Abstract
BACKGROUND: Diabetes mellitus is highly prevalent in Sudan and requires long-term management, placing a considerable demand on healthcare resources. This study estimates the direct and indirect costs of managing diabetes mellitus in children in Khartoum State, Sudan, and identifies factors influencing these costs. METHODS: A cross-sectional study was conducted with 138 children with diabetes across three public diabetes clinics in Khartoum State. Data were collected through face-to-face interviews with caregivers via a standardized questionnaire adapted from the KNCV Tuberculosis Foundation. Direct costs included laboratory tests, medications, provider fees, food, transportation during diagnosis, follow-up visits, and hospitalizations. Indirect costs were estimated through productivity loss, whereas intangible costs were measured via the willingness-to-pay method. Regression analysis in SPSS was employed to identify factors affecting total costs. RESULTS: The median annual cost of managing diabetes was 314 USD, with direct costs accounting for 74% of this total. Major cost drivers included food, lab tests, medications, and hospitalizations, with families spending 41% of their household income on diabetes care. Regression analysis indicated that male sex, combined therapy, and recent hospitalizations were associated with higher costs, whereas longer disease duration was associated with reduced costs. CONCLUSION: Diabetes imposes a substantial financial burden on families in Khartoum, consuming a significant portion of household income and straining resources. Targeted policy interventions are essential to improve healthcare access, expand insurance coverage, and provide financial support for families managing diabetes in resource-limited settings.