Ranjeva Sylvia L, Warf Benjamin C, Schiff Steven J
Medical Scientist Training Program, Pritzker School of Medicine, and Department of Ecology & Evolution, University of Chicago, Chicago, Illinois, USA.
Department of Engineering Science and Mechanics, Center for Neural Engineering, The Pennsylvania State University, University Park, Pennsylvania, USA.
BMJ Glob Health. 2018 Jan 12;3(1):e000347. doi: 10.1136/bmjgh-2017-000347. eCollection 2018.
The third Sustainable Development Goal for child health, which aims to end preventable deaths of newborns and children less than 5 years of age by 2030, cannot be met without substantial reduction of infection-specific neonatal mortality in the developing world. Neonatal infections are estimated to account for 26% of annual neonatal deaths, with mortality rates highest in sub-Saharan Africa (SSA). Reliable and comprehensive estimates of the incidence and aetiology surrounding neonatal sepsis in SSA remain incompletely available. We estimate the economic burden of neonatal sepsis in SSA.
Data available through global health agencies and in the medical literature were used to determine population demographics in SSA, as well as to determine the incidence, disease burden, mortality and resulting disabilities associated with neonatal sepsis. The disability-adjusted life years (DALY) associated with successful treatment or prevention of neonatal sepsis in SSA for 1 year were calculated. The value of a statistical life (VSL) methodology was estimated to evaluate the economic burden of untreated neonatal sepsis in SSA.
We conservatively estimate that 5.29-8.73 million DALYs are lost annually in SSA due to neonatal sepsis. Corresponding VSL estimates predict an annual economic burden ranging from $10 billion to $469 billion.
Our results highlight and quantify the scope of the public health and economic burden posed by neonatal sepsis in SSA. We quantify the substantial potential impact of more successful treatment and prevention strategies, and we highlight the need for greater investment in strategies to characterise, diagnose, prevent and manage neonatal sepsis and its long-term sequelae in SSA.
儿童健康的第三个可持续发展目标旨在到2030年消除5岁以下新生儿和儿童的可预防死亡。如果不大幅降低发展中世界特定感染导致的新生儿死亡率,这一目标将无法实现。据估计,新生儿感染占每年新生儿死亡人数的26%,撒哈拉以南非洲(SSA)的死亡率最高。关于SSA新生儿败血症发病率和病因的可靠且全面的估计仍然不完整。我们估计了SSA新生儿败血症的经济负担。
利用全球卫生机构和医学文献中的数据来确定SSA的人口统计学特征,以及确定与新生儿败血症相关的发病率、疾病负担、死亡率和由此导致的残疾情况。计算了SSA地区1年内成功治疗或预防新生儿败血症所带来的伤残调整生命年(DALY)。采用统计生命价值(VSL)方法来评估SSA地区未治疗的新生儿败血症的经济负担。
我们保守估计,由于新生儿败血症,SSA地区每年损失529万至873万个伤残调整生命年。相应的VSL估计预测每年的经济负担在100亿美元至4690亿美元之间。
我们的结果突出并量化了SSA地区新生儿败血症所带来的公共卫生和经济负担的范围。我们量化了更成功的治疗和预防策略可能产生的重大影响,并强调需要加大投资,以制定相关策略来识别、诊断、预防和管理SSA地区的新生儿败血症及其长期后遗症。