The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
Department of Child Health, Christian Medical College, Vellore, India.
J Infect Dis. 2021 Nov 23;224(Supple 5):S548-S557. doi: 10.1093/infdis/jiab329.
Primary data on causes and costs of hospitalization are necessary for costing and cost-effectiveness analysis. Data on incidence and causes of hospitalization and consequent expenses among Indian children are limited.
A cohort of 6000 children aged 0.5-15 years residing in urban Vellore was followed for 3 years, under the Vellore Typhoid Study, 2016-2017, and later under the Surveillance for Enteric Fever project, 2017-2019. Data on hospitalization events and associated antibiotic use, and direct medical costs for fever-related hospitalization of study children were obtained from caregivers through weekly follow-up by study field workers.
The incidence of hospitalization was 33 per 1000 child-years of observation. Children aged 0.5-5 years had the highest incidence of hospitalization. The top 5 infectious causes for hospitalization were acute undifferentiated fevers, respiratory tract infections, acute gastroenteritis, enteric fever, and dengue. The overall median cost of hospitalization for fever was 4243 (interquartile range, 2502-7215) Indian rupees (INR). An episode of dengue had a median cost of 5627 INR, followed by acute undifferentiated fevers and enteric fever with median costs of 3860 and 3507 INR, respectively.
Hospitalization for fever is common in young children and impacts household finances in low-income Indian households.
住院的原因和费用的原始数据对于成本和成本效益分析是必要的。关于印度儿童住院的发病率、原因和相关费用的数据有限。
2016-2017 年，在维洛尔伤寒研究中，对居住在城市维洛尔的 6000 名 0.5-15 岁的儿童进行了为期 3 年的队列研究，之后在 2017-2019 年的肠热病监测项目中进行了后续研究。通过研究现场工作人员每周的随访，从照顾者那里获得了与研究儿童发热相关住院事件及相关抗生素使用和直接医疗费用的相关数据。
住院率为每 1000 个儿童年观察 33 例。0.5-5 岁的儿童住院率最高。住院的前 5 大感染原因是急性未分化发热、呼吸道感染、急性肠胃炎、肠热病和登革热。发热住院的总中位数费用为 4243 卢比（四分位距，2502-7215）。登革热的住院费用中位数为 5627 卢比，其次是急性未分化发热和肠热病，住院费用中位数分别为 3860 卢比和 3507 卢比。
发热住院在幼儿中很常见，对印度低收入家庭的家庭财务状况产生影响。
