Household Characteristics, Cost of Illness and Coping Mechanism of Families of Hospitalized Acute Encephalitis Syndrome Children: A Mix Method Study


  • Gitali Kakoti Jorhat Medical College and Hospital, Jorhat, Assam, India
  • Bishnu Das Ram Jorhat Medical College and Hospital, Jorhat, Assam, India
  • Mandira Chetri Jorhat Medical College and Hospital, Jorhat, Assam, India



AES, Cost of illness, Family, Mixed method approach, Household characteristics


Background: AES is responsible for causing high social and economic burden to the affected families. The study was conducted to know the household characteristics, cost of illness and coping strategy adopted by the family members of AES children admitted to a tertiary care facility in Assam, India.

Methods: It was a sequential exploratory mixed method study, with a cross-sectional survey among AES children and their guardians, followed by In Depth interview.

Results: Out of 51 cases 55% were male. The median age was 11 years. 53% of the families belonged to lower socioeconomic class. 96% of families reported to reside in rural areas. Commonly reported household assets were mobile phone 94%, bicycle 86%, television 31% and motorcycle 29%. Three major themes were emerged to contribute towards economic burden. The first major theme is “Direct cost” due to patient transportation cost (mean Rs 1161.00) and hospital costs: mostly due to medicinal cost (mean Rs1955.00), investigational cost (mean Rs 2920.00) and food cost (mean Rs 8375.00). The second theme “Indirect cost” is due to work days loss: 100% care providers had missed work days during hospital stay of their children and 84% had missed work days during post hospital care. The third theme is “Inherent cost spotted through coping mechanisms” which mostly 94% included borrowing money from the market and 31.4% selling household assets.

Conclusion: Cost of illness is a huge burden to the AES afflicted families which demands reforms in health care financing and reimbursement in current context.


Griffiths MJ, Lemon JV, Rayamajhi A, Poudel P, Shrestha P, Srivastav V, et al. The Functional, Social and Economic Impact of Acute En-cephalitis Syndrome in Nepal - a Longitudinal Follow-Up Study. PLoSNegl Trop Dis. 2013; 7(9): e2383. Doi: PMid:24069467 PMCid:PMC3772013

Bhattacharjee C , Bhowmik D. Acute Encephalitis Syndrome- The Socio-economic Burden in India. Pharmaceutical and Biosciences Journal. 2019; 7(3): 18-23. Doi:

Solomon T, Thao T T, Lewthwaite P, Ooi M H, Kneen R, Dung N al. A cohort study to assess the new WHO Japanese Encephalitis surveillance standards. Bulletin of World Health Organization, 2008; 86: 178-86. Doi: PMid:18368204 PMCid:PMC2647413

Kik SV, Olthof S PJ, de Vries J TN, Menzies D, Kincler N, van Loenhout-Rooyakkers J et al. Direct and indirect costs of tuberculosis among immigrant patients in the Netherlands. BMC Public Health. 2009;9:283. Doi: PMid:19656370 PMCid:PMC2734849

Tarricone R. Cost-of-illness analysis What room in health economics? Health Policy .2006 July; 77(1) :51-63. Doi: PMid:16139925

Dongre A, Deshmukh P. Notion Press Media Pvt Ltd. Practical guide; Qualitative methods in Health and Educational Research. 1st Edi-tion. India; 2021, P 121-50.

SahaI , Paul B. Academic Publishers. Essentials of Biostatistics and Research Methodology .3rd Edition, India 2021, P 202-3.

Isaac Dambula and Ephraim N.B. Chibwana. Characteristics of Households and Household Members. Chapter 2, pp 9-24.

Factly. Available at:

Adhikari SR, Maskay NM, Sharma BP. Paying for hospital-based care of Kala-Azar in Nepal:assessing catastrophic, impoverishment and economic consequences. Health Policy and Planning. 2009 ;24:129-39. Doi: PMid:19181674

Miedema B, Easley J, Fortin P, Hamilton R, Mathews M. The economic impact on families when a child is diagnosed with cancer. Cur-rent Oncology .2008; 15(4):173-78. Doi: PMid:18769610 PMCid:PMC2528308

Verma A, Tripathi P, Rai N, Basu A, Jain A, Atam al. Long -Term Outcomes and Socioeconomic Impact of Japanese Encephalitis and Acute Encephalitis Syndrome in Uttar Pradesh, India. International Journal of Infection.2017 October;4(4):e15607. Doi:

Dockerty JD, Skegg DCG, Williams SM. Economic effects of childhood cancer on families. J Paediatr Child Health. 2003; 39: 254-58. Doi: PMid:12755929




How to Cite

Kakoti G, Das Ram B, Chetri M. Household Characteristics, Cost of Illness and Coping Mechanism of Families of Hospitalized Acute Encephalitis Syndrome Children: A Mix Method Study. Natl J Community Med [Internet]. 2023 Jan. 31 [cited 2024 May 29];14(01):31-8. Available from:



Original Research Articles