The cost of illness for childhood clinical pneumonia and invasive pneumococcal disease in Nigeria.
The cost of illness for childhood clinical pneumonia and invasive pneumococcal disease in Nigeria.
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DOI：
10.1136/bmjgh-2021-007080
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发表时间：
2022-01
影响因子：
8.1
通讯作者：
Adetifa IM
中科院分区：
文献类型：
--
作者：
Adamu AL;Karia B;Bello MM;Jahun MG;Gambo S;Ojal J;Scott A;Jemutai J;Adetifa IM
肺炎球菌病对儿童发病率和死亡率有重大影响，治疗费用昂贵。尼日利亚最近引进了肺炎球菌结合疫苗（PCV）来预防肺炎球菌病。本研究的目的是估计医疗服务提供者和家庭治疗5岁以下儿童肺炎球菌疾病的费用，并评估这些费用对家庭收入的影响。我们从尼日利亚卡诺的一家三级医院和一家二级医院招募了患有临床肺炎、肺炎球菌脑膜炎或肺炎球菌败血症的5岁以下儿童。我们从医疗记录中获得资源利用数据，以估计提供者的治疗成本，从护理人员访谈中获得家庭支出和收入损失数据，以估计家庭的治疗成本。我们将灾难性卫生支出（CHE）定义为家庭成本超过家庭月收入的25%，并估计了经历过这种情况的家庭比例。我们比较了不同家庭收入（从最贫穷到最不贫穷）的CHE。在招募的480名参与者中，244名患有门诊肺炎，236名因肺炎（117）、败血症（66）和脑膜炎（53）住院。门诊患者的中位数（IQR）提供者费用为17美元（14-22美元），住院患者为272美元（271-360美元）。家庭成本中位数为51美元（40-69美元）。总体而言，33%的家庭经历了CHE，而最贫困和最不贫困家庭分别有53%和4%经历了CHE。在二级医院就诊、被诊断为脑膜炎或败血症、医疗服务费用较高以及护理人员从事无薪工作的情况下，CHE的几率增加。提供者的费用很大，家庭的治疗费用对其收入有很大影响，对最贫穷的家庭来说尤其如此。维持PCV规划并确保高和公平的覆盖率以降低疾病负担，将减轻肺炎球菌疾病对卫生保健提供者和家庭的经济负担。
Pneumococcal disease contributes significantly to childhood morbidity and mortality and treatment is costly. Nigeria recently introduced the pneumococcal conjugate vaccine (PCV) to prevent pneumococcal disease. The aim of this study is to estimate health provider and household costs for the treatment of pneumococcal disease in children aged <5 years (U5s), and to assess the impact of these costs on household income. We recruited U5s with clinical pneumonia, pneumococcal meningitis or pneumococcal septicaemia from a tertiary level hospital and a secondary level hospital in Kano, Nigeria. We obtained resource utilisation data from medical records to estimate costs of treatment to provider, and household expenses and income loss data from caregiver interviews to estimate costs of treatment to households. We defined catastrophic health expenditure (CHE) as household costs exceeding 25% of monthly household income and estimated the proportion of households that experienced it. We compared CHE across tertiles of household income (from the poorest to least poor). Of 480 participants recruited, 244 had outpatient pneumonia, and 236 were hospitalised with pneumonia (117), septicaemia (66) and meningitis (53). Median (IQR) provider costs were US$17 (US$14–22) for outpatients and US$272 (US$271–360) for inpatients. Median household cost was US$51 (US$40–69). Overall, 33% of households experienced CHE, while 53% and 4% of the poorest and least poor households, experienced CHE, respectively. The odds of CHE increased with admission at the secondary hospital, a diagnosis of meningitis or septicaemia, higher provider costs and caregiver having a non-salaried job. Provider costs are substantial, and households incur treatment expenses that considerably impact on their income and this is particularly so for the poorest households. Sustaining the PCV programme and ensuring high and equitable coverage to lower disease burden will reduce the economic burden of pneumococcal disease to the healthcare provider and households.
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影响因子：
4.1
作者：
Enabulele, Osahon
通讯作者：
Enabulele, Osahon
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影响因子：
2.8
作者：
Charan J;Biswas T
通讯作者：
Biswas T
影响因子：
2.5
作者：
Chukwu, Joseph N.;Meka, Anthony O.;Ukwaja, Kingsley N.
通讯作者：
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影响因子：
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作者：
Etiaba, Enyi;Onwujekwe, Obinna;Adjagba, Alex
通讯作者：
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影响因子：
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Akweongo P;Dalaba MA;Hayden MH;Awine T;Nyaaba GN;Anaseba D;Hodgson A;Forgor AA;Pandya R
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Pandya R