Abstract
Background. Lack of medical coverage in Africa leads to inappropriate care that has an impact on the mortality rate. In this study, we aimed to evaluate the cost of severe acute sickle-cell related complications in Brazzaville. Methods. A retrospective study was conducted in 2014 in the Paediatric Intensive Care Unit. It concerned 94 homozygote sickle-cell children that developed severe acute sickle-cell disease related complications (average age 69 months). For each patient, we calculated the cost of care complication. Results. The household income was estimated as low (<XAF 90,000/<USD 158.40) in 27.7%. The overall median cost for hospitalization for sickle-cell related acute complications was XAF 65,460/USD 115.21. Costs were fluctuating depending on the generating factors of the severe acute complications (p = 0.041). They were higher in case of complications generated by bacterial infections (ranging from XAF 66,765/USD 117.50 to XAF 135,271.50/USD 238.07) and lower in case of complications associated with malaria (ranging from XAF 28,305/49.82 to XAF 64,891.63/USD 114.21). The mortality rate was 17% and was associated with the cost of the case management (p = 0.006). Conclusion. The case management cost of severe acute complications of sickle-cell disease in children is high in Congo.
Highlights
Sickle-cell disease is the most frequent haemoglobin disorder in the world, mostly in sub-Saharan Africa where 75% of the 300, 000 babies are born each year with haemoglobin disorders live [1, 2]
This study has examined the cost of severe acute sickle-cell disease (SCD) related complications in intensive care
Severe acute SCD related complications remain worrisome due to their graveness, but mainly due to the expenses that families must bear for their care
Summary
Sickle-cell disease is the most frequent haemoglobin disorder in the world, mostly in sub-Saharan Africa where 75% of the 300, 000 babies are born each year with haemoglobin disorders live [1, 2]. The nonaccessibility to care and medicines is linked in 54.61% to financial challenges [8] This inaccessibility is higher at the tertiary level of medical facilities such as the teaching hospital where the costs of care are far higher. In Africa and in Congo, contrary to the Western countries, morbidity and mortality are associated with the costs of sickle-cell disease (SCD) care. We aimed to evaluate the cost of severe acute sickle-cell related complications in Brazzaville. A retrospective study was conducted in 2014 in the Paediatric Intensive Care Unit It concerned 94 homozygote sickle-cell children that developed severe acute sickle-cell disease related complications (average age 69 months). The overall median cost for hospitalization for sickle-cell related acute complications was XAF 65,460/USD 115.21.
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