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. 2020 Dec 31;9(6):738-745.
doi: 10.1093/jpids/piaa157.

Estimating the Economic Impact of Respiratory Syncytial Virus and Other Acute Respiratory Infections Among Infants Receiving Care at a Referral Hospital in Malawi

Ranju Baral  1 , Ivan Mambule  2 , Elisabeth Vodicka  1 , Neil French  2   3 , Dean Everett  2   4 , Clint Pecenka  1 , Naor Bar-Zeev  2   5
Affiliations

Estimating the Economic Impact of Respiratory Syncytial Virus and Other Acute Respiratory Infections Among Infants Receiving Care at a Referral Hospital in Malawi

Ranju Baral et al. J Pediatric Infect Dis Soc. .

Abstract

Background: Respiratory syncytial virus (RSV) is a leading cause of respiratory illness among infants globally, yet economic burden data are scant, especially in low-income countries.

Methods: We collected data from 426 infants enrolled in the Queen Elizabeth Central Hospital respiratory disease surveillance platform to estimate the household and health system costs of managing RSV and other respiratory pathogens in Malawian infants. Total household cost per illness episode, including direct and indirect costs and lost income, was reported by parents/guardians at the initial visit and 6 weeks post discharge. The total cost to the health system was based on patient charts and hospital expenditures. All-cause acute respiratory infections (ARIs) and RSV costs for inpatient and outpatients are presented separately. All costs are in the 2018 US Dollar.

Results: The mean costs per RSV episode were $62.26 (95% confidence interval [CI]: $50.87-$73.66) and $12.51 (95% CI: $8.24-$16.79) for inpatient and outpatient cases, respectively. The mean cost per episode for all-cause ARIs was slightly higher among inpatients at $69.93 (95% CI: $63.06-$76.81) but slightly lower for outpatients at $10.17 (95% CI: $8.78-$11.57). Household costs accounted for roughly 20% of the total cost per episode. For the lowest-income families, household cost per inpatient RSV episode was about 32% of total monthly household income.

Conclusions: Among infants receiving care at a referral hospital in Malawi, the cost per episode in which RSV was detected is comparable to that of other episodes of respiratory illnesses where RSV was not detected. Estimates generated in this study can be used to evaluate the economic and financial impact of RSV and acute respiratory illness preventive interventions in Malawi.

Keywords: acute respiratory infections (ARIs); cost per episode; costs; household costs; respiratory syncytial virus (RSV).

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Figures

Figure 1.
Figure 1.
Patient flow diagram.
Figure 2.
Figure 2.
Loss of income as a proportion of total household income among families of inpatient cases. Monthly income quintile, poorest quintile (<$38); 2 ($38-$56); 3 ($57-$83); 4 ($90-$130); richest quintile (>$130). Numbers in the y-axis represents different income quintile. The horizontal bar within each box represents the median values within each sub group. The longer the box, the more dispersed is the data. In other words, the reported loss of income as a share of total household income among the poorest income group is much higher than that for the others.
See this image and copyright information in PMC

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