Chronic asthma in childhood and its economic impact on the family

Asthma is an inflammatory condition that leads to narrowing of airways, especially in the lower respiratory tract. Chronic asthma can cause airway swelling, cough, shortness of breath (SOB), and chest tightness. In Sri Lanka, between 13% to 25% of asthmatics are children who are between 5 to 11 years of age. The current study was planned to assess and explain the economic burden to families having children with bronchial asthma. This descriptive cross-sectional study was conducted with 388 patients (age range: 5 to 15 years) attending the asthma clinic at the Lady Ridgeway Hospital, Colombo, Sri Lanka over the period of April 2020 to September 2020. A total of 388 patients were studied with the majority being female children (n=203, 52.5%). The mean income of the guardians was noted as Rs. 46992 ± 62949. The total expenses related to drug purchase was Rs.1389.18 ±1237.06. The highest expenditure out of the cost of equipment(s) was for the nebulizer machines and masks (Rs. 10259.67 ± 2381.11). Expenses for the steroid inhalers was the highest (Rs. 1215.15 ± 225.68) in the category of “drugs”. Considering other expenses related to childhood asthma, an average of Rs.1033.06 ± 1796.70 were spent monthly on travel, and 73 (18.8%) parents spent Rs. 2465.48 (±2798.36) on vitamins and related foods to relieve asthma. Further, parents lost an average of Rs.4117.00 (±7776.38) monthly allowance due to absenteeism, and 30 (7.7%) parents had obtained loans to treat the child. Gender of the child, the number of people involved for clinic visit, spending night away from home, spending money on food at the clinic, use of ayurvedic treatment, providing additional supplements, and having medical insurance exhibited significant relationships with higher expenditure. There is a significant burden endured by guardians on account of childhood asthma. In addition to the expenditure on the drugs and equipment, a significant amount of money is spent by the families of the children with asthma on traveling to Colombo and staying overnight for clinics. This may be minimized by timely referral of patients to local clinics instead of getting them down to tertiary care centres on a regular basis.