Economic and social consequences of human african trypanosomiasis in Muchinga, Lusaka and Eastern provinces of Zambia

Abstract

Human African Trypanosomiasis (HAT) causes severe economic production losses in humans due to loss of man power and death. In Zambia most of the studies that have been done have focused on analysing the parasite while none have been conducted to establish the economic consequences of the burden of the disease on the affected populations. This study therefore aimed at determining the economic and social consequences of HAT in Lusaka, Muchinga and Eastern provinces of Zambia. This was achieved by a cross sectional survey, using a mixture of qualitative and quantitative research methods. Specifically, the economic and social consequences were measured at the household level using structured interviews and focus group discussions. In addition, mapping was done to determine the spatial distribution of HAT in the study areas. In order to assess the adequacy of the health delivery system in the management of HAT at the district level in the affected areas, structured questionnaires were administered to the medical officers and government officials (District Health Management Officers). All qualitative data were analysed using inductive approaches with two independent researchers working together to review the transcripts, develop the coding structure and extract the overarching themes and sub-themes emerging from the focus group discussions. From the quantitative data collected, descriptive statistics were generated for the variables under study. Analysis of variance (ANOVA) was used to determine associations between continuous variables. The burden of HAT on the study population was estimated using the Disability Adjusted Life Years (DALYs). This was calculated as Years of Life Lost (YLL) +Years of Life Lived with Disability (I×DW×L)]. Results from the study indicated that once a patient contracts HAT, an average of 4.9 months‘ worth of productive time would be lost due to the illness. In economic terms, this loss in productivity translated to a total of K1, 914.68 incomes lost for one individual due to the illness. Further, it was found that on average, a family would end up spending five times more than their monthly income on the cost of health care for a HAT patient. For the whole sample, (n = 64) the income lost due HAT (estimated as DALYs) was about K3.7 million. According to results, there were a lot of misconceptions about HAT that could be attributed to ignorance. The social consequences of the disease included stigma, dropping out of school, loss of friends due to amnesia and deformity. It was found that the current health care system was not able to adequately handle HAT cases because of inadequate qualified man-power and diagnostic equipment. From this study, it is evident that HAT has high economic and social consequences at both household and community levels. There is therefore need for the country to put up concerted efforts to reduce the burden of this disease and also to educate the communities so as to reduce stigmatisation that is associated with the disease.