The financial burden of sickle cell disease on households in Ekiti, Southwest Nigeria

Figures & data

Table 1 Characteristics of the children and their household income

Variable	Total number of patients n (%)
Sex
Male	64 (57.7)
Female	47 (42.3)
Age in months
15–59	49 (44.1)
60–120	41 (36.9)
> 120	21 (19.0)
Socioeconomic class
Upper	8 (7.2)
Middle	46 (41.4)
Lower	57 (51.4)
Enrolled on NHIS
Yes	8 (7.2)
No	103 (92.8)
Household monthly income (Naira)a
>₦100,000	21 (19.0)
₦50,000–100,000	42 (37.8)
₦12,500–49,999	48 (43.2)
Households with earnings less than minimum wage Less than national minimum wageb	40 (36.0)

Notes:

a Exchange rate averaged at 165 Naira =1 US dollar during the study.

b National minimum wage in Nigeria is ₦18,000 (US$109). N=111.

Abbreviation: NHIS, National Health Insurance Scheme.

Table 2 Associated comorbidities in the patients

Comorbidities	Total number of patients n (%)
Malaria	60 (54.1)
Vaso-occlusive crisis	58 (52.3)
Severe anemia	44 (39.6)
Sepsis	26 (23.4)
Febrile convulsion	4 (3.6)
Food poisoning	4 (3.6)
Kerosene poisoning	2 (1.8)
Osteomyelitis	2 (1.8)

Notes: Some patients had multiple comorbidities. N= 111.

Table 3 Health expenditures by categories of payment and social class

Expenditure type	Range (mean ± SD) (₦)	Total amount (₦)	% of total health expenditure
Laboratory tests	342–36,765 (6,739.38±6,087.00)	748,071.10	17.10
Drugs	814–87,505 (16,174.55±14,396.06)	1,795,375.70	40.70
Hospital utilitiesa	844–90,730 (16,637.89±15,016.29)	1,846,806.20	42.20
Grand total of health expenditure	2,000–215,000 (39,554.30±35,479.41)	4,390,253.00
	Lower social class (N=57)	Middle social class (N=46)	Upper social class (N=8)
	Range, % (mean ± SD)	Range, % (mean ± SD)	Range, % (mean ± SD)
Percentage of household income spent on SCD child’s health by social class groups	0.41–34.40 (9.13±8.12)	0.38–22.90 (4.59±4.97)	1.24–3.50 (1.99±0.97)

Notes:

a Hospital utilities include hospital cost of admission, blood transfusion services, surgical operations, consumables, consultation fees, medical records, and nursing charges. Exchange rate averaged at 165 Naira =1 US dollar during the study.

Abbreviations: SD, standard deviation; SCD, sickle cell disease.

Table 4 Relationships between variables and health expenditures

Variable	Family income spent on health expenditure
	<5%	5%–10%	>10%
Number of households n (%)	60 (54.1)	28 (25.2)	23 (20.7)a
Number of households on NHIS, n (%)
Yes	8 (7.2)	0 (0.0)	0 (0.0)
No	28 (25.2)	44 (39.6)	23 (20.7)
Social class, n (%)
Upper class	8 (7.2)	0 (0.0)	0 (0.0)
Middle class	33 (29.7)	9 (8.1)	4 (3.6)
Lower class	19 (17.1)	19 (17.1)	19 (17.1)
Monthly family income, n (%)
>₦100,000	21 (18.9)	0 (0.0)	0 (0.0)
₦50,000–100,000	23 (20.7)	15 (13.5)	4 (3.6)
₦12,500–49,999	16 (14.4)	13 (11.7)	19 (17.1)

Notes:

a Households with catastrophic health expenditure. Exchange rate averaged at 165 Naira =1 US dollar during the study. N=111.

Abbreviation: NHIS, National Health Insurance Scheme.

Table 5 Binary logistic regression for predictors of household catastrophic health expenditure

Variables	OR	95% CI	P-value
Parents took loan to offset hospital bills
Yes	21.694	5.399–87.176	0.000
No
Social class
Upper
Lower	10.481	2.322–47.310	0.002
Patient took ill during the study period
Yes	5.788	1.128–29.694	0.035
No
Household enrolled on NHIS
Yes	2.131	0.101–44.803	0.626
No

Note: P-value in bold font indicates statistical significance.

Abbreviations: OR, odds ratio; CI, confidence interval; NHIS, National Health Insurance Scheme.