Economic Burden of Bacteremic Melioidosis in Eastern and Northeastern, Thailand

Bhengsri, Saithip; Lertiendumrong, Jongkol; Baggett, Henry C.; Thamthitiwat, Somsak; Chierakul, Wirongrong; Tisayaticom, Kanjana; Tanwisaid, Kittisak; Chantra, Somrak; Kaewkungwal, Jaranit

doi:10.4269/ajtmh.13-0148

Cited by 15 publications

(18 citation statements)

References 17 publications

(22 reference statements)

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“…54 The annual incidence of bacteremic melioidosis was reported to be 4.6 and 14.4 cases per 100,000 persons in two Thailand provinces. 122 A study on the etiology of severe CAP in Singapore between 1989 and 1993 revealed that B. pseudomallei was identified in 10 cases among 48 patients. 57 The presence of endemic melioidosis has been also reported from Northern Australia, [123][124][125][126] Cambodia, 127,128 Hong Kong, 129 India, 130 Taiwan, 131 and Southern China.…”

Section: Burkholderia Pseudomalleimentioning

confidence: 99%

Community-Acquired Pneumonia in the Asia-Pacific Region

Song

Huh

Chung

2016

Semin Respir Crit Care Med

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Community-acquired pneumonia (CAP) is an important cause of mortality and morbidity worldwide. Aging population, dense urbanization, and poor access to health care make the Asia-Pacific region vulnerable to CAP. The high incidence of CAP poses a significant health and economic burden in this region. Common etiologic agents in other global regions including ,, ,, , and respiratory viruses are also the most prevalent pathogens in the Asia-Pacific region. But the higher incidence of and the presence of are unique to the region. The high prevalence of antimicrobial resistance in and has been raising the need for more prudent use of antibiotics. Emergence and spread of community-acquired methicillin-resistant deserve attention, while the risk has not reached significant level yet in cases of CAP. Given a clinical and socioeconomic importance of CAP, further effort to better understand the epidemiology and impact of CAP is warranted in the Asia-Pacific region.

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Section: Burkholderia Pseudomalleimentioning

confidence: 99%

Community-Acquired Pneumonia in the Asia-Pacific Region

Song

Huh

Chung

2016

Semin Respir Crit Care Med

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“…Approximately 400 cases are diagnosed at Sunpasitthiprasong Hospital, Ubon Ratchathani, each year, of which about 150 result in death [ 7 , 20 ]. At Nakhon Panom Hospital, about 100 cases are diagnosed each year with about 30 deaths [ 21 , 22 ]. Melioidosis is one of the 83 diseases notifiable by law under the National Communicable Disease Surveillance system in Thailand.…”

Section: Introductionmentioning

confidence: 99%

Melioidosis in Thailand: Present and Future

et al. 2018

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A recent modelling study estimated that there are 2800 deaths due to melioidosis in Thailand yearly. The Thailand Melioidosis Network (formed in 2012) has been working closely with the Ministry of Public Health (MoPH) to investigate and reduce the burden of this disease. Based on updated data, the incidence of melioidosis is still high in Northeast Thailand. More than 2000 culture-confirmed cases of melioidosis are diagnosed in general hospitals with microbiology laboratories in this region each year. The mortality rate is around 35%. Melioidosis is endemic throughout Thailand, but it is still not uncommon that microbiological facilities misidentify Burkholderia pseudomallei as a contaminant or another organism. Disease awareness is low, and people in rural areas neither wear boots nor boil water before drinking to protect themselves from acquiring B. pseudomallei. Previously, about 10 melioidosis deaths were formally reported to the National Notifiable Disease Surveillance System (Report 506) each year, thus limiting priority setting by the MoPH. In 2015, the formally reported number of melioidosis deaths rose to 112, solely because Sunpasithiprasong Hospital, Ubon Ratchathani province, reported its own data (n = 107). Melioidosis is truly an important cause of death in Thailand, and currently reported cases (Report 506) and cases diagnosed at research centers reflect the tip of the iceberg. Laboratory training and communication between clinicians and laboratory personnel are required to improve diagnosis and treatment of melioidosis countrywide. Implementation of rapid diagnostic tests, such as a lateral flow antigen detection assay, with high accuracy even in melioidosis-endemic countries such as Thailand, is critically needed. Reporting of all culture-confirmed melioidosis cases from every hospital with a microbiology laboratory, together with final outcome data, is mandated under the Communicable Diseases Act B.E.2558. By enforcing this legislation, the MoPH could raise the priority of this disease, and should consider implementing a campaign to raise awareness and melioidosis prevention countrywide.

