Table 9.

Patient and Caregiver Cost of Illness Due to Extensively Drug-resistant Typhoid Fever: Direct Medical, Direct Nonmedical, Indirect, and Total Costs, Karachi, Pakistan, September 2016–December 2018

	Patients Who Only Reported Outpatient Care Expenses and did not Have a Nontraumatic Terminal Ileal Perforationa				Patients Who Reported Inpatient Care Expenses or Had a Nontraumatic Terminal Ileal Perforationb				All Patients
Cost Type	n	Median	25th Pctl	75th Pctl	n	Median	25th Pctl	75th Pctl	n	Median	25th Pctl	75th Pctl
Direct medical costs, 2018 US$
Total direct medical costs	375	205.8	71.62	670.92	12	210.33	107.84	312.82	387	205.80	71.62	658.57
Registration	148	4.12	1.65	12.35	6	12.35	4.94	41.16	154	4.12	1.71	12.35
Clinical examination	12	3.50	1.23	5.15	4	10.29	2.68	20.58	16	3.91	1.23	6.38
Inpatient stay	0	N/A	N/A	N/A	12	45.28	16.46	82.32	12	45.28	16.46	82.32
Laboratory tests	66	22.23	8.23	43.63	6	18.52	3.70	41.16	72	22.23	8.23	42.40
Drugs and medications	149	18.93	6.84	65.00	11	82.32	16.46	164.64	160	23.05	7.20	74.91
Other servicesc	1	11.12	11.12	11.12	0	…	…	…	1	11.12	11.12	11.12
Direct nonmedical costs, 2018 US$
Total direct nonmedical costs	312	4.94	2.47	10.70	11	4.94	3.29	39.51	323	4.94	2.47	10.87
Transport	312	4.12	2.47	8.55	11	4.12	3.29	13.17	323	4.12	2.47	8.55
Food, lodging, childcare	43	34.21	16.46	82.32	5	18.52	9.88	34.21	48	33.57	16.46	82.32
Indirect costs: patient
Days spent seeking care	385	3.00	0.13	6.00	12	4.50	0.10	7.00	397	3.00	0.13	6.00
Days unable to work	11	48.00	8.00	60.00	0	…	…	…	11	48.00	8.00	60.00
Days of sick leave	11	22.00	15.00	30.00	0	…	…	…	11	22.00	15.00	30.00
School days lost	159	35.00	25.00	55.00	1	37.00	37.00	37.00	160	35.00	25.00	55.00
Total productivity loss, 2018 US$	22	179.64	92.69	264.81	0	…	…	…	22	179.64	92.69	264.81
Indirect costs: caregiver
Days spent accompanying the patient seeking care	382	6.06	0.42	12.06	12	4.60	0.40	13.56	394	6.04	0.42	12.08
Days unable to work	92	7.00	3.00	14.00	3	9.00	5.00	15.00	95	7.00	3.00	14.00
Days of sick leave	84	4.00	2.00	7.00	3	7.00	4.00	26.00	87	4.00	2.00	7.00
Total productivity loss, 2018 US$	174	29.58	13.76	66.20	6	52.96	33.10	99.31	180	33.10	17.73	66.20
Cost of illness, 2018 US$
Total cost of illness per case	382	252.58	82.39	764.16	12	246.55	160.73	387.12	394	251.34	82.82	729.56

N = 401. Extensively drug-resistant patients were defined as those with blood culture–confirmed Salmonella Typhi resistant to ampicillin, chloramphenicol, cotrimoxazole, and ceftriaxone, and resistant or with reduced susceptibility to fluoroquinolones.

Abbreviations: N/A, not applicable because it excludes inpatient care; Pctl, percentile.

^a Expenses by patients who only reported outpatient care, regardless of patient recruitment location (outpatient care, inpatient care, hospital laboratory, surgery) and excluding patients with nontraumatic terminal ileal perforation.

^b Expenses by patients with nontraumatic terminal ileal perforation, regardless of whether they reported inpatient care, and patients reporting inpatient care expenses, regardless of patient recruitment location (outpatient care, inpatient care, hospital laboratory, surgery).

^c Other services that patients did not report in the above categories (eg, medical materials or equipment for surgery).