Treatment costs and loss of work time to individuals with chronic lymphatic filariasis in rural communities in south India

This year-round case-control study investigated treatment costs and work ti me loss to people affected by chronic lymphatic filariasis in two rural com munities in south India. About three-quarters of the patients sought treatm ent for filariasis at least once and 52% of them paid for treatment, incurr ing a mean annual expenditure of Rs. 72 (U5 $ 2.1; range Rs. 0-1360 (US $ 3 9.0)). Doctor's fees and medicines constituted 57% and 23% of treatment cos ts. The proportion of people seeking treatment was smaller and treatment co sts constituted a higher proportion of household income in lower income gro ups. Most patients did not leave work, but spent only 4.36 +/- 3.41 h per d ay on economic activity compared to 5.25 +/- 3.52 h worked by controls; the mean difference of 0.89 +/- 4.20 h per day was highly significant (P < 0.0 1). This loss of work time is perpetual, as chronic disease manifestations are mostly irreversible. An estimated 8% of potential male labour input is lost due to the disease. Regression analyses revealed that lymphatic filari asis has a significant effect on work time allotted to economic activity (P < 0.05) bur not on absenteeism from work (P > 0.05). Female patients spent 0.31 +/- 1.42 h less on domestic activity compared to their matched contro ls (P < 0.05). The results clearly show that the chronic form of lymphatic filariasis inflicts a considerable economic burden on affected individuals.