The economic burden of mycetoma on households in the Sudan

Background: The fungal disease mycetoma, more commonly known as Madura foot after the Indian city where it was documented, enters the body through small cuts in the skin. Accurate data on the number of mycetoma patients in Sudan is difficult to obtain, in part because it is not a notifiable disease. Nevertheless, Mycetoma Research Centre (MRC) has registered over 7200 mycetoma cases in Sudan since 1991, so it is now a major public health problem with enormous cost burdens on the patients’. The study aims to assess the economic consequences or costs of mycetoma disease on patients in public hospitals in the Sudan, and provide the different classification of mycetoma costs that facing the patients, and explain to what extent mycetoma patients are able to cover this costs. Methods: This study is an exploratory study, the primary data are obtained from a questionnaire directed to a sample of patients treating from mycetoma in the Sudan, about 40 questionnaire were distributed to mycetoma patient’s in public hospitals in Khartoum state and Gazira state during the period August 2015 to February 2016. Results: The study showed that mycetoma has a negative impact on youth, productivity and employment. The cost of diagnosis and treatment is relatively high, total costs for patients per week is ranged between 901 – 1100 SDG. These costs vary but the main source of costs are: treatment costs, X-ray, lab tests and different diagnosis costs, Transportation and meals costs, and other additional costs. Also there are indirect costs such as leaving the work after become sick. 90% of the respondents mentioned that their income is not enough to cover all the costs. As income not enough they are resort to having support from friends and relatives, acquisition and borrowing, and other options, so those who cannot afford treatment costs suffer disproportionately, and those who do pay for care are at risk of falling into poverty. As a result of high costs and un-ability to cover these cost, most patients stopped therapy, were lost to follow-up in outpatient clinics, and presented late with a massive relapse that often required amputation and more treatments which means increasing the costs.