Hilda A Mujuru1, Eleanor Burnett2, Kusum J Nathoo3, Ismail Ticklay4, Nhamo A Gonah5, Arnold Mukaratirwa6, Chipo Berejena6, Portia Manangazira7, Maxwell Rupfutse8, Tyler Chavers2, Goitom G Weldegebriel9, Jason M Mwenda10, Umesh D Parashar2, Jacqueline E Tate2. 1. Harare Central Hospital, Harare, Zimbabwe; Department of Paediatrics and Child Health, University of Zimbabwe, Zimbabwe. Electronic address: hmujuru@mweb.co.zw. 2. Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States. 3. Harare Central Hospital, Harare, Zimbabwe; Department of Paediatrics and Child Health, University of Zimbabwe, Zimbabwe. 4. Department of Paediatrics and Child Health, University of Zimbabwe, Zimbabwe; Parirenyatwa Group Hospitals, Harare, Zimbabwe. 5. Chitungwiza Central Hospital, Chitungwiza, Zimbabwe. 6. National Virology Laboratory, Harare, Zimbabwe. 7. Epidemiology and Disease Control, Ministry of Health and Child Care, Harare, Zimbabwe. 8. World Health Organization Country Office, Harare, Zimbabwe. 9. World Health Organization, Intercountry Support Team, Harare, Zimbabwe. 10. World Health Organization, Regional Office for Africa, Brazzaville, Congo.
Abstract
INTRODUCTION: Diarrhoea is a leading killer of children <5 years old, accounting for 480,000 deaths in 2017. Zimbabwe introduced Rotarix into its vaccination program in 2014. In this evaluation, we estimate direct medical, direct non-medical, and indirect costs attributable to a diarrhea hospitalization in Zimbabwe after rotavirus vaccine introduction. METHODS: Children <5 years old admitted to Harare Central Hospital from June 2018 to April 2019 with acute watery diarrhea were eligible for this evaluation. A 3-part structured questionnaire was used to collect data by interview from the child's family and by review of the medical record. A stool specimen was also collected and tested for rotavirus. Direct medical costs were the sum of medications, consumables, diagnostic tests, and service delivery costs. Direct non-medical costs were the sum of transportation, meals and lodging for caregivers. Indirect costs are the lost income for household members. RESULTS: A total of 202 children were enrolled with a median age of 12 months (IQR: 7-21) and 48 (24%) had malnutrition. Children were sick for a median of 2 days and most had received outpatient medical care prior to admission. The median monthly household income was higher for well-nourished children compared to malnourished children (p < 0.001). The median total cost of a diarrhea illness resulting in hospitalization was $293.74 (IQR: 188.42, 427.89). Direct medical costs, with a median of $251.74 (IQR: 155.42, 390.96), comprised the majority of the total cost. Among children who tested positive for rotavirus, the median total illness cost was $243.78 (IQR: 160.92, 323.84). The median direct medical costs were higher for malnourished than well-nourished children (p < 0.001). CONCLUSION: Direct medical costs are the primary determinant of diarrhea illness costs in Zimbabwe. The descriptive findings from this evaluation are an important first step in calculating the cost effectiveness of rotavirus vaccine. Published by Elsevier Ltd.
INTRODUCTION: Diarrhoea is a leading killer of children <5 years old, accounting for 480,000 deaths in 2017. Zimbabwe introduced Rotarix into its vaccination program in 2014. In this evaluation, we estimate direct medical, direct non-medical, and indirect costs attributable to a diarrhea hospitalization in Zimbabwe after rotavirus vaccine introduction. METHODS: Children <5 years old admitted to Harare Central Hospital from June 2018 to April 2019 with acute watery diarrhea were eligible for this evaluation. A 3-part structured questionnaire was used to collect data by interview from the child's family and by review of the medical record. A stool specimen was also collected and tested for rotavirus. Direct medical costs were the sum of medications, consumables, diagnostic tests, and service delivery costs. Direct non-medical costs were the sum of transportation, meals and lodging for caregivers. Indirect costs are the lost income for household members. RESULTS: A total of 202 children were enrolled with a median age of 12 months (IQR: 7-21) and 48 (24%) had malnutrition. Children were sick for a median of 2 days and most had received outpatient medical care prior to admission. The median monthly household income was higher for well-nourished children compared to malnourished children (p < 0.001). The median total cost of a diarrhea illness resulting in hospitalization was $293.74 (IQR: 188.42, 427.89). Direct medical costs, with a median of $251.74 (IQR: 155.42, 390.96), comprised the majority of the total cost. Among children who tested positive for rotavirus, the median total illness cost was $243.78 (IQR: 160.92, 323.84). The median direct medical costs were higher for malnourished than well-nourished children (p < 0.001). CONCLUSION: Direct medical costs are the primary determinant of diarrhea illness costs in Zimbabwe. The descriptive findings from this evaluation are an important first step in calculating the cost effectiveness of rotavirus vaccine. Published by Elsevier Ltd.
Authors: Deborah E Atherly; Kristen D C Lewis; Jacqueline Tate; Umesh D Parashar; Richard D Rheingans Journal: Vaccine Date: 2012-04-27 Impact factor: 3.641
Authors: Laura K Beres; Jacqueline E Tate; Lungowe Njobvu; Bertha Chibwe; Cheryl Rudd; M Brad Guffey; Jeffrey S A Stringer; Umesh D Parashar; Roma Chilengi Journal: Clin Infect Dis Date: 2016-05-01 Impact factor: 9.079