Determinants of household costs associated with childhood diarrhea in 3 South Asian settings

Richard Rheingans, Matt Kukla, Abu Syed Golam Faruque, Dipika Sur, Anita K.M. Zaidi, Dilruba Nasrin, Tamer H. Farag, Myron M. Levine, Karen L. Kotloff

Research output: Contribution to journalArticlepeer-review

42 Citations (Scopus)


In addition to being a major cause of mortality in South Asia, childhood diarrhea creates economic burden for affected households. We used survey data from sites in Bangladesh, India, and Pakistan to estimate the costs borne by households due to childhood diarrhea, including direct medical costs, direct nonmedical costs, and productivity losses. Mean cost per episode was $1.82 in Bangladesh, $3.33 in India, and $6.47 in Pakistan. The majority of costs for households were associated with direct medical costs from treatment. Mean costs understate the distribution of costs, with 10% of cases exceeding $6.61, $8.07, and $10.11 in Bangladesh, India, and Pakistan, respectively. In all countries there was a trend toward lower costs among poorer households and in India and Pakistan there were lower costs for episodes among girls. For both poor children and girls this may reflect rationing of care, which may result in increased risks of mortality.

Original languageEnglish
Pages (from-to)S327-S335
JournalClinical Infectious Diseases
Issue numberSUPPL. 4
Publication statusPublished - 15 Dec 2012


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