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    Household costs of diarrhea by etiology in 7 countries, the Global Enterics Mulitcenter Study (GEMS)

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    Author
    Nasrin, Dilruba
    Roose, Anna
    Levine, Myron M.
    Kotloff, Karen L.
    Date
    2019-04-01
    Journal
    Open Forum Infectious Diseases
    Publisher
    Oxford University Press
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://www.doi.org/10.1093/ofid/ofz150
    Abstract
    Background. Although there are many overlapping features, pediatric diarrheal diseases can vary in severity, duration, clinical manifestations, and sequelae according to the causal pathogen, which in turn can impact the economic burden on patients and their families. We aimed to evaluate the household costs of diarrheal disease by pathogen in 7 countries. Methods. We analyzed data from the Global Enteric Multicenter Study (GEMS), a prospective, age-stratified, matched case- control study of moderate to severe diarrheal disease among children aged 0-59 months in 7 low-income countries; 4 in Africa (Kenya, Mali, Mozambique, The Gambia) and 3 in Asia (Bangladesh, India, Pakistan). Demographic, epidemiological, economic, and clinical data were collected, and a stool sample was obtained for microbiological analysis at enrollment. We used a multivariate generalized linear model to assess the effect of rotavirus, Cryptosporidium, heat-stable toxin (ST)-producing enterotoxigenic Escherichia coli (ETEC [ST only or LT plus ST]), Shigella, Campylobacter jejuni, norovirus GII, Vibrio cholerae O1, age, gender, in/ outpatient, and country on total costs to the patient/family. Results. Household out-of-pocket costs were higher in Mali than any other country. Within countries, household cost differences between pathogens were minimal and not statistically significantly different. Conclusions. We found no significant differences in household costs by pathogen. Despite data limitations, understanding pathogen-specific household costs (or lack thereof) is useful, as decision-makers could consider broader illness cost information and its relevance to a particular pathogen's economic burden and contribution to poverty when deciding which pathogens to target for interventions. © The Author(s) 2019.
    Keyword
    Costs
    Diarrhea
    Etiology
    GEMS
    Out-of-pocket
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85066411178&origin=inward; http://hdl.handle.net/10713/10079
    ae974a485f413a2113503eed53cd6c53
    10.1093/ofid/ofz150
    Scopus Count
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