Published in PLOS One on 2026-03-04, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. HealthSignal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Vuyisile Jabulile Ginindza, Andre Bovell, Makandwe Nyirenda, Themba G. Ginindza
Source: PLOS One • DOI 10.1371/journal.pone.0342892
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Uterine fibroids are common benign tumours of uterine smooth muscle. It has been established that uterine fibroids cause a marked global financial burden on healthcare systems and society; however, significant gaps exist in the knowledge of costs related to uterine fibroids. This study aimed to estimate costs associated with the diagnosis, care, and management of uterine fibroids in Eswatini.
The study employed the Cost of Illness (COI) method, a retrospective prevalence cost model. The provider’s perspective was used to estimate all identifiable direct medical costs of UFs. Data was collected from participants’ charge and claims records from the hospitals between 21 August 2021 and 21 August 2022. The study employed a bottom-up approach to estimate all patient costs related to uterine fibroids care and treatment. The costs were calculated at the 2022 price level and converted to United States dollars (USD) using private-payer prices.
The total annual direct medical cost of uterine fibroids in Eswatini was estimated at USD 837894.60. This includes the total estimated costs of outpatient treatment and care, surgical treatment and care, and inpatient treatment and care. The key cost drivers were surgical and inpatient costs, USD 421583.18 and USD 110716.59, respectively.
The total annual cost estimation of uterine fibroids care is significantly high, with the majority of the cost related to theatre and hospitalisation charges. Understanding these financial implications can help guide healthcare policies and resource management.
Introduction
Uterine fibroids (UFs) are highly prevalent, understudied non-cancerous myometrium tumours, with a significant economic burden on women [1]. The global burden of uterine fibroids increased from 1990 to 2019, with a significant rise in incidence and disability-adjusted life years (DALYs) observed globally, whereas mortality rates associated with uterine fibroids remained relatively stable [2]. UFs are the most prevalent benign gynaecological tumours, presenting a significant healthcare burden [3]. Research findings from the sub-Saharan region revealed a significant prevalence of uterine fibroids, with 67% reported [4], while histological analysis indicated that 79% of women were affected [5]. The values observed in numerous African countries differ from the global perspective, especially regarding the prevalence values attributed to Black women. Most studies indicated UFs’ occurrences below 30% [6–8]. The common signs and symptoms are pelvic pain, menorrhagia, irregular menses, and pelvic mass and result in significant morbidity among reproductive-age women and adverse pregnancy outcomes [8,9]. There is no direct cause of UFs, but they have been associated to modifiable and non-modifiable risk factors: age, race, obesity, alcohol, caffeine, and age of menarche [10,11].
Recent studies indicated that lower socio demographic index (SDI) regions have a higher burden of UFs, while disease reduction has been noted in higher SDI regions [2]. This disparity in treatment options is particularly pronounced among low-income women, who are more likely to receive invasive treatments, leading to increased medical bills and increased emergency department visits [12,13]. Current research findings in the United States of America indicate that the economic burden of uterine fibroids has increased compared to 2010 due to new costs associated with treatment methods, Magnetic Resonance-guided Focused Ultrasound (MRgFUS) and infertility, while the majority of the burden is attributed to lost work cost [14]. Additionally, the cost of medical management has decreased directly, while surgical interventions have increased, so the financial burden of surgical treatment options for UFs continues to be extensive [14–17].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Vuyisile Jabulile Ginindza, Andre Bovell, Makandwe Nyirenda, Themba G. Ginindza. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by HealthSignal. The researchers are the authors of the source study, not members of HealthSignal’s staff.
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