Estimating costs of care for meningitis infections in low- and middle-income countries

Portnoy, Allison; Jit, Mark; Lauer, Jeremy A.; Blommaert, Adriaan; Ozawa, Sachiko; Stack, Meghan L.; Murray, Jillian; Hutubessy, Raymond

doi:10.1016/j.vaccine.2014.11.061

Cited by 28 publications

(21 citation statements)

References 65 publications

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“…In the United States, meningitis accounts for about 72,000 hospitalized cases per year and costs 1.2 billion dollars annually (8). Surveys in 2010 found that meningitis caused 422,900 deaths and 262,800 cases of neurological disorders (9). The prevalence of meningitis in Asia is 0.48-2.4 in 1,000 live births.…”

Section: Introductionmentioning

confidence: 99%

Etiology, clinical findings and laboratory parameters in neonates with acute bacterial meningitis

Boskabadi¹,

Heidari²,

Zakerihamidi³

2020

IJM

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Background and Objectives: Neonatal meningitis is one of the most important and serious neonatal infections with a high mortality and morbidity rate. The present study aimed to investigate the causes, clinical signs, laboratory parameters and mortality rates in newborns with bacterial meningitis. Materials and Methods: This cross-sectional study was performed on 468 neonates aged 2-28 days admitted to NICU in Ghaem Hospital Mashhad, Iran by available sampling method during 2009-2018. Meningitis was confirmed according to positive results of CSF culture and clinical feature. By using researcher-made questionnaire, neonate's individual data in- cluding cardiopulmonary resuscitation, the Apgar score of the first and fifth minutes, gestational age, birth weight, clinical symptoms and laboratory data such as ESR, WBC and positive culture of CSF were studied. Results: Among 468 newborn suspected to infection, lumbar Puncture (LP) was performed for 233 cases (50%). Of 233 neonates, 148 neonates (63.5%) had negative results for CSF culture and 85 cases (36.5%) had positive CSF culture. 94% of cases with meningitis were born premature. Blood culture had positive results in 80% of infants with late-onset meningitis and negative in 20%. The most common clinical findings were respiratory symptoms (94%). Klebsiella pneumoniae and Entrobacter aerugenes were the most common microorganisms of meningitis. Gestational disorders were observed in 55.3% of newborns with meningitis. C-Reactive Protein (CRP) of neonates with meningitis was twice higher than normal cases, and leukocytes and proteins in the CSF in neonates with meningitis were higher than healthy ones. Finally, 36% of neonates with meningitis died in our study. For analyzing the relationships between variables, independent t-test was used after controlling the normality, and Chi-square was used for analyzing the relationship of variables with nominal scale. Conclusion: The most common pathogens of meningitis were Klebsiella pneumoniae and Enterobacter aerogenes. Respi- ratory symptoms were the most common clinical signs, and laboratory symptoms included increased CRP, increased leuko- cytes and proteins in CSF

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Section: Introductionmentioning

confidence: 99%

Etiology, clinical findings and laboratory parameters in neonates with acute bacterial meningitis

Boskabadi¹,

Heidari²,

Zakerihamidi³

2020

IJM

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“…Those surviving infection may have significant long-term sequelae, such as loss of limbs, problems with vision and hearing, seizures, and cognitive deficits (2). In addition, the costs associated with these infections are significant, both in the short term related to hospitalization and treatment and in the long-term related to lost contributions to society (3,4).…”

