Estimating costs associated with a community outbreak of meningococcal disease in a colombian Caribbean city.
Meningococcal disease is a serious and potentially life-threatening infection that is caused by the bacterium Neisseria meningitidis (N. meningitidis), and it can cause meningitis, meningococcaemia outbreaks and epidemics. The disease is fatal in 9-12% of cases and with a death rate of up to 40% among patients with meningococcaemia. The objective of this study was to estimate the costs of a meningococcal outbreak that occurred in a Caribbean city of Colombia. We contacted experts involved in the outbreak and asked them specific questions about the diagnosis and treatment for meningococcal cases during the outbreak. Estimates of costs of the outbreak were also based on extensive review of medical records available during the outbreak. The costs associated with the outbreak were divided into the cost of the disease response phase and the cost of the disease surveillance phase. The costs associated with the outbreak control and surveillance were expressed in US$ (2011) as cost per 1,000 inhabitants. The average age of patients was 4.6 years (SD 3.5); 50% of the cases died; 50% of the cases were reported to have meningitis (3/6); 33% were diagnosed with meningococcaemia and myocarditis (2/6); 50% of the cases had bacteraemia (3/6); 66% of the cases had a culture specimen positive for Neisseria meningitidis; 5 of the 6 cases had RT-PCR positive for N. meningitidis. All N. meningitidis were serogroup B; 50 doses of ceftriaxone were administered as prophylaxis. Vaccine was not available at the time. The costs associated with control of the outbreak were estimated at US$ 0.8 per 1,000 inhabitants, disease surveillance at US$ 4.1 per 1,000 inhabitants, and healthcare costs at US$ 5.1 per 1,000 inhabitants. The costs associated with meningococcal outbreaks are substantial, and the outbreaks should be prevented. The mass chemoprophylaxis implemented helped control the outbreak.
Centro de Investigación y Docencia, Hospital Infantil Napoleón Franco Pareja, Cartagena-Colombia ; Facultad de Medicina, Universidad de Cartagena, Cartagena-Colombia.
Hernando
H
Pinzón-Redondo
Grupo de Investigación en Economía de la Salud, Universidad de Cartagena, Cartagena-Colombia.
Wilfrido
W
Coronell-Rodriguez
Centro de Investigación y Docencia, Hospital Infantil Napoleón Franco Pareja, Cartagena-Colombia.
Inés
I
Díaz-Martinez
Centro de Investigación y Docencia, Hospital Infantil Napoleón Franco Pareja, Cartagena-Colombia.
Angel
A
Guzmán-Corena
International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Dagna
D
Constenla
Centro de Investigación y Docencia, Hospital Infantil Napoleón Franco Pareja, Cartagena-Colombia ; Grupo de Investigación en Economía de la Salud, Universidad de Cartagena, Cartagena-Colombia.
Nelson
N
Alvis-Guzmán
D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000191:economics; D002443:Ceftriaxone / Q000191:economics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003105:Colombia / Q000453:epidemiology; D017281:Cost of Illness; D004196:Disease Outbreaks / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000191:economics* / Q000453:epidemiology* / Q000382:microbiology; D009345:Neisseria meningitidis; D018571:Sentinel Surveillance
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone
Chemoprophylaxis; Cost; Invasive meningococcal disease; Outbreak