title: Economic Impact of Meningococcal Outbreaks in Brazil and Colombia.
abstract: Background.  The impact of meningitis outbreaks is substantial. We aim to calculate the costs of meningococcal outbreaks in Brazil and Colombia from the healthcare system perspective. Methods.  A review of the literature was performed on costs associated with meningococcal outbreak in Latin America. Structured interviews capturing information about the use of resources, expenses allocated to treatment of infection, immunization campaigns, and response activities during the outbreak and disease surveillance pre- and postoutbreak were directed at local health authorities in Brazil and Colombia to foster a greater understanding of the economic impact of meningococcal outbreaks. All costs were expressed in 2014 US values. Results.  The Vila Brandina outbreak in Brazil reported 3 cases that were associated with a total investigation and outbreak management cost of $34 425 ($11 475 per notified case), representing 2.7 more than the annual gross domestic product per capita in Brazil. In contrast, the outbreak in Cartagena de Indias in Colombia reported 6 cases at a cost of the disease response phase of $735 or 9.5% of the annual gross domestic product per capita ($123 per notified case). For the disease surveillance phase, the costs ranged from $3935 (in Cartagena de Indias) to $6667 (in Vila Brandina). Serogroups B and C were responsible for the majority of meningococcal outbreaks reported in Brazil and Colombia. Conclusions.  Findings of this study underscore the importance of meningococcal disease in the region. Future research should focus on a more detailed investigation of costs of meningococcal outbreaks covering all phases of an outbreak.
authors.affiliation: Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: D
authors.initials: D
authors.lastname: Constenla
authors.affiliation: Sabin Vaccine Institute , Washington, District of Columbia.
authors.forename: A
authors.initials: A
authors.lastname: Carvalho
authors.affiliation: Centro de Investigación y Docencia , Fundación Hospital Infantil Napoleón Franco Pareja, Grupo de Investigación en Economía de la Salud, Universidad de Cartagena , Colombia.
authors.forename: N
authors.initials: N
authors.lastname: Alvis Guzmán
keywords: Latin American countries; Neisseriameningitidis; caregiver costs; indirect costs; outbreaks