ArticleThe Lancet regional health. Western Pacific2022
Direct and indirect costs of acute diarrhea in children under five years of age in Indonesia: Health facilities and community survey.
Article in The Lancet regional health. Western Pacific, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- The relationship of vitamin D deficiency and childhood diarrhea: a systematic review and meta-analysis.BMC pediatrics · 2024Pooled it
- How do malaria testing and treatment subsidies affect drug shop client expenditures? A cross-sectional analysis in Western Kenya.BMJ open · 2022Trial
- A mixed-effects multilevel Poisson regression analysis of diarrhea prevalence among under-five children in Indonesia.Journal of health, population, and nutrition · 2026Article
- Financial burden of severe childhood illness on households in Lao People's Democratic Republic: A prospective cohort study.PLOS global public health · 2026Article
- How health systems factors, socioeconomic status, and care-seeking practices influence the cost of rotavirus-related diarrhea care in Mukuru informal settlements, Kenya.Frontiers in public health · 2026Article
- Cost of diarrhoea: a household perspective from seven countries in the Global Enteric Multicentre Study (GEMS).BMJ paediatrics open · 2025Article
- Efficacy of rotavirus vaccines in Indonesia: A review of genotype distribution and impact.Narra J · 2025Review
- Childhood diarrhoeal disease in South Asian countries: a population-based analysis.BMJ public health · 2025Article
- Methods used to account for caregivers' sex and gender within studies examining the financial burden of caregivers of children and adolescents : Results from a scoping review.ClinicoEconomics and outcomes research : CEOR · 2024Article
- Spatiotemporal analysis of diarrhea-related hospitalizations of children in Brazil's Midwest region from 2011 to 2020.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2024Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiarrhea remains a major cause of child morbidity and mortality in low- and middle-income countries. Reliable data on the economic burden of diarrhea is required to support the selection of appropriate health intervention programs. This study aimed to estimate the costs of acute diarrhea in children under five years of age in Indonesia, a large middle-income country with a substantial diarrheal burden.
methodsDirect medical cost data were extracted retrospectively for 1050 children under five years of age with acute diarrhea receiving inpatient care across 45 health facilities in seven Indonesian provinces during 2017-2020. Direct medical costs for children treated in outpatient settings were estimated by collecting unit costs associated with standard diarrhea case management in children. A structured interview of 240 caregivers of inpatients was also conducted retrospectively to estimate direct non-medical costs as well as indirect costs from caregiver income loss.
resultsThe weighted average direct medical cost for treatment of acute diarrhea as an inpatient and outpatient across health facility types was US$99.8 (SD±$56.8)(35% room costs, 29% professional fees, 26% medication costs, 10% diagnostic costs) and US$7.6 (SD±$4.3) (34% diagnostic costs, 28% medication costs, 27% professional fees, 10% registration fees), respectively. The average direct non-medical household cost for an acute diarrheal admission was US$4.90 and the indirect cost was US$9.90.
conclusionThere is a significant economic burden associated with acute diarrhea in children in Indonesia. This study, based on a wide variety of health care settings and geographical regions, provides data to inform the economic evaluation of rotavirus vaccines and other diarrheal prevention programs.
fundingThis work was supported by a research grant from the Murdoch Children's Research Institute (MCRI) and PATH; and the Indonesian Technical Advisory Group on Immunization (ITAGI).
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