Economic evaluation of epilepsy in Kiremba (Burundi): A case-control study

Purpose: Epilepsy is a common disease whose prevalence across Africa is extremely variable (from 5 to 74‰). Its social and economic consequences in this continent are not well established. The objective of this study was to compare the cost of care of patients with epilepsy with that of controls in the commune of Kiremba in Burundi. Methods: The survey was carried out in the commune of Kiremba from March 1, 2001, to April 30, 2001. A sample of cases (patients with epilepsy) and controls was taken from the general population. The economic analysis was conducted from the viewpoint of the patient. Data collected were direct medical costs (consultations, admissions to hospital, complementary examinations, treatments) and indirect costs (evaluated from the number of days of family life disrupted). Results: In this study, 1,056 patients were included (352 patients with epilepsy and 704 controls). The total annual cost of patients with epilepsy was US$11.0 against US$7.3 for controls (p = 0.03). The indirect costs represented 75.8% of the total cost. For the people with epilepsy that took antiepileptic treatment (n = 18), the annual average total cost became US$48.4. The number of disrupted days was 10.2 days (SD, 18.7 days) for the treated patients with epilepsy and 2.0 days (SD, 9.0 days) for the untreated ones (p < 0.001). Conclusions: Epilepsy was responsible for an extra cost: an increased direct cost along with more disruption of family life. This extra cost remained after adjustment for use of health care and antiepileptic treatments. Various measures could be envisioned to reduce the impact of indirect costs.