title: Cost of illness for cholera in a high risk urban area in Bangladesh: an analysis from household perspective.
abstract: BACKGROUND
  Cholera poses a substantial health burden to developing countries such as Bangladesh. In this study, the objective is to estimate the economic burden of cholera treatments incurred by households. The study was carried out in the context of a large vaccine trial in an urban area of Bangladesh.
  
  
  METHODS
  The study used a combination of prospective and retrospective incidence-based cost analyses of cholera illness per episode per household. A total of 394 confirmed cholera hospitalized cases were identified and treated in the study area during June-October 2011. Households with cholera patients were interviewed within 15 days after discharge from hospitals or clinics. To estimate the total cost of cholera illness a structured questionnaire was used, which included questions on direct medical costs, non-medical costs, and the indirect costs of patients and caregivers.
  
  
  RESULTS
  The average total household cost of treatment for an episode of cholera was US$30.40. Total direct and indirect costs constituted 24.6% (US$7.40) and 75.4% (US$23.00) of the average total cost, respectively. The cost for children under 5 years of age (US$21.50) was higher than that of children aged 5-14 years (US$17.50). The direct cost of treatment was similar for male and female patients, but the indirect cost was higher for males.
  
  
  CONCLUSIONS
  Our study suggests that by preventing one cholera episode (3 days on an average), we can avert a total cost of 2,278.50 BDT (US$30.40) per household. Among medical components, medicines are the largest cost driver. No clear socioeconomic gradient emerged from our study, but limited demographic patterns were observed in the cost of illness. By preventing cholera cases, large production losses can be reduced.
authors.affiliation: Enteric Vaccine, Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. arazzaque@icddrb.org.
authors.forename: Abdur Razzaque
authors.initials: AR
authors.lastname: Sarker
authors.forename: Ziaul
authors.initials: Z
authors.lastname: Islam
authors.forename: Iqbal Ansary
authors.initials: IA
authors.lastname: Khan
authors.forename: Amit
authors.initials: A
authors.lastname: Saha
authors.forename: Fahima
authors.initials: F
authors.lastname: Chowdhury
authors.forename: Ashraful Islam
authors.initials: AI
authors.lastname: Khan
authors.forename: Firdausi
authors.initials: F
authors.lastname: Qadri
authors.forename: Jahangir A M
authors.initials: JA
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000191:economics* / Q000453:epidemiology; D017281:Cost of Illness; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D014505:Urban Population