Abstract
Background Sepsis and meningitis are among the leading causes of neonatal deaths in sub-Saharan Africa (SSA). Neonatal sepsis caused ~400 000 deaths globally in 2015, half occurring in Africa. Despite this, there are few published data on the acute costs of neonatal sepsis or meningitis, with none in SSA.MethodsWe enrolled neonates admitted to 2 hospitals in South Africa and Mozambique between 16 April 2020 and 1 April 2021. In South Africa all cases were microbiologically confirmed, but in Mozambique both clinically suspected and microbiologically confirmed cases were included. Data were collected on healthcare resource use and length of stay, along with information on household expenditure and caregiving. We used unit costs of healthcare resources in local currencies to estimate healthcare provider costs per patient and costs per household. Results were converted to 2019 international dollars (I$).ResultsWe enrolled 11 neonates in Mozambique and 18 neonates in South Africa. Mean length of stay was 10 days (median, 9 [interquartile range {IQR}, 4–14) and 16 days (median, 15 [IQR, 13–18]), respectively. In Mozambique we estimated mean household costs of I$49.62 (median, 10.19 [IQR, 5.10–95.12]) and hospitalization costs of I$307.58 (median, 275.12 [IQR, 149.43–386.12]). In South Africa these costs were I$52.31 (median, 30.82 [IQR, 19.25–73.08]) and I$684.06 (median, 653.62 [IQR, 543.33–827.53]), respectively. ConclusionsWe found substantial costs associated with acute neonatal bacterial (all-cause) sepsis and meningitis in SSA. Our estimates will inform economic evaluations of interventions to prevent neonatal invasive bacterial infections.
Highlights
Sepsis and meningitis are amongst the leading causes of neonatal deaths in Sub-Saharan Africa (SSA)
Our study provides estimates of health care and household costs associated with acute neonatal sepsis and meningitis hospitalisations in Mozambique and South Africa
Due to pathogens including Group B Streptococcus (GBS), led to about 400000 deaths globally in 2015, half of which occurred in t the African region [3]. ip Despite this, there are few published studies on the cost of acute healthcare for sepsis and/or r meningitis in neonates from low- and middle-income countries (LMICs), with data concentrated sc mainly in the United States [4]
Summary
Vaccines and Infectious Diseases Analytics Research s Unit, Faculty of the Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Our estimates will inform cost-effectiveness analyses of interventions to e prevent invasive bacterial infections in neonates. Acc Key words: sepsis, meningitis, neonate, costs, health economics. The few published studies on acute healthcare costs of neonatal sepsis and/or meningitis are from high-income countries, and mainly from the United States. Our study provides estimates of health care and household costs associated with acute neonatal sepsis and meningitis hospitalisations in Mozambique and South Africa. Using hospital records and discharge questionnaires of 29 neonates hospitalized in Mozambique and t South Africa, we estimated mean costs to households and healthcare providers to be I$49.62 ip (median=10.19, IQR=5.10-95.12) and I$307.58 (median=275.12; IQR=149.43-386.12), and I$52.31. Interventions to a prevent neonatal sepsis and meningitis could reduce the costs to healthcare providers and households, as well as improving health outcomes. Further costing studies with larger study populations, across a range of te hospital settings and countries, and using similar tools to ours would make findings more Accep generalisable and give insights into cost drivers and contextual differences
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