@article{99688, keywords = {Infectious Diseases, Public Health, Environmental and Occupational Health, General Medicine, Parasitology, Africa, economic, elephantiasis, neglected tropical disease}, author = {Schurer JM and Bayisenge U and Hakizimana D and Rafferty E}, title = {‘My feet cannot stand on their own’: podoconiosis patient healthcare expenditures and income impacts in Rwanda}, abstract = {

Background: Podoconiosis is a progressive and debilitating form of tropical lymphoedema endemic to Rwanda. Although the physical and psychological consequences are well known, few studies have evaluated the financial burden of podoconiosis.

Methods: This cross-sectional, quantitative study aimed to characterize direct treatment costs and impacts on annual earnings among individuals living with podoconiosis. Participants from two highly endemic districts were invited to complete a survey focused on health-seeking history, insurance status, out-of-pocket costs and income changes. Direct treatment costs included medical expenditures (consultation, diagnostics, medication) and non-medical expenditures (food, transportation, accommodation).

Results: Overall, 226 adults (≥18 y of age) diagnosed with podoconiosis participated. Most had access to community-based health insurance (91.6%) but were unable to work (71.7%). Respondents sought care from health centres/posts (61.9%), hospitals (25.1%), traditional healers (5.8%) and/or community health workers (4.0%). On average, study participants paid US$32.50 (range US$0–779.23) annually, or 11.7% of their household salary, on podoconiosis treatments.

Conclusions: This study demonstrates the significant financial burden of podoconiosis on individuals and their communities. Increased attention on integrating podoconiosis management into primary care systems and testing cost-effective solutions is needed to protect those who are most vulnerable.

}, year = {2024}, journal = {Transactions of The Royal Society of Tropical Medicine and Hygiene}, publisher = {Oxford University Press (OUP)}, issn = {0035-9203, 1878-3503}, doi = {10.1093/trstmh/trae006}, language = {Eng}, }