ArticleBMJ open2017
The economic impact of childhood acute gastroenteritis on Malawian families and the healthcare system.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cost of Nine Pediatric Infectious Illnesses in Low- and Middle-Income Countries: A Systematic Review of Cost-of-Illness Studies.PharmacoEconomics · 2020Pooled it
- Cost of illness for childhood diarrhea in low- and middle-income countries: a systematic review of evidence and modelled estimates.BMC public health · 2020Pooled it
- Strengthening access to zinc and oral rehydration solution for childhood diarrheal treatment in Africa.Global health research and policy · 2025Article
- Economic cost of a case of diarrhoea in Uvira, Democratic Republic of the Congo: A cost of illness study.PLoS neglected tropical diseases · 2024Article
- The cost of care for children hospitalized with respiratory syncytial virus (RSV) associated lower respiratory infection in Kenya.BMC public health · 2024Article
- Quantifying the Cost ofOpen forum infectious diseases · 2024Article
- Article
- Do Out-of-Pocket Payments for Care for Children under 5 Persist Even in a Context of Free Healthcare in Burkina Faso? Evidence from a Cross-Sectional Population-Based Survey.Healthcare (Basel, Switzerland) · 2023Article
- Gastrointestinal Infection in South African Children under the Age of 5 years: A Mini Review.Gastroenterology research and practice · 2023Review
- The economics of healthcare access: a scoping review on the economic impact of healthcare access for vulnerable urban populations in low- and middle-income countries.International journal for equity in health · 2022Article
- Process Evaluation of "The Hygienic Family" Intervention: A Community-Based Water, Sanitation, and Hygiene Project in Rural Malawi.International journal of environmental research and public health · 2022Article
- Impact of Pediatric COVID-19 on Family Health-Related Quality of Life: A Qualitative Study from Latvia.Global pediatric health · 2021Article
- Estimating the Economic Impact of Respiratory Syncytial Virus and Other Acute Respiratory Infections Among Infants Receiving Care at a Referral Hospital in Malawi.Journal of the Pediatric Infectious Diseases Society · 2020Article
- Determinants of healthcare seeking and out-of-pocket expenditures in a "free" healthcare system: evidence from rural Malawi.Health economics review · 2020Article
- Cost-effectiveness and public health impact of RTS,S/AS01Wellcome open research · 2020Article
- Heterogeneity in potential impact and cost-effectiveness of ETEC andVaccine: X · 2019Article
- Potential impact and cost-effectiveness of future ETEC andVaccine: X · 2019Article
- Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
objectivesThis prospective cohort study sought to estimate health system and household costs for episodes of diarrhoeal illness in Malawi.
settingData were collected in two Malawian settings: a rural health centre in Chilumba and an urban tertiary care hospital in Blantyre.
participantsChildren under 5 years of age presenting with diarrhoeal disease between 1 January 2013 and 21 November 2014 were eligible for inclusion. Illnesses attributed to other underlying causes were excluded, as were illnesses commencing more than 2 weeks prior to presentation. Complete data were collected on 514 cases at both the time of the initial visit to the participating healthcare facility and 6 weeks after discharge. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was the total cost of an episode of illness. Costs to the health system were gathered from chart review (drugs and diagnostics) and actual hospital expenditure (staff and facility costs). Household costs, including lost income, were obtained by interview with the parents/guardians of patients.
resultsTotal costs in 2014 US$ for rural inpatient, rural outpatient, urban inpatient and urban outpatient were $65.33, $8.89, $60.23 and $14.51, respectively (excluding lost income). Mean household contributions to these costs were 15.8%, 9.8%, 21.3% and 50.6%.
conclusionThis study found significant financial burden from childhood diarrhoeal disease to the healthcare system and to households. The latter face the risk of consequent impoverishment, as the study demonstrates how the costs of seeking treatment bring the income of the majority of families in all income strata below the national poverty line in the month of illness.
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