A complexidade do custo socioeconômico da filariose linfática / The complexity of the socioeconomic costs of lymphatic filariasis

A falta de conhecimento do impacto socioeconômico das diversas doenças é, geralmente, um dos maiores obstáculos para a obtenção de verbas para investimentos em pesquisa aplicada, assim como para iniciar a implementação de programas de controle necessários aos países em desenvolvimento. Os autores analisam e ressaltam aspectos relevantes da complexidade de quantificação do impacto socioeconômico da filariose linfática e enfatizam as lacunas existentes em algumas áreas do conhecimento, que ainda não foram devidamente exploradas para os portadores da doença. Aos dados de literatura aliam os ecos do aprendizado adquirido através do atendimento de pacientes portadores de infecção e doença bancroftiana em serviço terciário de referência do Núcleo de Ensino Pesquisa e Assistência em Filariose (NEPAF), Recife, Brasil. O impacto social, no seu sentido mais abrangente, mostra indícios fortes de perdas na qualidade de vida dos pacientes, infelizmente ainda pouco documentadas e, até certo ponto, de muito difícil contabilização, pelo tão peculiar abandono social das comunidades endêmicas.

Lack of knowledge of the socioeconomic impact of various diseases is generally one of the biggest obstacles to obtaining funds for investment in applied research and for starting to implement control programs that are needed in developing countries. The authors analyze and emphasize important aspects of the complexity of quantifying the socioeconomic impact of lymphatic filariasis. They highlight the gaps that exist within some fields of knowledge and that these gaps have still not been properly explored with regard to individuals with this disease. They bring together the data in the literature and echoes from their own experience gained through caring for patients with Bancroftian infection and disease at a tertiary referral service (NEPAF - Filariasis Care, Research and Teaching Center, Recife, Brazil). The social impact, in its broadest sense, consists of strong indications of losses of quality of life among patients. Unfortunately, this is still poorly documented and, up to a certain point, very difficult to quantify because of the very particular social abandonment of the endemic communities.

Estimated costs of acute adenolymphangitis to patients with chronic manifestations of bancroftian filariasis in India.

In India, lymphatic filariasis persists as a major cause of clinical morbidity and as an impediment to socio-economic development. The direct costs incurred for the treatment of adeno-lymphangitis (ADL) episodes and the consequent indirect costs due to loss of income were determined from selected agricultural labour-intensive rural endemic pockets in Tamil Nadu. Information on the occurrence of ADL, its frequency and duration were collected using semi-structured questionnaire from randomly selected patients afflicted with chronic manifestations of bancroftian filariasis. Direct (treatment) cost per year per patient was found to range from Rs. 30 to 101 among patients with different manifestations. Income foregone (indirect cost) annually by each patient, which is a function of frequency and duration of ADL ranged from Rs. 182 to 702. ADL episodes among filarial patients alone cost a minimum of Rs. 4515 million for the nation every year. Cost benefit analysis of filariasis control programme in India showed that the benefits in terms of savings on treatment and work lost due ADL alone exceeded the cost by 24%. The per capita cost of the National Filaria Control Programme was calculated to be Rs. 2.6 per annuam.