Cost of diarrhoea: a household perspective from seven countries in the Global Enteric Multicentre Study (GEMS)
Abstract
Background The burden of diarrhoeal diseases is considerable in South Asia, as well as in sub-Saharan Africa. Its economic impact is more profound in resource-limited settings like low-income and middle-income countries (LMICs). In this study, we aimed to estimate the direct and indirect costs reported by the caregivers of participants from seven LMICs. Methods The current study is a secondary analysis using data from the multicentre, Global Enteric Multicentre Study, which enrolled under-5 children. This prospective case–control study was conducted in seven sites, all of which were in LMICs. After adjustment for inflation, cost data were collected from the caregivers and converted into international dollar (I$). Quantile regression models were developed after adjusting for age, sex and country. Results This study analysed data from 4592 participants. The median (IQR) total direct cost (TDC) and total indirect cost (TIC) were I$8.4 (I$11.0) and I$10.2 (I$14.3), respectively. Statistically significant differences were found across continents for multiple variables. The highest median TDC and TIC were in Bangladesh (I$13.6 and I$23.2, respectively), while mozambique reported the lowest (I$0.4 and I$4.9, respectively), with medication accounting for 60.9% of TDC. Quantile regression analysis showed TDC was positively associated with factors like family size, urban residence, moderate-to-severe disease, caregiver education and use of rehydration methods, while treated drinking…
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