Ding-Ping Liu1, Ting-Ann Wang2, Wan-Ting Huang3, Luan-Yin Chang4, En-Tzu Wang5, Shou-Hsia Cheng6, Ming-Chin Yang7. 1. Epidemic Intelligence Center, Centers for Disease Control, Taipei, Taiwan; Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan. Electronic address: dpliu@cdc.gov.tw. 2. Division of Acute Infectious Diseases, Centers for Disease Control, Taipei, Taiwan. Electronic address: tanwang@cdc.gov.tw. 3. Office of Preventive Medicine, Centers for Disease Control, Taipei, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: muagi@cdc.gov.tw. 4. Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: lychang@ntu.edu.tw. 5. Division of Acute Infectious Diseases, Centers for Disease Control, Taipei, Taiwan. Electronic address: etwang@cdc.gov.tw. 6. Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan. Electronic address: shcheng@ntu.edu.tw. 7. Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan. Electronic address: mcyang637@ntu.edu.tw.
Abstract
OBJECTIVES: This study aimed to assess the disease burden and economic impacts of human nonpolio enteroviruses (NPEV) and enterovirus A71 (EV-A71) infection in Taiwan. MATERIALS AND METHODS: We included children under five years old (n=983,127-1,118,649) with ICD-9-CM codes 0740 (herpangina) or 0743 (hand-foot-and-mouth disease) from the 2006 to 2010 National Health Insurance Database. Severity of enterovirus infection was assessed from outpatient/emergency visits, hospitalization (with/without intensive care unit [ICU] admission), infection with severe complications, and death. We estimated medical costs and indirect costs from the societal perspective. RESULTS: The annual rates of NPEV events for children under five years old ranged from 13.9% to 38.4%, of which 5.1-8.8% were hospitalized. EV-A71 accounted for 7.8% of all NPEV medical costs, but 79.1% of NPEV ICU costs. Travel costs and productivity loss of caregivers were $37.1 (range: $24.5-$64.7) million per year. These costs were not higher in the EV-A71 dominant year ($34.4 million) compared with those in the other years. Productivity losses resulting from premature mortality by NPEV infection were $0.8 (range: $0.0-$2.9) million per year, of which 96.3% were caused by EV-A71. CONCLUSIONS: Diseases associated with NPEV other than EV-A71 were responsible for most of the medical expenses. In addition, caregiver productivity loss by high rates of NPEV infection impacted the society much more than medical costs. A multi-valent vaccine that includes EV-A71 and other serotypes, for example coxsackievirus A16, may be beneficial to the health of children in Taiwan.
OBJECTIVES: This study aimed to assess the disease burden and economic impacts of human nonpolio enteroviruses (NPEV) and enterovirus A71 (EV-A71) infection in Taiwan. MATERIALS AND METHODS: We included children under five years old (n=983,127-1,118,649) with ICD-9-CM codes 0740 (herpangina) or 0743 (hand-foot-and-mouth disease) from the 2006 to 2010 National Health Insurance Database. Severity of enterovirus infection was assessed from outpatient/emergency visits, hospitalization (with/without intensive care unit [ICU] admission), infection with severe complications, and death. We estimated medical costs and indirect costs from the societal perspective. RESULTS: The annual rates of NPEV events for children under five years old ranged from 13.9% to 38.4%, of which 5.1-8.8% were hospitalized. EV-A71 accounted for 7.8% of all NPEV medical costs, but 79.1% of NPEV ICU costs. Travel costs and productivity loss of caregivers were $37.1 (range: $24.5-$64.7) million per year. These costs were not higher in the EV-A71 dominant year ($34.4 million) compared with those in the other years. Productivity losses resulting from premature mortality by NPEV infection were $0.8 (range: $0.0-$2.9) million per year, of which 96.3% were caused by EV-A71. CONCLUSIONS: Diseases associated with NPEV other than EV-A71 were responsible for most of the medical expenses. In addition, caregiver productivity loss by high rates of NPEV infection impacted the society much more than medical costs. A multi-valent vaccine that includes EV-A71 and other serotypes, for example coxsackievirus A16, may be beneficial to the health of children in Taiwan.
Authors: Le Nguyen Thanh Nhan; Hugo C Turner; Truong Huu Khanh; Nguyen Thanh Hung; Le Bich Lien; Nguyen Thi Thu Hong; Le Nguyen Truc Nhu; Nguyen Thi Han Ny; Lam Anh Nguyet; Tran Tan Thanh; Hoang Minh Tu Van; Ho Lu Viet; Trinh Huu Tung; Tran Thi Lan Phuong; Angela Devine; Guy Thwaites; Nguyen Van Vinh Chau; Louise Thwaites; H Rogier van Doorn; Le Van Tan Journal: Open Forum Infect Dis Date: 2019-07-01 Impact factor: 3.835
Authors: Niila V V Saarinen; Virginia M Stone; Minna M Hankaniemi; Magdalena A Mazur; Tytti Vuorinen; Malin Flodström-Tullberg; Heikki Hyöty; Vesa P Hytönen; Olli H Laitinen Journal: Viruses Date: 2020-01-09 Impact factor: 5.048