{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:35:59Z","timestamp":1790174159085,"version":"4.1.0"},"reference-count":27,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000},"content-version":"unspecified","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP38590"],"award-info":[{"award-number":["OPP38590"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Korea International Cooperation Agency","award":["KOICA-IVI 6\/16\/2017"],"award-info":[{"award-number":["KOICA-IVI 6\/16\/2017"]}]},{"DOI":"10.13039\/100004441","name":"Swedish International Development Cooperation Agency","doi-asserted-by":"crossref","award":["5410054"],"award-info":[{"award-number":["5410054"]}],"id":[{"id":"10.13039\/100004441","id-type":"DOI","asserted-by":"crossref"}]},{"name":"UK Foreign, Commonwealth and Development Office and Wellcome","award":["214662\/Z\/18\/Z"],"award-info":[{"award-number":["214662\/Z\/18\/Z"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,3,1]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the economic burden of cholera in Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>Cholera affected 44 countries in Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The analysis used data from public sources in Africa published until September 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Based on existing data from field-based cost-of-illness studies, estimated cholera incidence rates, and reported cholera cases to WHO, this research estimates the economic burden of cholera in Africa from a societal perspective with 2015 as the base year. The estimate included out-of-pocket costs, public health system costs, productivity loss related to illness and an optional productivity loss related to premature deaths valued by the human capital approach. As various input data such as cholera incidence, hospitalisation rates and the number of workdays lost were not well defined, a series of scenario analyses and uncertainty analyses, accounting for unknowns and data variability, was conducted. Similarly, the value of time lost due to illness and deaths using the human capital approach was explored through scenario analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2015, an estimated 1\u2009008\u2009642 cases in 44 African countries resulted in an economic burden of US$130\u2009million from cholera-related illness and its treatment. When the estimated 38\u2009104 cholera deaths were included in the analysis, the economic burden increased to US$1\u2009billion or international $2.4\u2009billion for the same year. At the same time, when only the 71\u2009126 cases and 937 deaths reported to the WHO are considered, the economic burden was only US$68\u2009million for the year 2015. The estimates of economic burden are thus heavily dependent on the cholera incidence rate, how time lost due to illness and deaths are calculated, hospitalisation rates and hospitalisation costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings can be used as an economic justification for cholera control in Africa and for generating value-for-money evidence to underpin Ending Cholera\u2014A Global Roadmap to 2030 with considerations to study limitations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-044615","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T12:32:07Z","timestamp":1616502727000},"page":"e044615","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Model-based estimation of the economic burden of cholera in Africa"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0596-8072","authenticated-orcid":false,"given":"Vittal","family":"Mogasale","sequence":"first","affiliation":[{"name":"Policy and Economic Research, International Vaccine Institute, Gwanak-gu, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Mwaura","family":"Ngogoyo","sequence":"additional","affiliation":[{"name":"Department of Health, County government of Nyandarua, Ol Kalou, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijayalaxmi V","family":"Mogasale","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yenepoya Medical College Hospital, Mangalore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,23]]},"reference":[{"key":"2025121409361831000_11.3.e044615.1","unstructured":"WHO . 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