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BIBTEX RIS

Costs of Influenza Illness and Acute Respiratory Infections by Household Income Level: Catastrophic Health Expenditures and Implications for Health Equity

2025; Wiley; Volume: 19; Issue: 1 Linguagem: Inglês

10.1111/irv.70059

1750-2659

Natalie Wodniak, Radhika Gharpure, Luzhao Feng, Xiaozhen Lai, Hai Fang, Jianmei Tian, Tao Zhang, Genming Zhao, Fernando Salcedo‐Mejía, NJ Alvis-Zakzuk, Jorge Jara, Fatimah S. Dawood, Gideon O. Emukule, Linus Ndegwa, I‐Ching Sam, Tsogt Mend, Baigalmaa Jantsansengee, Stefano Tempia, Cheryl Cohen, Sibongile Walaza, Wanitchaya Kittikraisak, Arthorn Riewpaiboon, Kathryn E. Lafond, Nelly Mejía, William W. Davis,

Global Health Care Issues

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.