Abstract
Rotavirus is one of the most important causative agents of gastroenteritis in both infants and children worldwide, resulting in a high mortality and burden of disease, mainly in low-income, developing countries. Oral rehydration therapy with zinc supplementation is currently the recommended way to prevent death from diarrheal dehydration. In this study, we aimed to estimate the effectiveness of zinc supplementation in combination therapy of patients with suspected rotavirus infection in Indonesia. The perspective of this pharmacoeconomic study refer to the economic vantage point of cost-of-illness analysis. Achievement of this goal was possible with the construction of a decision tree model and determination of decision rules for inclusion of zinc supplementation into the combination therapy. The input parameters of the model were hospitalization days of patients stratified by the presence or absence of rotavirus infection as well as the additional inclusion of zinc supplementation. The criterion for prediction and decision making was the global rotavirus prevalence. The feature of the simulation was that the costs were expressed as relative to each other, which allowed to unify the proposed methodology. Retrospective analysis of clinical database of Indonesian patients with acute diarrhea has shown that zinc supplementation would be rational in case of rotavirus prevalence among these patients is higher than 81.5%. It was shown that additional zinc supplementation would be costeffective with probability of 0.62 and 0.53 – in the positive range of cost ratio variation or if costs for less than 43% of baseline therapy per day costs on an average.
Highlights
Curcuma xanthorrhiza belongs to the Zingiberaceae family and locally known as temulawak
We proposed a new method using quantitative analysis of multi-components by single marker (QAMS) for quality control of C. xanthorrhiza based on the determination of curcuminoids content by only use curcumin as a single marker
Preparation of standard solution Curcuminoids standard stock solution were prepared by appropriate amount of BDMC, DMC and CUR were dissolved with methanol in a 10mL volumetric flask to obtain 500 μg.mL-1 respectively
Summary
Curcuma xanthorrhiza belongs to the Zingiberaceae family and locally known as temulawak. Wang et al (2006) systematically proposed a quantitative analysis of multicomponent by single marker (QAMS) This method, based on the principle of the absorption (A), is linearly proportional to the concentration (W) of an analyte within a concentration range (W = f.A). It only uses one component to determine other components and use their internal relationship and proportion (Zhu et al 2017) In recent years, this method has been widely used as an alternative method for quality control of many medicinal plants (Li et al 2017; Peng et al 2018; Wang et al 2016; Xu et al 2017). We proposed a new method using QAMS for quality control of C. xanthorrhiza based on the determination of curcuminoids content by only use curcumin as a single marker. By using only one component to determine other curcuminoids, it will increase the effectiveness, efficiency, and cost of analysis without sacrificing the quality of the analytical result
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