Typhoid and Paratyphoid Cost of Illness in Pakistan: Patient and Health Facility Costs From the Surveillance for Enteric Fever in Asia Project II

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Mejia, Nelly ; Qamar, Farah ; Yousafzai, Mohammad T ; Raza, Jamal ; Garrett, Denise O ; Date, Kashmira ; Abimbola, Taiwo ; Pallas, Sarah W
• Description:
  Background
  
  The objective of this study was to estimate the cost of illness from enteric fever (typhoid and paratyphoid) at selected sites in Pakistan.
  
  Methods
  
  We implemented a cost-of-illness study in 4 hospitals as part of the Surveillance for Enteric Fever in Asia Project (SEAP) II in Pakistan. From the patient and caregiver perspective, we collected direct medical, nonmedical, and indirect costs per case of enteric fever incurred since illness onset by phone after enrollment and 6 weeks later. From the health care provider perspective, we collected data on quantities and prices of resources used at 3 of the hospitals, to estimate the direct medical economic costs to treat a case of enteric fever. We collected costs in Pakistani rupees and converted them into 2018 US dollars. We multiplied the unit cost per procedure by the frequency of procedures in the surveillance case cohort to calculate the average cost per case.
  
  Results
  
  We collected patient and caregiver information for 1029 patients with blood culture–confirmed enteric fever or with a nontraumatic terminal ileal perforation, with a median cost of illness per case of US $196.37 (IQR, US $72.89–496.40). The median direct medical and nonmedical costs represented 8.2% of the annual labor income. From the health care provider perspective, the estimated average direct medical cost per case was US $50.88 at Hospital A, US $52.24 at Hospital B, and US $11.73 at Hospital C.
  
  Conclusions
  
  Enteric fever can impose a considerable economic burden in Pakistan. These new estimates of the cost of illness of enteric fever can improve evaluation and modeling of the costs and benefits of enteric fever prevention and control measures, including typhoid conjugate vaccines.
  
  
• Subjects:
  AcademicSubjects/MED00290 Cost Of Illness Enteric Fever Health Facilities Humans Pakistan Paratyphoid Paratyphoid Fever Supplement Articles Typhoid Typhoid Fever

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• Source:
  Clin Infect Dis. 2020; 71(Suppl 3):S319-S335
• Pubmed ID:
  33258941
• Pubmed Central ID:
  PMC7750929
• Document Type:
  Journal Article
• Volume:
  71
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9f60cf905d0b31ae9c5674895061a9888e00b2133528734e223caa2e4e4440e9
• Download URL:
  https://stacks.cdc.gov/view/cdc/111643/cdc_111643_DS1.pdf
• File Type:
  [PDF - 1.79 MB ]