Abbas Kaja M, Dorratoltaj Nargesalsadat, O'Dell Margaret L, Bordwine Paige, Kerkering Thomas M, Redican Kerry J
Virginia Tech,
New River Health District, Virginia Department of Health,
Front Public Health Serv Syst Res. 2015 Jul;4(4):21-28. doi: 10.13023/FPHSSR.0404.04.
The multi-state fungal meningitis outbreak started in September 2012 in Tennessee. The cause of the outbreak was injection of contaminated lots of methylprednisolone acetate used in epidural spinal injections. Roanoke and New River Valley were the epicenter of this outbreak in Virginia, with two clinical centers having administered the contaminated injections to their patients. New River Health District, in coordination with hospitals, and state and federal agencies, deployed its resources to control the local impact of the outbreak.
The objective of this study was to conduct an economic evaluation of the fungal meningitis outbreak response in New River Valley of Virginia, from the local public health department perspective.
The health department conducted the outbreak investigation from October 2012 until March 2013 to ascertain that all possible cases were identified and treated. Data were collected on the costs associated with the local health department in the outbreak response, and the epidemiologic effectiveness estimated, using the metric of disability adjusted life years (DALYs).
The cost incurred by the local health department was estimated to be $30,493; the epidemiologic effectiveness was estimated to be 138 DALYs averted among the patients, for an incremental cost-effectiveness ratio of $221 per DALY averted.
The incremental cost effectiveness ratio of the fungal meningitis outbreak response in New River Valley assists the local health department to analyze the costs and epidemiologic effectiveness of the outbreak response.
2012年9月，田纳西州爆发了多州真菌性脑膜炎疫情。疫情起因是硬膜外脊髓注射中使用了受污染批次的醋酸甲泼尼龙。罗阿诺克和新河河谷是弗吉尼亚州此次疫情的中心，有两个临床中心将受污染的注射剂用于患者。新河卫生区与医院以及州和联邦机构协调，调配资源以控制疫情在当地的影响。
本研究的目的是从当地公共卫生部门的角度，对弗吉尼亚州新河河谷应对真菌性脑膜炎疫情进行经济评估。
卫生部门于2012年10月至2013年3月开展了疫情调查，以确定所有可能的病例均已被识别并得到治疗。收集了与当地卫生部门应对疫情相关的成本数据，并使用伤残调整生命年（DALY）指标估算了流行病学效果。
当地卫生部门产生的成本估计为30,493美元；估计流行病学效果为避免患者出现138个伤残调整生命年，每避免一个伤残调整生命年的增量成本效果比为221美元。
新河河谷应对真菌性脑膜炎疫情的增量成本效果比有助于当地卫生部门分析疫情应对的成本和流行病学效果。
