The Economic Impact of Cutaneous Leishmaniasis in Sri Lanka

Abstract

Cutaneous leishmaniasis (CL) is a neglected tropical disease which affects mainly the poorest communities in developing countries. Considering the limited published information on economic impact of CL in Sri Lanka, the current study was conducted with the objective of revealing the nature and magnitude of the economic impact of CL in three selected disease endemic regions in Kurunegala District, Sri Lanka. The patient records of CL notified of relevant Medical Officer of Health (MOH) office during 2013- 2016 were obtained. Patient households were visited and data collection was done using an interviewed administered questionnaire. The majority of patients (57%) were economically active at the time of infection. Of them, 65% were the only contributors to household economy. Total median costs including both direct and indirect costs were 66.85 USD (Rs. 10,831) (IQR = 57.26 - 86.78 USD), while total median economic loss to households was 61.27 USD (Rs. 9,927) (IQR= 49.61- 75.04 USD). From provider perspective, total median cost per patient was 22.83 USD (Rs. 3,696). The mean total economic loss was denoted as 65.26 USD (Rs. 10,572) which is about 5.4% of the annual household income and 20.9% of the mean annual per capita income of the study population. Although economic impact of CL infection is not catastrophic according to current interpretation, the infection may have significant economic impacts on households when considering the mean economic loss to household as a percentage of the mean annual per capita income of the population.

Economic impact of localized cutaneous leishmaniasis on adult patients of a referral service in Belo Horizonte, Minas Gerais State, Brazil

“…Transport and food comprised the higher direct non-medical costs; expenses on food were associated with traveled distance for CL diagnosis, which is corroborated by prior studies, that reported an increase in CL expenses due to travel demand 8,14 . The low resolubility of the primary health care of the state of Minas Gerais in caring and managing patients with CL signs, verified by this study, may increase these expenses.…”

“…The participants of this study reported no expenses with hospitalization and caregivers for themselves or their children. In this study, the median total cost with CL was USD 125.38, much higher than that found by an economic evaluation study conducted in Sri Lanka (USD 66.85) 8 . Considering Brazil minimum wage at the period of data collection, equivalent to USD 283.02 (BRL 908.05), CL average monthly cost of USD 133.80 (BRL 429.50) may represent a significant economic loss for patients.…”

“…Yet, some families report significant expenses with leishmaniasis diagnosis and treatment, not covered by their country health systems 7 . A recent study conducted in Sri Lanka reported a mean economic loss for households at completion of CL treatment of USD 76.59, about 5.4% of the annual household income and 20.9% of the mean annual per capita income of the study population 8 .…”

The Diversity of Midgut Bacteria among Wild‐Caught Phlebotomus argentipes (Psychodidae: Phlebotominae), the Vector of Leishmaniasis in Sri Lanka

“…In Sri Lanka, the first indigenous case was identified in 1992, which was of the cutaneous type [24]. At present, more than 2,000 cases have been identified from 2000 to 2009 and nearly 8,487 patients have been recorded during 2009-2016 representing at least one case from all 25 administrative districts [25]. In 2018, the caseload has been increased compared to the past years denoting cases from nonendemic regions.…”

Morphological identification keys for adults of sand flies (Diptera: Psychodidae) in Sri Lanka

“…Later in the period from 2009 to 2016, nearly 8487 cases were notified representing at least one case from all 25 districts of the country. Some districts had an increasing trend of the disease prevalence with more than 100 new cases each year [14,15]. Therefore, more attention was drawn toward diagnostic, treatment, and vector-related studies of leishmaniasis by the scientific community.…”