ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Paediatric Education and Research Ladder, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Clin Infect Dis. 2022 Jan 20;74(Suppl_1):S64-S69. doi: 10.1093/cid/ciab815.
Sepsis and meningitis are among the leading causes of neonatal deaths in sub-Saharan Africa (SSA). Neonatal sepsis caused ~400 000 deaths globally in 2015, half occurring in Africa. Despite this, there are few published data on the acute costs of neonatal sepsis or meningitis, with none in SSA.
We enrolled neonates admitted to 2 hospitals in South Africa and Mozambique between 16 April 2020 and 1 April 2021. In South Africa all cases were microbiologically confirmed, but in Mozambique both clinically suspected and microbiologically confirmed cases were included. Data were collected on healthcare resource use and length of stay, along with information on household expenditure and caregiving. We used unit costs of healthcare resources in local currencies to estimate healthcare provider costs per patient and costs per household. Results were converted to 2019 international dollars (I$).
We enrolled 11 neonates in Mozambique and 18 neonates in South Africa. Mean length of stay was 10 days (median, 9 [interquartile range {IQR}, 4-14) and 16 days (median, 15 [IQR, 13-18]), respectively. In Mozambique we estimated mean household costs of I$49.62 (median, 10.19 [IQR, 5.10-95.12]) and hospitalization costs of I$307.58 (median, 275.12 [IQR, 149.43-386.12]). In South Africa these costs were I$52.31 (median, 30.82 [IQR, 19.25-73.08]) and I$684.06 (median, 653.62 [IQR, 543.33-827.53]), respectively.
We found substantial costs associated with acute neonatal bacterial (all-cause) sepsis and meningitis in SSA. Our estimates will inform economic evaluations of interventions to prevent neonatal invasive bacterial infections.
在撒哈拉以南非洲（SSA），败血症和脑膜炎是导致新生儿死亡的主要原因之一。2015 年，全球有近 40 万新生儿因败血症死亡，其中一半发生在非洲。尽管如此，关于新生儿败血症或脑膜炎的急性成本的公开数据很少，在 SSA 则完全没有。
我们招募了 2020 年 4 月 16 日至 2021 年 4 月 1 日期间在南非和莫桑比克的 2 家医院住院的新生儿。在南非，所有病例均经微生物学确认，但在莫桑比克，包括临床疑似和微生物学确诊病例。我们收集了医疗资源使用情况和住院时间，以及家庭支出和护理信息。我们使用当地货币的医疗资源单位成本来估计每位患者和每个家庭的医疗服务提供者成本。结果转换为 2019 年国际美元（I$）。
我们在莫桑比克招募了 11 名新生儿，在南非招募了 18 名新生儿。平均住院时间分别为 10 天（中位数，9 [四分位距 {IQR}，4-14]）和 16 天（中位数，15 [IQR，13-18]）。在莫桑比克，我们估计家庭平均成本为 I$49.62（中位数，10.19 [IQR，5.10-95.12]），住院费用为 I$307.58（中位数，275.12 [IQR，149.43-386.12]）。在南非，这些成本分别为 I$52.31（中位数，30.82 [IQR，19.25-73.08]）和 I$684.06（中位数，653.62 [IQR，543.33-827.53]）。
我们发现 SSA 中急性新生儿细菌性（所有原因）败血症和脑膜炎的费用很高。我们的估计将为预防新生儿侵袭性细菌感染的干预措施的经济评估提供信息。
