Service de Médecine préventive et d'Épidémiologie, Centre hospitalier universitaire (CHU), Monastir (Tunisie).
Laboratoire de recherche, Épidémiologie appliquée à la santé de la mère et de l'enfant, CHU Monastir, Tunisie.
East Mediterr Health J. 2019 Dec 29;25(12):861-871. doi: 10.26719/emhj.19.036.
Pneumococcal infections are an important cause of morbidity and mortality in the world and in Tunisia. Data on the economic burden of these infections are needed to inform decision-making to include pneumococcal vaccinations in routine childhood immunization.
This study aimed to estimate the medical cost of hospitalizations due to invasive pneumococcal disease (pneumonia and meningitis) among children aged under 15 years old in Tunisia.
A prospective multicentre study was conducted in 15 paediatric departments, across different socio-economic areas of Tunisia, from June 2014 to May 2015. All children aged under 15 years old who were hospitalized for pneumococcal pneumonia or confirmed bacterial meningitis were enrolled. A case report form was completed for every eligible case. Activity Based Costing method was used to estimate the hospital cost. Data entry and statistical analysis were conducted using SPSS, version 20.0.
During the study period, 727 children were hospitalized for pneumococcal pneumonia and 60 children were hospitalized for bacterial meningitis, among them 21(35%) had confirmed pneumococcal meningitis. The median hospital cost for pneumococcal pneumonia was 353.910 Tunisian Dinars (TND) and TND 1680.632 for pneumococcal meningitis. Using overall data extrapolation, it was estimated that nearly 1091 hospitalizations for pneumococcal pneumonia and 69 hospitalizations for pneumococcal meningitis occurred each year in Tunisian children aged under 15 years of age, incurring total costs of TND 502 079.408.
The economic burden of pneumococcal infections seems to be substantial in Tunisia. The estimated costs does not reflect the real costs of this infection. Cost-effectiveness studies would be helpful to inform policy-makers to take appropriate decisions.
肺炎球菌感染是全世界和突尼斯发病率和死亡率的重要原因。需要了解这些感染的经济负担数据，以便为将肺炎球菌疫苗纳入常规儿童免疫规划提供决策依据。
本研究旨在估计突尼斯 15 岁以下儿童因侵袭性肺炎球菌病（肺炎和脑膜炎）住院的医疗费用。
2014 年 6 月至 2015 年 5 月，在突尼斯不同社会经济地区的 15 个儿科部门进行了一项前瞻性多中心研究。所有因肺炎球菌性肺炎或确诊细菌性脑膜炎住院的 15 岁以下儿童均纳入研究。为每例符合条件的病例填写病例报告表。采用作业成本法估算医院成本。使用 SPSS 版本 20.0 进行数据录入和统计分析。
研究期间，727 例儿童因肺炎球菌性肺炎住院，60 例儿童因细菌性脑膜炎住院，其中 21 例（35%）为确诊的肺炎球菌性脑膜炎。肺炎球菌性肺炎的中位数住院费用为 353.910 突尼斯第纳尔（TND），肺炎球菌性脑膜炎的住院费用为 1680.632 TND。根据总体数据推断，每年约有 1091 例肺炎球菌性肺炎和 69 例肺炎球菌性脑膜炎住院，15 岁以下儿童的总费用为 502079408 TND。
肺炎球菌感染的经济负担在突尼斯似乎很大。估计的成本并未反映出这种感染的实际成本。成本效益研究将有助于为决策者提供信息，以便做出适当的决策。
