertiary centre in Nigeria. Int Health. 2011;3:213–218. CrossRefGoogle ScholarPubMed
9. Ali Abdel, Gabir Ali, Thorbecke, E. The state and path of poverty in Sub-Saharan Africa: Some preliminary results. J Afr Econ. 2000;9:9–40.Google Scholar
10. World Bank. World development indicators. Washington, DC: World Bank; 2003.Google Scholar
11. United Nations Development Programme (UNDP). Human development indicators. New York: United Nations Development Programme; 2001.Google Scholar
12. Ichoku, HE, Fonta, W. The distributive effect of health care financing in Nigeria. PEP Working Paper, 2006 No 2006-17. Canada: University of Laval.Google Scholar
13. Soyibo, A, Lawanson, O, Olaniyan, L. National health accounts of Nigeria, 1998–2002. Final report submitted to World Health Organization, Geneva. Ibadan: University of Ibadan; 2005.Google Scholar
14. Onwujekwe, O, Hanson, K, Uzochukwu, B. Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria. PLoS One 2012;7:e40811. doi: 10.1371/journal.pone.0040811.CrossRefGoogle ScholarPubMed
15. Federal Republic of Nigeria Official Gazette (15 May 2007). Legal notice on publication of the details of the breakdown of the national and state provisional totals 2006 Census (PDF). http://www.nigerianstat.gov.ng/nbsapps/Connections/Pop2006.pdf (assessed April 13, 2013).Google Scholar
16. Nigeria Demographic Profile 2012. http://www.indexmundi.com/nigeria/demographics_profile.html (assessed on April 13, 2013).Google Scholar
17. Center for Disease Control and Prevention, Atlanta, USA. CDC. http://www.cdc.gov (accessed April 14, 2013).Google Scholar
18. Dada, TO. Parasites and epilepsy in Nigeria. Trop Geogr Med. 1970;22:313–322.Google ScholarPubMed
19. Yardim, MS, Cilingiroglu, N, Yardim, N. Catastrophic health expenditure and impoverishment in Turkey. Health Policy. 2010;94:26–33.CrossRefGoogle ScholarPubMed
20. Xu, K, Klavus, J, Kawabata, K, et al. Household health system contributions and capacity to pay. Definitional, empirical and technical challenges. In: Murray, CJL, Evans, DB, eds. Health system performance assessment: Debates, methods and new empiricism. 2003. http://www.who.int/health_financing/documents/hspa_chp39-hh_contrib_ctp.dpf (accessed March 4, 2013).Google Scholar
21. Beukelman, DR, Mirenda, P. Augmentative and alternative communication: Management of severe communication disorders in children and adults (2nd ed.). Baltimore: Paul H Brookes Publishing; 1999:246–249. ISBN 1-55766-333-5.Google Scholar
22. Olusegun, OL, Thomas, IR, Ikorok, MM. Curbing maternal and child mortality: The Nigeria experience. Int J Nurs Midwif. 2012;2;4:33–39.Google Scholar
23. Strzelczyk, A, Reese, JP, Dodel, R, Hamer, HM. Cost of epilepsy: A systematic review. Pharmacoeconomics. 2008;26:463–476.CrossRefGoogle ScholarPubMed
24. Javanbakht, M, Baradaran, HR, Mashayekhi, A, et al. Cost-of-illness analysis of type 2 diabetes mellitus in Iran. PLoS One. 2011;6:e26864. doi: 10.1371/lournal.pone.0026864.CrossRefGoogle ScholarPubMed
25. Estghamati, A, Khalilzadeh, O, Anvari, M, et al. The Economic costs of diabetes: A population-based study in Tehran, Iran. Diadetologia. 2009;52:1520–1527.CrossRefGoogle Scholar
26. Chisholm, D, Saxena, S. Cost-effectiveness of strategies to combat neuropsychiatric conditions in sub-Saharan Africa and South East Asia: Mathematical modeling study. BMJ. 2012;344:e609. doi: 10.1136/bmj.e60.CrossRefGoogle Scholar
27. Gay Frankenfield, RN. Cost of epilepsy higher than previous estimates. WebMD Health News. 2000. http://www.webmd.com/epilepsy/news/20000330/cost-epilepsy-higher-previous-estimate (accessed September 2013).Google Scholar
28. Xu, K, Evans, D, Kawabata, K, et al. Household catastrophic health expenditure: A multi-country analysis. Lancet. 2003;362:111–117.CrossRefGoogle Scholar
29. Gotsadze, G, Zoidze, A, Rukhadze, N. Household catastrophic health expenditure: Evidence from Georgia and its policy implications. BMC Health Serv Res. 2009;9:69. doi: 10.1186/1472-6963-9-69.CrossRefGoogle ScholarPubMed
30. Onoka, CA, Onwujekwe, OE, Hanson, K, Uzochukwu, B. Examining catastrophic health expenditure at variable threshold using household consumption expenditure diaries. Trop Med Int Health. 2011;16:1334–1341. doi: 10.1111/j.1365-3156.2011.02836.x.CrossRefGoogle ScholarPubMed
31. Monye, FN. An Appraisal of the National Health Insurance Scheme of Nigeria. Commonwealth Law Bull. 2006;32:415–422.CrossRefGoogle Scholar
32. Organization of African Unity (OAU). Abuja declaration on HIV/AIDS, tuberculosis, and other related infectious diseases. Abuja: OAU; 2001.Google Scholar
33. WHO. Health financing strategy for Asia Pacific region 2010–2015. Geneva: WHO; 2009.Google Scholar
34. Xu, K, Evans, DB, Carrin, G, Aguilar-Rivera, AM. Designing health financing systems to reduce catastrophic health expenditure. Technical Briefs for Policy Makers no. 2 Geneva: World Health Organization; 2005.Google Scholar
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