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Change in economic burden of diarrhoea in children under-five in Bangladesh : 2007 vs. 2018

Sin, May Phyu LU orcid ; Hasan, Md Zahid and Forsberg, Birger C (2023) In Journal of Global Health 13. p.1-12
Abstract

BACKGROUND: In Bangladesh, diarrhoea in children under-five is a major public health problem with cost implications. Although under-five diarrhoea mortality and morbidity have declined from 2007 to 2018, change in the economic burden is unknown. This study determined the change in the societal economic burden of under-five diarrhoea in Bangladesh comparing 2007 to 2018.

METHODS: A prevalence-based, retrospective cost analysis was conducted from a societal perspective, including costs to households, providers, and economic loss from premature deaths. Data were obtained from the previous cost of illness studies, government reports, and international databases. Direct costs for treatment were estimated by the bottom-up costing... (More)

BACKGROUND: In Bangladesh, diarrhoea in children under-five is a major public health problem with cost implications. Although under-five diarrhoea mortality and morbidity have declined from 2007 to 2018, change in the economic burden is unknown. This study determined the change in the societal economic burden of under-five diarrhoea in Bangladesh comparing 2007 to 2018.

METHODS: A prevalence-based, retrospective cost analysis was conducted from a societal perspective, including costs to households, providers, and economic loss from premature deaths. Data were obtained from the previous cost of illness studies, government reports, and international databases. Direct costs for treatment were estimated by the bottom-up costing approach. Indirect costs on the loss of productivity of caretakers and loss from premature deaths were calculated by the human capital method. Total costs were presented in both local currency (Bangladeshi Taka (BDT)) and US dollars (US$)) in 2018 price. Sensitivity analyses were conducted to assess the robustness of the input parameters.

RESULTS: A 36.4% reduction was found on the economic burden of under-five diarrhoea when comparing 2007 and 2018; US$1 209 million (95% CI = 1066 million-1299 million) for 2007 and US$769 million (95% CI = 484 million-873 million) for 2018. Economic loss from premature deaths imposed the highest costs (2007 = 66%, 2018 = 66% of all) followed by indirect costs on the loss of productivity of caretakers (2007 = 21%, 2018 = 26%) and direct medical costs (2007 = 13%, 2018 = 8%).

CONCLUSIONS: Societal costs from diarrhoeal diseases were reduced from 2007 to 2018 in Bangladesh. However, the economic burden was equivalent to 0.29% of country's gross domestic product in 2018 and remains a challenge. The major contributor to the costs was premature mortality from diarrhoeal diseases. Premature deaths are still prevalent though they to a large extent are avoidable. To further limit the economic burden, under-five diarrhoea mortality and morbidity reduction should be accelerated.

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author
; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cost of illness, Child, Bangladesh/epidemiology, Mortality, Premature, Diarrhea
in
Journal of Global Health
volume
13
article number
04089
pages
1 - 12
publisher
Edinburgh University Global Health Society
external identifiers
  • scopus:85168737313
  • pmid:37622687
ISSN
2047-2986
DOI
10.7189/jogh.13.04089
language
English
LU publication?
no
additional info
Copyright © 2023 by the Journal of Global Health. All rights reserved.
id
945cc57f-0a0c-4c94-96ae-684f4d9409d1
date added to LUP
2024-09-12 10:09:31
date last changed
2024-09-13 04:02:50
@article{945cc57f-0a0c-4c94-96ae-684f4d9409d1,
  abstract     = {{<p>BACKGROUND: In Bangladesh, diarrhoea in children under-five is a major public health problem with cost implications. Although under-five diarrhoea mortality and morbidity have declined from 2007 to 2018, change in the economic burden is unknown. This study determined the change in the societal economic burden of under-five diarrhoea in Bangladesh comparing 2007 to 2018.</p><p>METHODS: A prevalence-based, retrospective cost analysis was conducted from a societal perspective, including costs to households, providers, and economic loss from premature deaths. Data were obtained from the previous cost of illness studies, government reports, and international databases. Direct costs for treatment were estimated by the bottom-up costing approach. Indirect costs on the loss of productivity of caretakers and loss from premature deaths were calculated by the human capital method. Total costs were presented in both local currency (Bangladeshi Taka (BDT)) and US dollars (US$)) in 2018 price. Sensitivity analyses were conducted to assess the robustness of the input parameters.</p><p>RESULTS: A 36.4% reduction was found on the economic burden of under-five diarrhoea when comparing 2007 and 2018; US$1 209 million (95% CI = 1066 million-1299 million) for 2007 and US$769 million (95% CI = 484 million-873 million) for 2018. Economic loss from premature deaths imposed the highest costs (2007 = 66%, 2018 = 66% of all) followed by indirect costs on the loss of productivity of caretakers (2007 = 21%, 2018 = 26%) and direct medical costs (2007 = 13%, 2018 = 8%).</p><p>CONCLUSIONS: Societal costs from diarrhoeal diseases were reduced from 2007 to 2018 in Bangladesh. However, the economic burden was equivalent to 0.29% of country's gross domestic product in 2018 and remains a challenge. The major contributor to the costs was premature mortality from diarrhoeal diseases. Premature deaths are still prevalent though they to a large extent are avoidable. To further limit the economic burden, under-five diarrhoea mortality and morbidity reduction should be accelerated.</p>}},
  author       = {{Sin, May Phyu and Hasan, Md Zahid and Forsberg, Birger C}},
  issn         = {{2047-2986}},
  keywords     = {{Cost of illness; Child; Bangladesh/epidemiology; Mortality, Premature; Diarrhea}},
  language     = {{eng}},
  month        = {{08}},
  pages        = {{1--12}},
  publisher    = {{Edinburgh University Global Health Society}},
  series       = {{Journal of Global Health}},
  title        = {{Change in economic burden of diarrhoea in children under-five in Bangladesh : 2007 vs. 2018}},
  url          = {{http://dx.doi.org/10.7189/jogh.13.04089}},
  doi          = {{10.7189/jogh.13.04089}},
  volume       = {{13}},
  year         = {{2023}},
}