title: A population-based estimate of the economic burden of influenza in Peru, 2009-2010.
abstract: Influenza disease burden and economic impact data are needed to assess the potential value of interventions. Such information is limited from resource-limited settings. We therefore studied the cost of influenza in Peru.
  
  
  
  We used data collected during June 2009-December 2010 from laboratory-confirmed influenza cases identified through a household cohort in Peru. We determined the self-reported direct and indirect costs of self-treatment, outpatient care, emergency ward care, and hospitalizations through standardized questionnaires. We recorded costs accrued 15-day from illness onset. Direct costs represented medication, consultation, diagnostic fees, and health-related expenses such as transportation and phone calls. Indirect costs represented lost productivity during days of illness by both cases and caregivers. We estimated the annual economic cost and the impact of a case of influenza on a household.
  
  
  
  There were 1321 confirmed influenza cases, of which 47% sought health care. Participants with confirmed influenza illness paid a median of $13 [interquartile range (IQR) 5-26] for self-treatment, $19 (IQR 9-34) for ambulatory non-medical attended illness, $29 (IQR 14-51) for ambulatory medical attended illness, and $171 (IQR 113-258) for hospitalizations. Overall, the projected national cost of an influenza illness was $83-$85 millions. Costs per influenza illness represented 14% of the monthly household income of the lowest income quartile (compared to 3% of the highest quartile).
  
  
  
  Influenza virus infection causes an important economic burden, particularly among the poorest families and those hospitalized. Prevention strategies such as annual influenza vaccination program targeting SAGE population at risk could reduce the overall economic impact of seasonal influenza.
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Callao, Peru.|Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Yeny O
authors.initials: YO
authors.lastname: Tinoco
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Azziz-Baumgartner
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Callao, Peru.
authors.forename: Hugo
authors.initials: H
authors.lastname: Rázuri
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Callao, Peru.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Kasper
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Callao, Peru.
authors.forename: Candice
authors.initials: C
authors.lastname: Romero
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Callao, Peru.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Ortiz
authors.affiliation: General Directorate of Epidemiology, Ministry of Health, Lima, Peru.
authors.forename: Jorge
authors.initials: J
authors.lastname: Gomez
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Uyeki
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Callao, Peru.|Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Bausch
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Callao, Peru.|Division of Global Disease Detection International Emerging Infections Program, Centers for Disease Control and Prevention, Nairobi, Kenya.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Montgomery
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000191:economics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010568:Peru; D055815:Young Adult
keywords: Costs; healthcare economics; human influenza; population based; prevention and control