Cholera costs differed between Nepal and Mozambique, study finds

Researchers conducted a prospective cost-of-illness study alongside cholera-control projects in Nepal and Mozambique. They consecutively enrolled eligible cases and collected patient cost data and provider costs. The analysis included 273 cases from 38 facilities in Nepal and 252 cases from cholera treatment centers in Mozambique; data covered epidemic and endemic periods in both settings. Costs were reported in 2023 US dollars, with bootstrapped 95% confidence intervals.

During epidemic periods, mean cost per episode was US$113.50 in Nepal (95% CI, 93.30–133.70) and US$54.10 in Mozambique (95% CI, 50.80–57.00). During endemic periods, costs were US$63.60 in Nepal (95% CI, 48.40–78.70) and US$72.50 in Mozambique (95% CI, 65.00–80.50). After purchasing-power-parity adjustment, mean costs were I$346.90 in Nepal and I$155.30 in Mozambique.

The authors report that government subsidies covered cholera treatment for all enrolled patients in Mozambique. In Nepal, 89.5% reported out-of-pocket payments during endemic periods, which accounted for 92.6–96.6% of direct medical costs. The findings highlight differing financial burdens and support context-specific financing and prevention strategies. As a cost-of-illness study in two settings, the results describe costs rather than testing the effects of specific financing or prevention policies.