{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:50:11Z","timestamp":1740138611940,"version":"3.37.3"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T00:00:00Z","timestamp":1709856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Dean's Research"},{"name":"University of Global Health Equity"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Podoconiosis is a progressive and debilitating form of tropical lymphoedema endemic to Rwanda. Although the physical and psychological consequences are well known, few studies have evaluated the financial burden of podoconiosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This cross-sectional, quantitative study aimed to characterize direct treatment costs and impacts on annual earnings among individuals living with podoconiosis. Participants from two highly endemic districts were invited to complete a survey focused on health-seeking history, insurance status, out-of-pocket costs and income changes. Direct treatment costs included medical expenditures (consultation, diagnostics, medication) and non-medical expenditures (food, transportation, accommodation).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 226 adults (\u226518\u00a0y of age) diagnosed with podoconiosis participated. Most had access to community-based health insurance (91.6%) but were unable to work (71.7%). Respondents sought care from health centres\/posts (61.9%), hospitals (25.1%), traditional healers (5.8%) and\/or community health workers (4.0%). On average, study participants paid US$32.50 (range US$0\u2013779.23) annually, or 11.7% of their household salary, on podoconiosis treatments.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study demonstrates the significant financial burden of podoconiosis on individuals and their communities. Increased attention on integrating podoconiosis management into primary care systems and testing cost-effective solutions is needed to protect those who are most vulnerable.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/trae006","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T12:10:16Z","timestamp":1709899816000},"page":"589-596","source":"Crossref","is-referenced-by-count":0,"title":["\u2018My feet cannot stand on their own\u2019: podoconiosis patient healthcare expenditures and income impacts in Rwanda"],"prefix":"10.1093","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6122-5332","authenticated-orcid":false,"given":"Janna M","family":"Schurer","sequence":"first","affiliation":[{"name":"Center for One Health, University of Global Health Equity , Butaro , Rwanda"},{"name":"Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University , North Grafton, MA , 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