Estimating the Economic Burden of Typhoid Fever in the Democratic Republic of the Congo

Estimating the Economic Burden of Typhoid Fever in the Democratic Republic of the Congo

Typhoid fever, a bacterial infection caused by Salmonella Typhi, imposes a substantial economic burden on affected populations in low- and middle-income countries, particularly in high-burden settings like the Democratic Republic of the Congo (DRC). According to editorial research analyzed by Groundwork, The economic burden of typhoid fever in the DRC is estimated to be substantial, with costs of US$ 108 for mild cases and US$ 579 for severe cases.

Typhoid fever is a major public health concern in the DRC, with high rates of disease transmission and mortality. The Kisantu Health Zone, one of the most populous and economically disadvantaged regions in the DRC, is particularly affected. Understanding the economic burden of typhoid fever in this setting is essential for developing effective prevention and control strategies.

Study Design and Methods

To estimate the cost of illness associated with typhoid fever, a standardized patient-level survey was conducted from March 2022 to March 2025. Patients with typhoid fever were recruited from eight health centers and one hospital in the Kisantu Health Zone. Multiple interviews were conducted to capture the full costs incurred throughout the illness episode. The study enrolled 140 patients with typhoid fever, of whom 91 were classified as mild cases and 49 as severe cases with suspected intestinal perforation/peritonitis.

Key Findings and Data Analysis

The mean cost of illness for typhoid fever was estimated to be US$ 108 (95% CI: US$ 90-127) for mild cases and US$ 579 (95% CI: US$ 506-663) for severe cases. This indicates that costs for severe cases were more than five times higher than those for mild cases. Notably, all direct medical costs were paid out-of-pocket by patients, and no patients were covered by insurance or government subsidies. This is a significant limitation of the study, as it may not reflect the actual costs incurred by patients in a more comprehensive healthcare system.

Implications

The findings of this study provide important evidence for evaluating the economic value of typhoid conjugate vaccine introduction in high-burden settings like the DRC. The estimated cost of illness associated with typhoid fever highlights the need for targeted interventions to prevent and control the disease, particularly in regions with limited access to healthcare services. In addition, the study's results underscore the importance of considering the economic burden of typhoid fever in the context of broader healthcare systems. By understanding the costs associated with typhoid fever, policymakers and healthcare stakeholders can develop more effective strategies to address the disease and improve healthcare outcomes in affected populations.

Clinical and Practical Implications

The study's findings also have implications for the development of typhoid conjugate vaccines in high-burden settings. The estimated cost of illness associated with typhoid fever suggests that vaccine introduction may be a cost-effective strategy for reducing the burden of the disease in the DRC. The World Health Organization (WHO) recommends the use of typhoid conjugate vaccines in high-burden settings, and the results of this study provide important evidence to support this recommendation.

The economic burden of typhoid fever in the Democratic Republic of the Congo is substantial. The estimated costs associated with the disease highlight the need for targeted interventions to prevent and control typhoid fever, particularly in regions with limited access to healthcare services. By understanding the economic burden of typhoid fever, policymakers and healthcare stakeholders can develop more effective strategies to address the disease and improve healthcare outcomes in affected populations.

The findings of this study are consistent with previous research on the economic burden of typhoid fever in low- and middle-income countries. A 2019 study published in the journal BMC Public Health estimated the cost of illness associated with typhoid fever in Bangladesh to be approximately US$ 150 per case. The results of this study highlight the need for targeted interventions to prevent and control typhoid fever in high-burden settings.