Societal costs and morbidity of pertussis in adolescents and adults
Societal costs and morbidity of pertussis in adolescents and adults
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DOI：
10.1086/425006
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发表时间：
2004-12-01
影响因子：
11.8
通讯作者：
Lieu, TA
中科院分区：
文献类型：
--
作者：
Lee, GM;Lett, S;Lieu, TA
背景自20世纪80年代以来，青少年和成人百日咳的报告发病率一直在稳步上升。为了了解为青少年和成人配制的无细胞百日咳疫苗的益处是否可以抵消其成本，政策制定者需要有关百日咳发病率和社会（医疗和非医疗）成本的信息。通过马萨诸塞州增强型百日咳监测系统确定确诊为百日咳疾病的青少年（年龄，10 - 17岁）和成人（年龄，大于或等于18岁）。我们评估了1998年1月至2000年12月期间确诊百日咳的患者队列的医疗费用;通过前瞻性访谈评估了2001年12月至2003年1月期间确诊百日咳的患者队列的非医疗费用;以及两个队列的发病率。我们的主要结果的措施是平均成本每例，在2002年美元。在对医疗费用的分析中，发现1679名青少年和936名成年人的平均费用分别为242美元和326美元（）。在对314名青少年和203名成年人的采访中，成年人的非医疗费用（447美元）显著高于青少年（155美元）。共有83%的青少年因百日咳平均缺课5.5天（范围0.4 - 32天），61%的成年人因百日咳平均缺课9.8天（范围0.1-180天）。38%的青少年和61%的成年人在访谈时仍在咳嗽，分别发生在咳嗽发作后的平均106天和94天。百日咳在青少年和成人中引起显著的发病率和成本，其中时间损失占成本的最大比例。在决定未来可能使用的疫苗时，应考虑社会成本。
Background. Since the 1980s, the reported incidence of pertussis among adolescents and adults has been steadily increasing. To understand whether the benefits of an acellular pertussis vaccine formulated for adolescents and adults might offset its costs, policy makers will need information about morbidity and societal ( medical and nonmedical) costs of pertussis.Methods. Adolescents ( age, 10 - 17 years) and adults ( age, greater than or equal to 18 years) with confirmed pertussis illness were identified by the Massachusetts enhanced pertussis surveillance system. We evaluated medical costs in a cohort of patients who had confirmed pertussis during the period of January 1998 through December 2000; nonmedical costs, by means of prospective interviews, in a cohort of patients who had confirmed pertussis during the period of December 2001 through January 2003; and morbidity in both cohorts. Our main outcome measures were mean costs per case, in 2002 US$.Results. In the analysis of medical costs, 1679 adolescents and 936 adults were found to have mean costs of $ 242 and $ 326, respectively (). In interviews with 314 adolescents and 203 adults, adults had significantly P < .05 higher nonmedical costs ($ 447) than those of adolescents ($ 155). A total of 83% of adolescents missed a mean of 5.5 days from school ( range, 0.4 - 32 days), and 61% of adults missed a mean of 9.8 days from work ( range, 0.1-180 days) because of pertussis. Thirty-eight percent of adolescents and 61% of adults were still coughing at the time of the interview, which occurred an average of 106 days and 94 days, respectively, after cough onset.Conclusions. Pertussis causes significant morbidity in and costs for adolescents and adults, with time losses comprising the largest proportion of the cost. Societal costs should be considered when making decisions about potential vaccine use in the future.