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confidence: 99%

Multicenter Evaluation of BioFire FilmArray Meningitis/Encephalitis Panel for Detection of Bacteria, Viruses, and Yeast in Cerebrospinal Fluid Specimens

et al. 2016

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Rapid diagnosis and treatment of infectious meningitis and encephalitis are critical to minimize morbidity and mortality. Comprehensive testing of cerebrospinal fluid (CSF) often includes Gram stain, culture, antigen detection, and molecular methods, paired with chemical and cellular analyses. These methods may lack sensitivity or specificity, can take several days, and require significant volume for complete analysis. The FilmArray Meningitis/Encephalitis (ME) Panel is a multiplexed in vitro diagnostic test for the simultaneous, rapid (ϳ1-h) detection of 14 pathogens directly from CSF specimens: Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Streptococcus agalactiae, cytomegalovirus, enterovirus, herpes simplex virus 1 and 2, human herpesvirus 6, human parechovirus, varicella-zoster virus, and Cryptococcus neoformans/Cryptococcus gattii. We describe a multicenter evaluation of 1,560 prospectively collected CSF specimens with performance compared to culture (bacterial analytes) and PCR (all other analytes). The FilmArray ME Panel demonstrated a sensitivity or positive percentage of agreement of 100% for 9 of 14 analytes. Enterovirus and human herpesvirus type 6 had agreements of 95.7% and 85.7%, and L. monocytogenes and N. meningitidis were not observed in the study. For S. agalactiae, there was a single false-positive and false-negative result each, for a sensitivity and specificity of 0 and 99.9%, respectively. The specificity or negative percentage of agreement was 99.2% or greater for all other analytes. The FilmArray ME Panel is a sensitive and specific test to aid in diagnosis of ME. With use of this comprehensive and rapid test, improved patient outcomes and antimicrobial stewardship are anticipated.

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“…The case management costs are calculated by multiplying the estimated number of cases of MenA under each strategy by an average cost of case management calculated using a multilinear regression analysis including data from 27 countries on the direct medical costs (DMCs) of meningitis cases in low- and middle-income countries [ 18 ]. Original data for Burkina Faso come from Colombini et al [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

Costs of Neisseria meningitidis Group A Disease and Economic Impact of Vaccination in Burkina Faso

Colombini

Trotter

Madrid

et al. 2015

Clinical Infectious Diseases

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Background. Five years since the successful introduction of MenAfriVac in a mass vaccination campaign targeting 1- to 29-year-olds in Burkina Faso, consideration must be given to the optimal strategies for sustaining population protection. This study aims to estimate the economic impact of a range of vaccination strategies in Burkina Faso.Methods. We performed a cost-of-illness study, comparing different vaccination scenarios in terms of costs to both households and health systems over a 26-year time horizon. These scenarios are (1) reactive vaccination campaign (baseline comparator); (2) preventive vaccination campaign; (3) routine immunization at 9 months; and (4) a combination of routine and an initial catchup campaign of children under 5. Costs were estimated from a literature review, which included unpublished programmatic documents and peer-reviewed publications. The future disease burden for each vaccination strategy was predicted using a dynamic transmission model of group A Neisseria meningitidis.Results. From 2010 to 2014, the total costs associated with the preventive campaign targeting 1- to 29-year-olds with MenAfriVac were similar to the estimated costs of the reactive vaccination strategy (approximately 10 million US dollars [USD]). Between 2015 and 2035, routine immunization with or without a catch-up campaign of 1- to 4-year-olds is cost saving compared with the reactive strategy, both with and without discounting costs and cases. Most of the savings are accrued from lower costs of case management and household costs resulting from a lower burden of disease. After the initial investment in the preventive strategy, 1 USD invested in the routine strategy saves an additional 1.3 USD compared to the reactive strategy.Conclusions. Prevention strategies using MenAfriVac will be significantly cost saving in Burkina Faso, both for the health system and for households, compared with the reactive strategy. This will protect households from catastrophic expenditures and increase the development capacity of the population.

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Estimating costs of care for meningitis infections in low- and middle-income countries

Cited by 28 publications

References 65 publications

Etiology, clinical findings and laboratory parameters in neonates with acute bacterial meningitis

Etiology, clinical findings and laboratory parameters in neonates with acute bacterial meningitis

Multicenter Evaluation of BioFire FilmArray Meningitis/Encephalitis Panel for Detection of Bacteria, Viruses, and Yeast in Cerebrospinal Fluid Specimens

Costs of Neisseria meningitidis Group A Disease and Economic Impact of Vaccination in Burkina Faso

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