Economic Burden Attributed to Children Presenting to Hospitals With Hand, Foot, and Mouth Disease in Vietnam.

Autor: Nhan LNT; Children's Hospital 1, Ho Chi Minh City, Vietnam.; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam., Turner HC; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Khanh TH; Children's Hospital 1, Ho Chi Minh City, Vietnam., Hung NT; Children's Hospital 1, Ho Chi Minh City, Vietnam., Lien LB; Children's Hospital 1, Ho Chi Minh City, Vietnam., Hong NTT; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam., Nhu LNT; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam., Ny NTH; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam., Nguyet LA; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam., Thanh TT; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam., Van HMT; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam., Viet HL; Children's Hospital 2, Ho Chi Minh City, Vietnam., Tung TH; Children's Hospital 2, Ho Chi Minh City, Vietnam., Phuong TTL; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Devine A; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Mahidol Oxford Tropical Research Unit, Bangkok, Thailand., Thwaites G; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Chau NVV; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Thwaites L; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK., van Doorn HR; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Tan LV; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2019 Jul 01; Vol. 6 (7).
DOI: 10.1093/ofid/ofz284
Abstrakt: Background: Hand, foot, and mouth disease (HFMD) has become a major public health concern in the Asia-Pacific region. Knowledge of its economic burden is essential for policy makers in prioritizing the development and implementation of interventions.
Methods: A multi-hospital-based study was prospectively conducted at 3 major hospitals in Ho Chi Minh City, Vietnam, during 2016-2017. Data on direct and productivity costs were collected alongside clinical information and samples and demographic information from study participants.
Results: A total of 466 patients were enrolled. Two hundred three of 466 (43.6%) patients lived in Ho Chi Minh City, and 72/466 (15.5%) had severe HFMD. An enterovirus was identified in 74% of 466 patients, with EV-A71, CV-A6, CV-A10, and CV-A16 being the most common viruses identified (236/466, 50.6%). The mean economic burden per case was estimated at US$400.80 (95% confidence interval [CI], $353.80-$448.90), of which the total direct (medical) costs accounted for 69.7%. There were considerable differences in direct medical costs between groups of patients with different clinical severities and pathogens (ie, EV-A71 vs non-EV-A71). In Vietnam, during 2016-2017, the economic burden posed by HFMD was US$90 761 749 (95% CI, $79 033 973-$103 009 756).
Conclusions: Our findings are of public health significance because for the first time we demonstrate that HFMD causes a substantial economic burden in Vietnam, and although multivalent vaccines are required to control HFMD, effective EV-A71 vaccine could substantially reduce the burden posed by severe HFMD. The results will be helpful for health policy makers in prioritizing resources for the development and implementation of intervention strategies to reduce the burden of HFMD.
(© The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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