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“…Following the high number of hospitalised patients and mortality rates due to this disease, expensive treatment and cost are needed, which may result in long-term economic effects on the society, including the loss of productivity. 8 …”

Section: Discussionmentioning

confidence: 99%

“… 7 As a solution, thorough treatment and management in the acute stage of this disease are essential, including a continuous eradication treatment. 8 Hospital costs and economic burden have become critical issues. 9 Based on the previous retrospective studies, 28 of melioidosis patients (32.9%) required an intensive care unit (ICU) admission at a teaching hospital in Kuala Lumpur from 1988 to 2010, 10 while 27 patients (20.3%) had to be admitted to the ICU at Singapore General Hospital from 1996 to 2002.…”

Section: Introductionmentioning

confidence: 99%

“… 11 Consequently, admission to ICU increased the overall cost of treatment. 8 Furthermore, a limited number of studies in Malaysia on melioidosis were published, and no published journal has reported on the cost of treating the melioidosis or the economic burden of melioidosis. Notably, medical cost is also related to the duration of stay at the hospital, 12 which is an essential parameter for measuring the source utilised to predict future costs.…”

Section: Introductionmentioning

confidence: 99%

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The Trend of Direct Medical Cost of Meliodiosis Patients in Kedah: A Retrospective Study from 2014 to 2017

Kamaruddin¹,

Wan-Arfah²,

Naing³

et al. 2021

CEOR

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Purpose This study was conducted to determine the direct medical cost of treating melioidosis patients. The calculation was made according to the variables extracted from medical records. Materials and Methods Data collection was performed retrospectively on a total of 293 cases from Hospital Sultanah Bahiyah, Kedah, Malaysia. The data consisted of personal information, treatment history, and investigation findings, including blood results, USG abdomen results, and CT scan results. The site of culture and sensitivity were also obtained. The total direct medical cost was based on the antibiotics/treatments received by the patients, diagnostic test and investigations performed. The trend analysis used to see the pattern of costs from 2014 to 2017. All the costs were compared based on patients’ status and duration of stay at the hospital using the independent t -test. Results The overall mean of direct medical cost for melioidosis amounted to US $233.61 (RM931.33). Overall, the finding confirms a huge reduction (44.7%) of direct medical cost from 2014 to 2017 ( P = 0.001). From 2015 to 2016, there was a 19.1% reduction of direct medical cost ( P >0.95), followed by a 38.8% reduction in costs from 2016 to 2017 ( P = 0.019). In the case of the duration of stay, the mean of total direct medical cost among patients with ≥14 duration of stay was higher compared to those with <14 duration of stay ( p < 0.001). There was no significant mean difference of direct medical cost between patients who were cured and died. Conclusion Despite the higher mortality of melioidosis cases compared to other infectious diseases, there is a limitation in the amount of published data on the management cost of melioidosis. The importance of cost in managing this disease should be underlined to perform a fully prepared management toward the disease.

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Economic Burden of Bacteremic Melioidosis in Eastern and Northeastern, Thailand

Cited by 15 publications

References 17 publications

Community-Acquired Pneumonia in the Asia-Pacific Region

Community-Acquired Pneumonia in the Asia-Pacific Region

Melioidosis in Thailand: Present and Future

The Trend of Direct Medical Cost of Meliodiosis Patients in Kedah: A Retrospective Study from 2014 to 2017

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