New Vaccine Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, 3051, Australia.
Department of Pediatrics, The University of Melbourne, Melbourne, Australia.
BMC Infect Dis. 2023 Feb 6;23(1):73. doi: 10.1186/s12879-023-08024-2.
Little information is available on the costs of respiratory syncytial virus (RSV) in Vietnam or other low- and middle-income countries. Our study estimated the costs of LRTIs associated with RSV infection among children in southern Vietnam.
We conducted a prospective cohort study evaluating household and societal costs associated with LRTIs stratified by RSV status and severity among children under 2 years old who sought care at a major pediatric referral hospital in southern Vietnam. Enrollment periods were September 2019-December 2019, October 2020-June 2021 and October 2021-December 2021. RSV status was confirmed by a validated RT-PCR assay. RSV rapid detection antigen (RDA) test performance was also evaluated. Data on resource utilization, direct medical and non-medical costs, and indirect costs were collected from billing records and supplemented by patient-level questionnaires. All costs are reported in 2022 US dollars.
536 children were enrolled in the study, with a median age of 7 months (interquartile range [IQR] 3-12). This included 210 (39.2%) children from the outpatient department, 318 children (59.3%) from the inpatient respiratory department (RD), and 8 children (1.5%) from the intensive care unit (ICU). Nearly 20% (105/536) were RSV positive: 3.9 percent (21/536) from the outpatient department, 15.7% (84/536) from the RD, and none from the ICU. The median total cost associated with LRTI per patient was US$52 (IQR 32-86) for outpatients and US$184 (IQR 109-287) for RD inpatients. For RSV-associated LRTIs, the median total cost per infection episode per patient was US$52 (IQR 32-85) for outpatients and US$165 (IQR 95-249) for RD inpatients. Total out-of-pocket costs of one non-ICU admission of RSV-associated LRTI ranged from 32%-70% of the monthly minimum wage per person (US$160) in Ho Chi Minh City. The sensitivity and the specificity of RSV RDA test were 88.2% (95% CI 63.6-98.5%) and 100% (95% CI 93.3-100%), respectively.
These are the first data reporting the substantial economic burden of RSV-associated illness in young children in Vietnam. This study informs policymakers in planning health care resources and highlights the urgency of RSV disease prevention.
关于呼吸道合胞病毒（RSV）在越南或其他中低收入国家的成本，信息有限。我们的研究估计了越南南部儿童因 RSV 感染导致的下呼吸道感染（LRTI）的成本。
我们进行了一项前瞻性队列研究，评估了在越南南部一家主要儿科转诊医院寻求治疗的 2 岁以下儿童中，与 RSV 状态和严重程度相关的 LRTI 相关的家庭和社会成本。登记期为 2019 年 9 月至 12 月、2020 年 10 月至 2021 年 6 月和 2021 年 10 月至 2021 年 12 月。RSV 状态通过经过验证的 RT-PCR 检测确认。还评估了 RSV 快速检测抗原（RDA）检测的性能。从计费记录中收集了资源利用、直接医疗和非医疗成本以及间接成本的数据，并通过患者水平的问卷进行了补充。所有成本均以 2022 年美元报告。
共有 536 名儿童入组研究，中位年龄为 7 个月（四分位距 [IQR] 3-12）。其中 210 名（39.2%）来自门诊部，318 名（59.3%）来自住院呼吸科（RD），8 名（1.5%）来自重症监护病房（ICU）。近 20%（105/536）为 RSV 阳性：3.9%（21/536）来自门诊部，15.7%（84/536）来自 RD，ICU 中无。每位 LRTI 患者的门诊患者总费用中位数为 52 美元（IQR 32-86），RD 住院患者为 184 美元（IQR 109-287）。对于 RSV 相关的 LRTI，每位感染患者的总费用中位数为门诊患者 52 美元（IQR 32-85），RD 住院患者 165 美元（IQR 95-249）。RSV 相关 LRTI 非 ICU 住院的总自付费用范围为胡志明市每人每月最低工资（160 美元）的 32%-70%。RSV RDA 检测的灵敏度和特异性分别为 88.2%（95%CI 63.6-98.5%）和 100%（95%CI 93.3-100%）。
这是越南首次报告 RSV 相关疾病对幼儿造成的重大经济负担。本研究为决策者规划医疗保健资源提供了信息，并强调了 RSV 疾病预防的紧迫性。
