Akpan Edifofon, Thean Li Jun, Baskota Rabindra, Mani Jyotishna, Mow Maria, Kama Mike, Tuicakau Meciusela, Kado Joseph, Romani Lucia, Kaldor John, Engelman Daniel, Steer Andrew C, Carvalho Natalie
School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Murdoch Children's Research Institute, Tropical Diseases Group, Melbourne, Australia.
PLOS Glob Public Health. 2024 Oct 10;4(10):e0003706. doi: 10.1371/journal.pgph.0003706. eCollection 2024.
Scabies and related bacterial skin and soft tissue infections (SSTIs) are highly prevalent in many tropical, low- and middle-income settings. These skin conditions contribute to higher healthcare costs and burdens on healthcare systems. The Big Skin Health Intervention Fiji Trial ("Big SHIFT") carried out surveillance for scabies and SSTIs from July 2018 to June 2019 in the Northern Division of Fiji, an area with high prevalence of scabies, prior to a division-wide ivermectin-based mass drug administration (MDA) campaign. Using data from Big SHIFT, we sought to estimate the annual direct healthcare costs of scabies and related SSTIs for the Northern Division and extrapolate these costs to the national level. We categorized SSTIs as being potentially scabies-related or unlikely scabies-related, based on a previous study. The analysis used a health system perspective, with the main resource use categories of outpatient visits, bed days during admissions, medicines, and diagnostic tests. We extrapolated the total annual number of cases and direct healthcare costs for all divisions in Fiji based upon previous scabies and impetigo prevalence data across all divisions. The average cost per PHC presentation for scabies was US$17.7, and for potentially scabies-related SSTI was $18.3. The average cost per hospital admission for a potentially scabies-related SSTI case was $439. The estimated annual healthcare costs of scabies and related SSTIs in Fiji was US$3.0 million, with cost per capita of $3.3. Scabies and related SSTIs lead to a heavy economic burden in Fiji and prevention would reduce these healthcare costs.
疥疮及相关细菌性皮肤和软组织感染（SSTIs）在许多热带、低收入和中等收入地区极为普遍。这些皮肤疾病增加了医疗成本，并给医疗系统带来了负担。斐济大皮肤健康干预试验（“大转变”）于2018年7月至2019年6月在斐济北部地区开展了疥疮和SSTIs监测，该地区疥疮患病率较高，随后进行了全地区基于伊维菌素的大规模药物管理（MDA）运动。利用“大转变”的数据，我们试图估算斐济北部地区疥疮及相关SSTIs的年度直接医疗成本，并将这些成本推算至国家层面。根据之前的一项研究，我们将SSTIs分为可能与疥疮相关或不太可能与疥疮相关两类。该分析采用了卫生系统视角，主要资源使用类别包括门诊就诊、住院天数、药品和诊断测试。我们根据斐济所有地区先前的疥疮和脓疱病患病率数据，推算出斐济所有地区的年度病例总数和直接医疗成本。疥疮每次初级卫生保健就诊的平均成本为17.7美元，可能与疥疮相关的SSTI为18.3美元。与疥疮相关的SSTI病例每次住院的平均成本为439美元。斐济疥疮及相关SSTIs的估计年度医疗成本为300万美元，人均成本为3.3美元。疥疮及相关SSTIs给斐济带来了沉重的经济负担，预防措施将降低这些医疗成本。
