Financial hardship among patients suffering from neglected tropical diseases: A systematic review and meta-analysis of global literature.

<h4>Introduction</h4>Neglected tropical diseases (NTDs) mainly affect underprivileged populations, potentially resulting in catastrophic health spending (CHS) and impoverishment from out-of-pocket (OOP) costs. This systematic review aimed to summarize the financial hardship caused by NTD...

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Main Authors: Chanthawat Patikorn, Jeong-Yeon Cho, Joshua Higashi, Xiao Xian Huang, Nathorn Chaiyakunapruk
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-05-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0012086&type=printable
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author Chanthawat Patikorn
Jeong-Yeon Cho
Joshua Higashi
Xiao Xian Huang
Nathorn Chaiyakunapruk
author_facet Chanthawat Patikorn
Jeong-Yeon Cho
Joshua Higashi
Xiao Xian Huang
Nathorn Chaiyakunapruk
author_sort Chanthawat Patikorn
collection DOAJ
description <h4>Introduction</h4>Neglected tropical diseases (NTDs) mainly affect underprivileged populations, potentially resulting in catastrophic health spending (CHS) and impoverishment from out-of-pocket (OOP) costs. This systematic review aimed to summarize the financial hardship caused by NTDs.<h4>Methods</h4>We searched PubMed, EMBASE, EconLit, OpenGrey, and EBSCO Open Dissertations, for articles reporting financial hardship caused by NTDs from database inception to January 1, 2023. We summarized the study findings and methodological characteristics. Meta-analyses were performed to pool the prevalence of CHS. Heterogeneity was evaluated using the I2 statistic.<h4>Results</h4>Ten out of 1,768 studies were included, assessing CHS (n = 10) and impoverishment (n = 1) among 2,761 patients with six NTDs (Buruli ulcer, chikungunya, dengue, visceral leishmaniasis, leprosy, and lymphatic filariasis). CHS was defined differently across studies. Prevalence of CHS due to OOP costs was relatively low among patients with leprosy (0.0-11.0%), dengue (12.5%), and lymphatic filariasis (0.0-23.0%), and relatively high among patients with Buruli ulcers (45.6%). Prevalence of CHS varied widely among patients with chikungunya (11.9-99.3%) and visceral leishmaniasis (24.6-91.8%). Meta-analysis showed that the pooled prevalence of CHS due to OOP costs of visceral leishmaniasis was 73% (95% CI; 65-80%, n = 2, I2 = 0.00%). Costs of visceral leishmaniasis impoverished 20-26% of the 61 households investigated, depending on the costs captured. The reported costs did not capture the financial burden hidden by the abandonment of seeking healthcare.<h4>Conclusion</h4>NTDs lead to a substantial number of households facing financial hardship. However, financial hardship caused by NTDs was not comprehensively evaluated in the literature. To develop evidence-informed strategies to minimize the financial hardship caused by NTDs, studies should evaluate the factors contributing to financial hardship across household characteristics, disease stages, and treatment-seeking behaviors.
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spelling doaj-art-7eb5e6260abc41be9fafdbda7b9f1df12025-08-20T03:25:46ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352024-05-01185e001208610.1371/journal.pntd.0012086Financial hardship among patients suffering from neglected tropical diseases: A systematic review and meta-analysis of global literature.Chanthawat PatikornJeong-Yeon ChoJoshua HigashiXiao Xian HuangNathorn Chaiyakunapruk<h4>Introduction</h4>Neglected tropical diseases (NTDs) mainly affect underprivileged populations, potentially resulting in catastrophic health spending (CHS) and impoverishment from out-of-pocket (OOP) costs. This systematic review aimed to summarize the financial hardship caused by NTDs.<h4>Methods</h4>We searched PubMed, EMBASE, EconLit, OpenGrey, and EBSCO Open Dissertations, for articles reporting financial hardship caused by NTDs from database inception to January 1, 2023. We summarized the study findings and methodological characteristics. Meta-analyses were performed to pool the prevalence of CHS. Heterogeneity was evaluated using the I2 statistic.<h4>Results</h4>Ten out of 1,768 studies were included, assessing CHS (n = 10) and impoverishment (n = 1) among 2,761 patients with six NTDs (Buruli ulcer, chikungunya, dengue, visceral leishmaniasis, leprosy, and lymphatic filariasis). CHS was defined differently across studies. Prevalence of CHS due to OOP costs was relatively low among patients with leprosy (0.0-11.0%), dengue (12.5%), and lymphatic filariasis (0.0-23.0%), and relatively high among patients with Buruli ulcers (45.6%). Prevalence of CHS varied widely among patients with chikungunya (11.9-99.3%) and visceral leishmaniasis (24.6-91.8%). Meta-analysis showed that the pooled prevalence of CHS due to OOP costs of visceral leishmaniasis was 73% (95% CI; 65-80%, n = 2, I2 = 0.00%). Costs of visceral leishmaniasis impoverished 20-26% of the 61 households investigated, depending on the costs captured. The reported costs did not capture the financial burden hidden by the abandonment of seeking healthcare.<h4>Conclusion</h4>NTDs lead to a substantial number of households facing financial hardship. However, financial hardship caused by NTDs was not comprehensively evaluated in the literature. To develop evidence-informed strategies to minimize the financial hardship caused by NTDs, studies should evaluate the factors contributing to financial hardship across household characteristics, disease stages, and treatment-seeking behaviors.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0012086&type=printable
spellingShingle Chanthawat Patikorn
Jeong-Yeon Cho
Joshua Higashi
Xiao Xian Huang
Nathorn Chaiyakunapruk
Financial hardship among patients suffering from neglected tropical diseases: A systematic review and meta-analysis of global literature.
PLoS Neglected Tropical Diseases
title Financial hardship among patients suffering from neglected tropical diseases: A systematic review and meta-analysis of global literature.
title_full Financial hardship among patients suffering from neglected tropical diseases: A systematic review and meta-analysis of global literature.
title_fullStr Financial hardship among patients suffering from neglected tropical diseases: A systematic review and meta-analysis of global literature.
title_full_unstemmed Financial hardship among patients suffering from neglected tropical diseases: A systematic review and meta-analysis of global literature.
title_short Financial hardship among patients suffering from neglected tropical diseases: A systematic review and meta-analysis of global literature.
title_sort financial hardship among patients suffering from neglected tropical diseases a systematic review and meta analysis of global literature
url https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0012086&type=printable
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