Does improved risk information increase the value of cholera prevention? An analysis of stated vaccine demand in slum areas of urban Bangladesh.

Autor: Aziz S; Moravian College, 1200 Main Street, Bethlehem, PA, 18018, USA. Electronic address: azizs@moravian.edu., Pakhtigian EL; School of Public Policy, Penn State University, Pond Lab, University Park, PA, 16802, USA. Electronic address: emilypakhtigian@psu.edu., Akanda AS; University of Rhode Island, 1 Lippit Road, Kingston, RI, 02881, USA. Electronic address: akanda@uri.edu., Jutla A; University of Florida, Gainesville, FL, 32611, USA. Electronic address: ajutla@ufl.edu., Huq A; University of Maryland, 3132 Bioscience Research Building, College Park, MD, 20742, USA. Electronic address: huq@umd.edu., Alam M; International Centre for Diarrhoeal Disease Research, Shaheed Tajiddin Ahmed Avenue, Mohakhali, Dhaka, 1212, Bangladesh. Electronic address: munirul@icddrb.org., Ashan GU; School of Health and Life Sciences, North South University, Bashundhara, Dhaka, 1229, Bangladesh. Electronic address: gias.ahsan@northsouth.edu., Colwell RR; Institute of Advanced Computer Studies, University of Maryland, 3103 Center of Bioinformatics and Computational Biology, College Park, MD, 20742, USA. Electronic address: rcolwell@umiacs.umd.edu.
Jazyk: angličtina
Zdroj: Social science & medicine (1982) [Soc Sci Med] 2021 Mar; Vol. 272, pp. 113716. Date of Electronic Publication: 2021 Jan 26.
DOI: 10.1016/j.socscimed.2021.113716
Abstrakt: As the world's longest running pandemic, cholera poses a substantial public health burden in Bangladesh, where human vulnerability intersects with climatic variability. Barriers to safe water and sanitation place the health of millions of Bangladeshis in jeopardy - especially those who have highly constrained choices in preventing and responding to cholera. In this paper we investigate demand for cholera prevention among residents in the Mirpur and Karail slum areas of urban Dhaka. Using survey data from 2023 households in two slum areas, we analyze responses from a contingent valuation questionnaire that elicited willingness to pay (WTP) for cholera vaccines across household members and under varying disease risk scenarios, finding higher valuation for cholera prevention for children and under scenarios of greater epidemic risk. We estimate the average WTP for a cholera vaccine for a child ranges from TK 134-167 (US$ 1.58-1.96). Consistently, respondents with prior knowledge of the cholera vaccine reported lower WTP valuations, providing suggestive evidence of concerns about vaccine effectiveness and preferences for cholera treatment over prevention. We supplement the contingent valuation analysis with cost of illness estimates from both our household sample as well as from administrative hospital records of over 34,000 cholera patients. We estimate that a household incurs costs of TK 801-922 (US$ 9.43-10.50) per episode of cholera that requires medical treatment. Taken together, these findings indicate higher WTP for cholera treatment compared to prevention, but increased interest in prevention under early warning system scenarios of high disease risk.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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