Estimating the cost of congenital Zika syndrome to families and healthcare providers in Rio de Janeiro and Pernambuco, Brazil: results of a case-control study

Abstract

Background: Children with congenital Zika syndrome (CZS) have a wide range of additional healthcare needs. This study aimed to estimate the direct costs of CZS from the health provider and family perspectives, and the indirect costs for families, in two Brazilian states: Rio de Janeiro and Pernambuco. Methods: A case-control study was undertaken between May 2017-January 2018 recruiting 174 cases with severe CZS, 41 with mild/moderate CZS and 269 children with no CZS, across the two sites, from existing studies. The primary caregiver was interviewed using a structured questionnaire to collect information on healthcare use and costs incurred during the previous 12 months. In Rio de Janeiro, health care utilization data was also extracted from electronic medical records. We estimated direct and indirect costs incurred as a result of CZS from the perspective of the health system and families. Results: Children with CZS accessed more healthcare facilities and reported longer travel and waiting times than children unaffected by CZS. Total costs from the health provider perspective of outpatient visits, were highest for children with severe CZS (U$1,411) followed by children with mild/moderate CZS (U$264) and children without CZS (U$107). This pattern was apparent for direct costs incurred by families, while median indirect costs were low. Families of children with CZS reported high levels of catastrophic expenditures; Expenses incurred by families to meet their child’s needs as a proportion of household income was 30% (IQR=14%-67%, p<0.01) for children with severe CZS, 11% (IQR=4%-33%, p<0.01) for mild/moderate CZS, and 1% (IQR=0%-8%) for controls. Costs incurred by families were generally higher in Rio de Janeiro than Pernambuco. Conclusions: Families of children affected by CZS in Brazil may need additional public health resources and social benefits to protect them from incurring catastrophic expenses while meeting the needs of their children.

The economic burden of congenital Zika Syndrome in Brazil: an overview at 5 years and 10 years

“…The term ‘burden’ is used to be consistent with the economic literature, but not to suggest that children with CZS are themselves a burden. This paper builds on our previous work estimating the incremental cost of having a baby with CZS measured over the first 2 years of life 21 (incremental cost is the additional cost experienced by one group vs another in this case of a baby with vs a baby without CZS). The lessons learnt in this paper could be applicable to future epidemics, where an infection during pregnancy causes congenital brain abnormalities.…”

Tecnologias assistivas para a comunicação e a participação de crianças com a Síndrome Congênita do Zika Vírus

“…Os resultados destes estudos indicam que a longo prazo poderá ocorrer comprometimento cognitivo e sugere que crianças que são assintomáticas ao nascer, apesar de terem sido expostas ao ZV durante o período fetal, ainda podem ser suscetíveis a resultados adversos em seu desenvolvimento e em sua condição de saúde. Portanto, é fundamental a estruturação de redes intersetoriais envolvendo o sistema educacional, a saúde e a assistência social, para monitoramento integral dessas crianças, agora em idade escolar (LOPES et al, 2018;PINTO;BARROS, 2021;.…”