Stefano Tempia1, Jocelyn Moyes2, Adam L Cohen3, Sibongile Walaza2, Meredith L McMorrow4, Ijeoma Edoka5, Heather Fraser5, Florette K Treurnicht6, Orienka Hellferscee7, Nicole Wolter7, Anne von Gottberg7, Johanna M McAnerney6, Halima Dawood8, Ebrahim Variava9, Cheryl Cohen10. 1. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; MassGenics, Duluth, Georgia, Unites States of America; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: stefanot@nicd.ac.za. 2. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 3. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Department of Immunization, Vaccines and Biological, World Health Organization, Geneva, Switzerland. 4. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa. 5. South Africa Medical Research Council/Wits Centre for Health Economic and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 6. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa. 7. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 8. Department of Medicine, Greys Hospital, Pietermaritzburg, South Africa; Caprisa, University of KwaZulu-Natal, Pietermaritzburg, South Africa. 9. Department of Medicine, Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa; Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa. 10. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: cherylc@nicd.ac.za.
Abstract
BACKGROUND: Data on influenza economic burden in risk groups for severe influenza are important to guide targeted influenza immunization, especially in resource-limited settings. However, this information is limited in low- and middle-income countries. METHODS: We estimated the cost (from a health system and societal perspective) and years of life lost (YLL) for influenza-associated illness in South Africa during 2013-2015 among (i) children aged 6-59 months, (ii) individuals aged 5-64 years with HIV, pulmonary tuberculosis (PTB) and selected underlying medical conditions (UMC), separately, (iii) pregnant women and (iv) individuals aged ≥65 years, using publicly available data and data collected through laboratory-confirmed influenza surveillance and costing studies. All costs were expressed in 2015 prices using the South Africa all-items Consumer Price Index. RESULTS: During 2013-2015, the mean annual cost of influenza-associated illness among the selected risk groups accounted for 52.1% ($140.9/$270.5 million) of the total influenza-associated illness cost (for the entire population of South Africa), 45.2% ($52.2/$115.5 million) of non-medically attended illness costs, 43.3% ($46.7/$107.9 million) of medically-attended mild illness costs and 89.3% ($42.0/$47.1 million) of medically-attended severe illness costs. The YLL among the selected risk groups accounted for 86.0% (262,069 /304,867 years) of the total YLL due to influenza-associated death. CONCLUSION: In South Africa, individuals in risk groups for severe influenza accounted for approximately half of the total influenza-associated illness cost but most of the cost of influenza-associated medically attended severe illness and YLL. This study provides the foundation for future studies on the cost-effectiveness of influenza immunization among risk groups.
BACKGROUND: Data on influenza economic burden in risk groups for severe influenza are important to guide targeted influenza immunization, especially in resource-limited settings. However, this information is limited in low- and middle-income countries. METHODS: We estimated the cost (from a health system and societal perspective) and years of life lost (YLL) for influenza-associated illness in South Africa during 2013-2015 among (i) children aged 6-59 months, (ii) individuals aged 5-64 years with HIV, pulmonary tuberculosis (PTB) and selected underlying medical conditions (UMC), separately, (iii) pregnant women and (iv) individuals aged ≥65 years, using publicly available data and data collected through laboratory-confirmed influenza surveillance and costing studies. All costs were expressed in 2015 prices using the South Africa all-items Consumer Price Index. RESULTS: During 2013-2015, the mean annual cost of influenza-associated illness among the selected risk groups accounted for 52.1% ($140.9/$270.5 million) of the total influenza-associated illness cost (for the entire population of South Africa), 45.2% ($52.2/$115.5 million) of non-medically attended illness costs, 43.3% ($46.7/$107.9 million) of medically-attended mild illness costs and 89.3% ($42.0/$47.1 million) of medically-attended severe illness costs. The YLL among the selected risk groups accounted for 86.0% (262,069 /304,867 years) of the total YLL due to influenza-associated death. CONCLUSION: In South Africa, individuals in risk groups for severe influenza accounted for approximately half of the total influenza-associated illness cost but most of the cost of influenza-associated medically attended severe illness and YLL. This study provides the foundation for future studies on the cost-effectiveness of influenza immunization among risk groups.
Authors: Noelle-Angelique M Molinari; Ismael R Ortega-Sanchez; Mark L Messonnier; William W Thompson; Pascale M Wortley; Eric Weintraub; Carolyn B Bridges Journal: Vaccine Date: 2007-04-20 Impact factor: 3.641
Authors: J M McAnerney; C Cohen; A L Cohen; S Tempia; S Walaza; K K Wong; J Im; F Marks; H Dawood; U Panzner; K H Keddy; C Von Mollendorf Journal: S Afr Med J Date: 2019-04-29
Authors: Leigh F Johnson; Joel Mossong; Rob E Dorrington; Michael Schomaker; Christopher J Hoffmann; Olivia Keiser; Matthew P Fox; Robin Wood; Hans Prozesky; Janet Giddy; Daniela Belen Garone; Morna Cornell; Matthias Egger; Andrew Boulle Journal: PLoS Med Date: 2013-04-09 Impact factor: 11.069