登革热疾病的家庭成本：墨西哥格雷罗州登革热预防随机对照试验的次要结果
Household costs of dengue illness: secondary outcomes from a randomised controlled trial of dengue prevention in Guerrero state, Mexico.
作者信息
Legorreta-Soberanis José, Paredes-Solís Sergio, Morales-Pérez Arcadio, Nava-Aguilera Elizabeth, Serrano-de Los Santos Felipe René, Dimas-Garcia Diana Lisseth, Ledogar Robert J, Cockcroft Anne, Andersson Neil
机构信息
Centro de Investigación de Enfermedades Tropicales de la Universidad Autónoma de Guerrero, Acapulco, Guerrero, Mexico.
CIETinternational, New York, NY, USA.
出版信息
BMC Public Health. 2017 May 30;17(Suppl 1):411. doi: 10.1186/s12889-017-4304-x.
BACKGROUND
Dengue is a serious public health problem with an important economic impact. This study used data from a cluster randomised controlled trial of community mobilisation for dengue prevention to estimate the household costs of treatment of dengue illness. It examined the economic impact of the trial intervention in the three coastal regions of Mexico's Guerrero State.
METHODS
The 2010 baseline survey covered households in a random sample of 90 clusters in the coastal regions; the clusters were randomly allocated to intervention or control and re-surveyed in 2012. The surveys asked about dengue cases in the last 12 months, expenditures on their treatment, and work or school days lost by patients and care givers. We did not assign monetary value to days lost, since a lost day to a person of low earning power is of equal or higher value to that person than to one who earns more.
RESULTS
The 12,312 households in 2010 reported 1020 dengue cases in the last 12 months (1.9% of the sample population). Most (78%) were ambulatory cases, with a mean cost of USD 51 and 10.8 work/school days, rising to USD 96 and 11.4 work/school days if treated by a private physician. Hospitalised cases cost USD 28-94 in government institutions and USD 392 in private hospitals (excluding additional inpatient charges), as well as 9.6-17.3 work/school days. Dengue cases cost households an estimated 412,825 work/school days throughout the three coastal regions. In the follow up survey, 6.1% (326/5349) of households in intervention clusters and 7.9% (405/5139) in control clusters reported at least one dengue case. The mean of days lost per case was similar in intervention and control clusters, but the number of days lost from dengue and all elements of costs for dengue cases per 1000 population were lower in intervention clusters. If the total population of the three coastal regions had received the intervention, some 149,401 work or school days lost per year could have been prevented.
CONCLUSION
The economic effect of dengue on households, including lost work days, is substantial. The Camino Verde trial intervention reduced household costs for treatment of dengue cases.
TRIAL REGISTRATION
The trial was registered as ISRCTN:27,581,154 .
背景
登革热是一个严重的公共卫生问题，具有重大经济影响。本研究利用一项关于社区动员预防登革热的整群随机对照试验的数据，来估计登革热疾病的家庭治疗成本。研究考察了该试验干预措施对墨西哥格雷罗州三个沿海地区的经济影响。
方法
2010年基线调查涵盖了沿海地区90个整群中的随机抽样家庭；这些整群被随机分配到干预组或对照组，并于2012年进行重新调查。调查询问了过去12个月内的登革热病例、其治疗费用以及患者和护理人员损失的工作日或上学日。我们没有为损失的天数赋予货币价值，因为对于低收入者而言，损失一天对其的价值与高收入者相当甚至更高。
结果
2010年的12312户家庭报告在过去12个月内有1020例登革热病例（占样本人口的1.9%）。大多数（78%）为门诊病例，平均费用为51美元，损失10.8个工作日或上学日；若由私人医生治疗，费用升至96美元，损失11.4个工作日或上学日。住院病例在政府机构的费用为28 - 94美元，在私立医院为392美元（不包括额外的住院费用），同时损失9.6 - 17.3个工作日或上学日。登革热病例使三个沿海地区的家庭总共损失了估计412825个工作日或上学日。在后续调查中，干预组整群中有6.1%（326/5349）的家庭以及对照组整群中有7.9%（405/5139）的家庭报告至少有一例登革热病例。干预组和对照组中每例病例的平均损失天数相似，但干预组中每1000人口因登革热损失的天数以及登革热病例的所有费用要素均较低。如果三个沿海地区的总人口都接受了干预，每年大约可避免149401个工作日或上学日的损失。
结论
登革热对家庭的经济影响巨大，包括工作日损失。“绿色之路”试验干预降低了家庭治疗登革热病例的成本。
试验注册
该试验注册为ISRCTN:27581154 。
Zotero 插件