Diarrhea hospitalization costs among children <5 years old in Madagascar

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Burnett, Eleanor ; Rahajamanana, Vonintsoa Lalaina ; Raboba, Julia Liliane ; Weldegebriel, Goitom ; Masembe, Yolande Vuo ; Mwenda, Jason M. ; Parashar, Umesh D. ; Tate, Jacqueline E. ; Robinson, Annick Lalaina
• Description:
  Background:
  
  Following a recommendation by the World Health Organization, Madagascar introduced rotavirus vaccine in 2014. Though national rotavirus vaccine coverage has remained <80%, rotavirus hospitalizations declined by 78%. Gavi, the Vaccine Alliance, has provided financial support for rotavirus vaccine, however the Malagasy government has increasing responsibility for the financial cost.
  
  Methods:
  
  In this evaluation, we describe the direct medical, direct non-medical, and indirect cost of illness due to diarrhea among children <5 years old at a public pediatric referral hospital. A 3-part structured questionnaire was administered during and following the hospitalization and the child’s hospital record was reviewed.
  
  Results:
  
  In total, 96 children were included in this analysis. The median total cost of the illness was $156.00 (IQR: 104.00, 210.86) and the median direct medical cost was $107.22. Service delivery costs represented a median of 44% of the inpatient costs; medications and diagnostic tests represented a median of 28% and 20% of the total costs of the hospitalization, respectively. The median percentage of the total illness costs paid by the household was 67%. Among households with income of <$61/month, the median costs of the illness paid by the household were $78.55, representing a median of 168% of the household’s monthly expenses. Among households earning >$303/month, the median costs paid by the household were $147.30, representing a median of 53% of the household’s monthly expenses. Among all household income levels, caregivers commonly paid these bills from savings, borrowed money, and donations.
  
  Conclusions:
  
  Our findings will be useful in assessing the cost-effectiveness of rotavirus vaccine by decisionmakers. These results may also help hospital administrators and healthcare providers better understand the financial constraints of families
  
  
• Subjects:
  Child Child, Preschool Cost Of Illness Diarrhea Hospitalization Humans Infant Rotavirus Infections Rotavirus Vaccines
• Source:
  Vaccine. 38(47):7440-7444
• Pubmed ID:
  33051040
• Pubmed Central ID:
  PMC8095251
• Document Type:
  Journal Article
• Funding:
  001/WHO_/World Health Organization/International ; CC999999/ImCDC/Intramural CDC HHS/United States
• Place as Subject:
  Madagascar
• Volume:
  38
• Issue:
  47
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a148d144ede176ca9320ec0ff540b6d59725fa5ff44b6471b777a68f245fc97f
• Download URL:
  https://stacks.cdc.gov/view/cdc/105959/cdc_105959_DS1.pdf
• File Type:
  [PDF - 409.05 KB ]