The immediate treatment outcomes and cost estimate for managing clinical measles in children admitted at Mulago Hospital: A retrospective cohort study.


Journal

PLOS global public health
ISSN: 2767-3375
Titre abrégé: PLOS Glob Public Health
Pays: United States
ID NLM: 9918283779606676

Informations de publication

Date de publication:
2023
Historique:
received: 28 12 2022
accepted: 22 06 2023
medline: 21 7 2023
pubmed: 21 7 2023
entrez: 21 7 2023
Statut: epublish

Résumé

Over the recent years, the Ministry of Health in Uganda has reported multiple measles outbreaks in various districts despite the availability of a safe cost effective vaccine. Measles, especially among the unvaccinated can lead to serious complications including death while its management heavily burdens the family and health care system. This study aims to determine the immediate treatment outcomes and estimate the cost of treating a measles case. A retrospective cohort study using records review was conducted among children 0-12 years admitted at Mulago hospital throughout 2018. Demographics, complications, vaccination status, discharge status, duration of hospital stay, type of treatment, supplies and investigations done were abstracted from the patient charts. Treatment costs were obtained from the hospital pharmacy price list while the unit cost of utilities, human resource, food and security were obtained from the hospital accounts department. Patients' characteristics were summarized descriptively. Cost information, was reported as mean with standard deviation (SD) and range, and was stratified and presented as direct health care (blood test, radiology and treatment) and direct non health care costs. Among 267 reviewed patient charts, the median age was 1.0 ((IQR 0.75-2) years. 63patients (24%) were immunised, 79 (29%) were not immunized, Median length of hospital stay was 4.0 days (IQR 3.0-7.0) with majority (n = 207, 77%) staying < 7 days. 30 patients (11%) died with mortality highest among the unimmunised (n = 13, 44%) and severe pneumonia (39.5%) was the commonest complication. 114.5 USD was estimated to treat a child with measles. Human resource (79.33USD, SD 4.63) and treatment costs (21.98USD, SD 22.77) were the largest expenses. Complications are common in majority of fatal measles cases and these carry a high cost to the healthcare system.

Identifiants

pubmed: 37478055
doi: 10.1371/journal.pgph.0001523
pii: PGPH-D-22-02083
pmc: PMC10361502
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e0001523

Informations de copyright

Copyright: © 2023 Namugga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Barbara Namugga (B)

Kampala Uganda Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda.

Ombeva Malande (O)

Kampala Uganda Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda.

Jonathan Kitonsa (J)

Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, London, England.

Leonard Manirakiza (L)

Uganda National Bureau of Standards, Kampala, Uganda.

Cecily Banura (C)

Kampala Uganda Department of Medical Epidemiology and Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda.

Ezekiel Mupere (E)

Kampala Uganda Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda.

Classifications MeSH