title: Economic burden of acute lower respiratory tract infection in South African children.
abstract: BACKGROUND
  Acute lower respiratory tract infections (ALRTI) are a leading cause of childhood mortality, but there are few data on disease costs in developing countries.
  
  
  OBJECTIVE
  This study's purpose was to analyse ALRTI's costs-of-illness and economic burden in urban South African children.
  
  
  METHODS
  ALRTI costs-of-illness (expressed in US$ 2010) at a tertiary hospital were measured using a micro-costing approach nested within a clinical trial. Demographic, epidemiological and data on use of health resources were integrated with costs-of-illness to estimate the economic burden of ALRTI in urban South African children aged <5 years.
  
  
  RESULTS
  745 children experiencing 858 ALRTI episodes were studied. 338 (39.4%), 513 (59.8%) and 7 (0.8%) episodes were managed in short-stay, paediatric ward and intensive care settings, respectively. Mean lengths of stay in short-stay, paediatric ward and intensive care (ICU) were 1.4, 8.1 and 14.4 days, respectively. The societal costs-of-illness per ALRTI episode managed in short-stay and paediatric ward settings, respectively, were US$266 (95% CI 245-286) and 1287 (95% CI 1174-1401) in HIV-infected patients, and US$257 (95% CI 247-267) and 1032 (95% CI 931-1133) in HIV-uninfected patients. Family costs were not collected in ICUs. ICU direct medical costs were US$5968 (95% CI 4025-8056) in HIV-uninfected patients and US$7849 in one HIV-infected patient. Under-5 children experienced an estimated 424,220 episodes annually of ALRTI. ALRTI treatment cost the public health system an estimated US$28,975,000 while an additional US$539,000 of costs were borne by families.
  
  
  CONCLUSIONS
  ALRTIs in children <5 years impose a heavy economic burden on families and the South African public health-care system.
authors.affiliation: Department of Preventive Medicine and Community Health, New Jersey Medical School, Newark, USA. sinhaan1@umdnj.edu
authors.forename: Anushua
authors.initials: A
authors.lastname: Sinha
authors.forename: Soyeon
authors.initials: S
authors.lastname: Kim
authors.forename: Gary
authors.initials: G
authors.lastname: Ginsberg
authors.forename: Heather
authors.initials: H
authors.lastname: Franklin
authors.forename: Robert
authors.initials: R
authors.lastname: Kohberger
authors.forename: David
authors.initials: D
authors.lastname: Strutton
authors.forename: Shabir A
authors.initials: SA
authors.lastname: Madhi
authors.forename: Ulla K
authors.initials: UK
authors.lastname: Griffiths
authors.forename: Keith P
authors.initials: KP
authors.lastname: Klugman
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D017281:Cost of Illness; D003906:Developing Countries / Q000191:economics; D005190:Family; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000191:economics; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000191:economics; D008297:Male; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D012141:Respiratory Tract Infections / Q000191:economics* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D013019:South Africa / Q000453:epidemiology; D016896:Treatment Outcome; D014505:Urban Population
chemical_list: D022242:Pneumococcal Vaccines