Pediatric cryptosporidiosis: An evaluation of health care and societal costs in Peru, Bangladesh and Kenya

PLoS One. 2017 Aug 23;12(8):e0182820. doi: 10.1371/journal.pone.0182820. eCollection 2017.

Abstract

Cryptosporidium is a leading cause of pediatric diarrhea in resource-limited settings; yet, few studies report the health care costs or societal impacts of this protozoan parasite. Our study examined direct and indirect costs associated with symptomatic cryptosporidiosis in infants younger than 12 months in Kenya, Peru and Bangladesh. Inputs to the economic burden model, such as disease incidence, population size, health care seeking behaviour, hospital costs, travel costs, were extracted from peer-reviewed literature, government documents, and internationally validated statistical tools for each country. Indirect losses (i.e. caregiver income loss, mortality, and growth faltering) were also estimated. Our findings suggest that direct treatment costs per symptomatic cryptosporidiosis episode were highest in Kenya ($59.01), followed by Peru ($23.32), and Bangladesh ($7.62). The total annual economic impacts for the 0-11 month cohorts were highest in Peru ($41.5M; range $0.88-$599.3M), followed by Kenya ($37.4M; range $1.6-$804.5M) and Bangladesh ($9.6M, range $0.28-$91.5M). For all scenarios, indirect societal costs far outweighed direct treatment costs. These results highlight the critical need for innovative improvements to current prevention, diagnostic and treatment strategies available in resource poor settings, as well as the need for solutions that span multiple disciplines including food and water safety, sanitation and livestock production.

MeSH terms

  • Bangladesh / epidemiology
  • Cryptosporidiosis / epidemiology*
  • Humans
  • Infant
  • Kenya / epidemiology
  • Peru / epidemiology

Grants and funding

Doctoral (ER) and postdoctoral (JMS) stipend support was awarded by the Integrated Training Program in Infectious Diseases, Food Safety and Public Policy (ITraP), which is funded by the Natural Sciences and Engineering Research Council (NSERC). Funding was also provided by the Burroughs Wellcome Fund Collaborative Research Travel Grant. Support for this project was also provided by PATH with funding from the UK government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.