tetano
Editor, Senior Moderator
Influenza Other Respir Viruses
. 2025 Jan;19(1):e70059.
doi: 10.1111/irv.70059. Costs of Influenza Illness and Acute Respiratory Infections by Household Income Level: Catastrophic Health Expenditures and Implications for Health Equity
Natalie Wodniak[SUP] 1 2 [/SUP], Radhika Gharpure[SUP] 1 [/SUP], Luzhao Feng[SUP] 3 [/SUP], Xiaozhan Lai[SUP] 4 [/SUP], Hai Fang[SUP] 5 6 [/SUP], Jianmei Tian[SUP] 7 [/SUP], Tao Zhang[SUP] 8 [/SUP], Genming Zhao[SUP] 8 [/SUP], Fernando Salcedo-Mejía[SUP] 9 [/SUP], Nelson J Alvis-Zakzuk[SUP] 9 10 11 [/SUP], Jorge Jara[SUP] 12 [/SUP], Fatimah Dawood[SUP] 1 [/SUP], Gideon O Emukule[SUP] 13 [/SUP], Linus K Ndegwa[SUP] 13 [/SUP], I-Ching Sam[SUP] 14 [/SUP], Tsogt Mend[SUP] 15 [/SUP], Baigalmaa Jantsansengee[SUP] 15 [/SUP], Stefano Tempia[SUP] 16 17 18 [/SUP], Cheryl Cohen[SUP] 16 17 [/SUP], Sibongile Walaza[SUP] 16 17 [/SUP], Wanitchaya Kittikraisak[SUP] 1 2 [/SUP], Arthorn Riewpaiboon[SUP] 19 [/SUP], Kathryn E Lafond[SUP] 1 [/SUP], Nelly Mejia[SUP] 20 [/SUP], William W Davis[SUP] 1 2 [/SUP]
Affiliations
Background: Seasonal influenza illness and acute respiratory infections can impose a substantial economic burden in low- and middle-income countries (LMICs). We assessed the cost of influenza illness and acute respiratory infections across household income strata.
Methods: We conducted a secondary analysis of data from a prior systematic review of costs of influenza and other respiratory illnesses in LMICs and contacted authors to obtain data on cost of illness (COI) for laboratory-confirmed influenza-like illness and acute respiratory infection. We calculated the COI by household income strata and calculated the out-of-pocket (OOP) cost as a proportion of household income.
Results: We included 11 studies representing 11 LMICs. OOP expenses, as a proportion of annual household income, were highest among the lowest income quintile in 10 of 11 studies: in 4/4 studies among the general population, in 6/7 studies among children, 2/2 studies among older adults, and in the sole study for adults with chronic medical conditions. COI was generally higher for hospitalizations compared with outpatient illnesses; median OOP costs for hospitalizations exceeded 10% of annual household income among the general population and children in Kenya, as well as for older adults and adults with chronic medical conditions in China.
Conclusions: The findings indicate that influenza and acute respiratory infections pose a considerable economic burden, particularly from hospitalizations, on the lowest income households in LMICs. Future evaluations could investigate specific drivers of COI in low-income household and identify interventions that may address these, including exploring household coping mechanisms. Cost-effectiveness analyses could incorporate health inequity analyses, in pursuit of health equity.
Keywords: acute respiratory infection; catastrophic health expenditure; cost of illness; health equity; household income; influenza.
. 2025 Jan;19(1):e70059.
doi: 10.1111/irv.70059. Costs of Influenza Illness and Acute Respiratory Infections by Household Income Level: Catastrophic Health Expenditures and Implications for Health Equity
Natalie Wodniak[SUP] 1 2 [/SUP], Radhika Gharpure[SUP] 1 [/SUP], Luzhao Feng[SUP] 3 [/SUP], Xiaozhan Lai[SUP] 4 [/SUP], Hai Fang[SUP] 5 6 [/SUP], Jianmei Tian[SUP] 7 [/SUP], Tao Zhang[SUP] 8 [/SUP], Genming Zhao[SUP] 8 [/SUP], Fernando Salcedo-Mejía[SUP] 9 [/SUP], Nelson J Alvis-Zakzuk[SUP] 9 10 11 [/SUP], Jorge Jara[SUP] 12 [/SUP], Fatimah Dawood[SUP] 1 [/SUP], Gideon O Emukule[SUP] 13 [/SUP], Linus K Ndegwa[SUP] 13 [/SUP], I-Ching Sam[SUP] 14 [/SUP], Tsogt Mend[SUP] 15 [/SUP], Baigalmaa Jantsansengee[SUP] 15 [/SUP], Stefano Tempia[SUP] 16 17 18 [/SUP], Cheryl Cohen[SUP] 16 17 [/SUP], Sibongile Walaza[SUP] 16 17 [/SUP], Wanitchaya Kittikraisak[SUP] 1 2 [/SUP], Arthorn Riewpaiboon[SUP] 19 [/SUP], Kathryn E Lafond[SUP] 1 [/SUP], Nelly Mejia[SUP] 20 [/SUP], William W Davis[SUP] 1 2 [/SUP]
Affiliations
- PMID: 39789855
- PMCID: PMC11718101
- DOI: 10.1111/irv.70059
Background: Seasonal influenza illness and acute respiratory infections can impose a substantial economic burden in low- and middle-income countries (LMICs). We assessed the cost of influenza illness and acute respiratory infections across household income strata.
Methods: We conducted a secondary analysis of data from a prior systematic review of costs of influenza and other respiratory illnesses in LMICs and contacted authors to obtain data on cost of illness (COI) for laboratory-confirmed influenza-like illness and acute respiratory infection. We calculated the COI by household income strata and calculated the out-of-pocket (OOP) cost as a proportion of household income.
Results: We included 11 studies representing 11 LMICs. OOP expenses, as a proportion of annual household income, were highest among the lowest income quintile in 10 of 11 studies: in 4/4 studies among the general population, in 6/7 studies among children, 2/2 studies among older adults, and in the sole study for adults with chronic medical conditions. COI was generally higher for hospitalizations compared with outpatient illnesses; median OOP costs for hospitalizations exceeded 10% of annual household income among the general population and children in Kenya, as well as for older adults and adults with chronic medical conditions in China.
Conclusions: The findings indicate that influenza and acute respiratory infections pose a considerable economic burden, particularly from hospitalizations, on the lowest income households in LMICs. Future evaluations could investigate specific drivers of COI in low-income household and identify interventions that may address these, including exploring household coping mechanisms. Cost-effectiveness analyses could incorporate health inequity analyses, in pursuit of health equity.
Keywords: acute respiratory infection; catastrophic health expenditure; cost of illness; health equity; household income; influenza.
