Endocrine Abstracts (2015) 38 P248 | DOI: 10.1530/endoabs.38.P248

Cost of illness among patients with diabetic foot ulcer in secondary and tertiary health facilities in Kano, northwestern Nigeria

Fakhraddeen Muhammad1, Lateefah Pedro5, Hassan Suleiman5, Enikuomehin Adenike2, Rahila Mukhtar3, Fauziyyah Muhammad4 & Andrew Uloko1


1Aminu Kano Teaching Hospital, Kano, Nigeria; 2Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun, Nigeria; 3Hospital Management Board, Kano, Nigeria; 4G.S.S. Shadawanka, Bauchi, Nigeria; 5Bayero University, Kano, Nigeria.


Background: In Nigeria, the economic burden of diabetes foot ulcer is enormous for several reasons and there are very few studies that look at the economic cost of diabetes foot care. This study estimated the cost of illness among patients with diabetes foot ulcer in secondary and tertiary health facilities in Kano.

Methods: The study was a cross-sectional evaluation involving ninety patients with diabetes having various degrees of foot ulcerations. A structured questionnaire was used to estimate the direct medical, non-medical, and indirect costs of illness. Ulcer was examined clinically. HbA1c was done to determine the glycaemic control of subjects.

Results: The mean±S.D. age of the subjects was 59.3±15.1 years with M:F ratio of 4:1. Among the male participants, 68.1% were the breadwinners of their families. About 60% of the participants earn <$100 monthly. The total cost of illness of diabetic foot ulcer for the 90 participants was $164 484.38 (average=$1827.61). The direct cost of illness was $125 987.81 (average=$1399.86) making up 76.6% of the total cost of care. Direct medical cost was $85 086.88 (average=$945.41). The direct non-medical cost was $40 900.94 (average =$454.49). The total indirect cost was $38 497.38 (average=$427.74). Drugs accounted for the largest share of the total cost (21.9%). Out of pocket payment accounted for 90% of payment. The duration and location of foot ulcer, duration and frequency of hospital admission, average monthly income and presence of co-morbidities were significantly associated with increase cost of illness, P<0.05.

Conclusion: The cost of diabetic foot ulcer in Kano is prohibitive and the patients mostly affected are poor, unemployed, and the breadwinners of their families. Improved healthcare funding for diabetes care and subsidy on DM medications is advised to stem the tide of the disease.

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