Costs of Influenza Illness and Acute Respiratory Infections by Household Income Level: Catastrophic Health Expenditures and Implications for Health Equity
Issued Date
2025-01-01
Resource Type
ISSN
17502640
eISSN
17502659
Scopus ID
2-s2.0-85214350219
Pubmed ID
39789855
Journal Title
Influenza and other Respiratory Viruses
Volume
19
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Influenza and other Respiratory Viruses Vol.19 No.1 (2025)
Suggested Citation
Wodniak N., Gharpure R., Feng L., Lai X., Fang H., Tian J., Zhang T., Zhao G., Salcedo-Mejía F., Alvis-Zakzuk N., Jara J., Dawood F., Emukule G., Ndegwa L., Sam I.C., Mend T., Jantsansengee B., Tempia S., Cohen C., Walaza S., Kittikraisak W., Riewpaiboon A., Lafond K., Mejia N., Davis W. Costs of Influenza Illness and Acute Respiratory Infections by Household Income Level: Catastrophic Health Expenditures and Implications for Health Equity. Influenza and other Respiratory Viruses Vol.19 No.1 (2025). doi:10.1111/irv.70059 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/102827
Title
Costs of Influenza Illness and Acute Respiratory Infections by Household Income Level: Catastrophic Health Expenditures and Implications for Health Equity
Author's Affiliation
Chinese Academy of Medical Sciences & Peking Union Medical College
Children's Hospital of Soochow University
Universidad de la Costa
National Institute for Communicable Diseases
Universiti Malaya
Centers for Disease Control and Prevention
Peking University
Pan American Health Organization
Centers for Disease Control (CDC), Thailand Field Station
Wits School of Public Health
Mahidol University
Fudan University
Universidade de São Paulo
Peking University Health Science Center
National Center for Communicable Diseases
ALZAK Foundation
Children's Hospital of Soochow University
Universidad de la Costa
National Institute for Communicable Diseases
Universiti Malaya
Centers for Disease Control and Prevention
Peking University
Pan American Health Organization
Centers for Disease Control (CDC), Thailand Field Station
Wits School of Public Health
Mahidol University
Fudan University
Universidade de São Paulo
Peking University Health Science Center
National Center for Communicable Diseases
ALZAK Foundation
Corresponding Author(s)
Other Contributor(s)
Abstract
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.