title: Routine paediatric sickle cell disease (SCD) outpatient care in a rural Kenyan hospital: utilization and costs.
abstract: BACKGROUND
  More than 70% of children with sickle cell disease (SCD) are born in sub-Saharan Africa where the prevalence at birth of this disease reaches 2% or higher in some selected areas. There is a dearth of knowledge on comprehensive care received by children with SCD in sub-Saharan Africa and its associated cost. Such knowledge is important for setting prevention and treatment priorities at national and international levels. This study focuses on routine care for children with SCD in an outpatient clinic of the Kilifi District Hospital, located in a rural area on the coast of Kenya.
  
  
  OBJECTIVE
  To estimate the per-patient costs for routine SCD outpatient care at a rural Kenyan hospital.
  
  
  METHODS
  We collected routine administrative and primary cost data from the SCD outpatient clinic and supporting departments at Kilifi District Hospital, Kenya. Costs were estimated by evaluating inputs - equipment, medication, supplies, building use, utility, and personnel - to reflect the cost of offering this service within an existing healthcare facility. Annual economic costs were similarly calculated based on input costs, prorated lifetime of equipment and appropriate discount rate. Sensitivity analyses evaluated these costs under different pay scales and different discount rate.
  
  
  RESULTS
  We estimated that the annual economic cost per patient attending the SCD clinic was USD 138 in 2010 with a range of USD 94 to USD 229.
  
  
  CONCLUSIONS
  This study supplies the first published estimate of the cost of routine outpatient care for children born with SCD in sub-Saharan Africa. Our study provides policy makers with an indication of the potential future costs of maintaining specialist outpatient clinics for children living with SCD in similar contexts.
authors.affiliation: African Population Health Research Center, Nairobi, Kenya. damendah@aphrc.org
authors.forename: Djesika D
authors.initials: DD
authors.lastname: Amendah
authors.forename: George
authors.initials: G
authors.lastname: Mukamah
authors.forename: Albert
authors.initials: A
authors.lastname: Komba
authors.forename: Carolyne
authors.initials: C
authors.lastname: Ndila
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000191:economics*; D000755:Anemia, Sickle Cell / Q000191:economics* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D017048:Health Care Costs; D006780:Hospitals, Rural; D006801:Humans; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D055815:Young Adult