Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
Fernandes Figueira National Institute of Woman, Child and Adolescent Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
BMJ Glob Health. 2022 Jul;7(7). doi: 10.1136/bmjgh-2022-008784.
The aim of this paper is to estimate the economic burden of children with congenital Zika Syndrome (CZS) in Brazil over 5-10 years.
We conducted a modelling study based on data collected in a case-control study in Brazil, including children with CZS (cases) and typically developing children (controls), born in 2015 and 2016. In total, 484 participants were recruited in two sites, Recife and Rio de Janeiro. Social and economic information was collected in a survey from the carers of cases and controls, and detailed healthcare utilisation was recorded for each child in the Rio de Janeiro cohort prospectively in a database. We used this information to estimate the cost per child with severe, moderate and no CZS and incremental cost per child with severe and moderate versus no CZS from a disaggregated societal perspective. These estimates were incorporated into an economic burden model to estimate the incremental burden of the CZS epidemic in Brazil over 5 years and 10 years.
The societal cost per child with severe CZS was US$50 523 to 10 years of age (born in 2015 and 2016), substantially higher than the costs for moderate CZS (US$29 283) and without CZS (US$12 331). The incremental economic burden of severe versus no CZS in Brazil over 10 years was US$69.4 million from the household and US$129.0 million from the government perspective. For moderate CZS, these figures amounted to US$204.1 million and US$86.6 million. Over 10 years, 97% of the total societal economic cost of severe CZS is borne by the government, but only 46% for moderate CZS.
The economic burden of CZS is high at the household, provider and government levels. The compensatory government payments helped to alleviate some of the additional costs incurred by families with a child qualifying for the disability benefits, and could be scaled to include the children with moderate CZS.
本文旨在估算巴西先天性寨卡综合征（CZS）患儿在 5-10 年内的经济负担。
我们开展了一项基于巴西病例对照研究数据的建模研究，该研究纳入了 2015 年和 2016 年出生的 CZS 患儿（病例）和典型发育儿童（对照）。总共在两个地点（累西腓和里约热内卢）招募了 484 名参与者。病例和对照的照护者完成了一项调查以收集社会经济信息，而里约热内卢队列中的每名儿童都前瞻性地在数据库中记录了详细的医疗保健使用情况。我们使用这些信息从分散的社会角度估算了每名严重、中度和无 CZS 患儿的成本以及每名严重和中度 CZS 患儿相对于无 CZS 患儿的增量成本。这些估算值被纳入经济负担模型，以估算巴西在 5 年和 10 年内 CZS 流行的增量负担。
患有严重 CZS 的儿童从出生到 10 岁（2015 年和 2016 年出生）的社会成本为 50523 美元至 10 年，远高于中度 CZS（29283 美元）和无 CZS（12331 美元）的成本。从家庭角度来看，巴西在 10 年内因严重 CZS 造成的额外经济负担为 6940 万美元，从政府角度来看为 1.29 亿美元。对于中度 CZS，这些数字分别为 2.041 亿美元和 8660 万美元。在 10 年内，严重 CZS 造成的社会总经济成本的 97%由政府承担，但中度 CZS 仅为 46%。
CZS 给家庭、医疗服务提供者和政府带来了高昂的经济负担。政府的补偿性支付有助于减轻符合残疾福利资格的家庭所承担的部分额外费用，并且可以扩大到包括患有中度 CZS 的儿童。
