Cholera Outbreaks in Greater Accra Region, Ghana: The Economic Costs to the Health Facility and Affected Households

Abstract

Ghana experienced its worst cholera outbreak in the last three decades in 2014. However, evidence of the economic costs of the disease on the health system and affected households has not been fully documented. This study therefore sought to determine economic cost associated with recent outbreak the disease. Two districts which were high and low incidence areas (HIA and LIA) were selected for comparative cost studies. A total of 418 (282 HIA and 136 LIA) households which experienced at least one case of cholera infection were interviewed. The Cost of Illness (COI) method was adopted to identify and cost the disease at household and health facility levels. The Tobit Regression model was employed to determine the correlates of cholera incidence. STATA 13 software was used for analysis. The average direct cost to households in the HIA amounted to GH¢342.00 (USD 106.88), almost 2 folds higher than in the LIA GH¢198.47 (USD 62.02). Total cost saving of the episode of cholera was GH¢317,444.10 (USD 99,201.28) in the LIA but rose to almost 8 folds more in the HIA (GH¢2,504,357.12; USD 782,611.60). Total cost of treatment in health facilities were above 10 folds more in the HIA (GH¢66,745.00; USD 20,862.58) compared with LIA (GH¢6,300 USD 1,968.75). Households with the lowest income category had the greatest incidence of cholera (0.073) compared to other categories and drinking water sources such as from neighbouring homes as well as marital status of individuals were significant in the incidence of cholera.