A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa
Rattachement africain : Afrique du Sud. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: While some evidence has been demonstrated the cost-effectiveness of routine hepatitis A vaccination in middle-income countries, the evidence is still limited in other settings including in South Africa. Given this, the evidence base around the cost of care for hepatitis A needs to be developed towards considerations of introducing hepatitis A vaccines in the national immunisation schedule and guidelines. OBJECTIVES: To describe the severity, clinical outcomes, and cost of hepatitis A cases presenting to two tertiary healthcare centers in Cape Town, South Africa. METHODS: We conducted a retrospective folder review of patients presenting with hepatitis A at two tertiary level hospitals providing care for urban communities of metropolitan Cape Town, South Africa. Patients included in this folder review tested positive for hepatitis A immunoglobulin M between 1 January 2008 and 1 March 2018. RESULTS: In total, 239 folders of hepatitis A paediatric patients < 15 years old and 212 folders of hepatitis A adult patients [Formula: see text] 15 years old were included in the study. Before presenting for tertiary level care, more than half of patients presented for an initial consultation at either a community clinic or general physician. The mean length of hospital stay was 7.45 days for adult patients and 3.11 days for paediatric patients. Three adult patients in the study population died as a result of hepatitis A infection and 29 developed complicated hepatitis A. One paediatric patient in the study population died as a result of hepatitis A infection and 27 developed complicated hepatitis A, including 4 paediatric patients diagnosed with acute liver failure. The total cost per hepatitis A hospitalisation was $1935.41 for adult patients and $563.06 for paediatric patients, with overhead costs dictated by the length of stay being the largest cost driver. CONCLUSION: More than 1 in every 10 hepatitis A cases (13.3%) included in this study developed complicated hepatitis A or resulted in death. Given the severity of clinical outcomes and high costs associated with hepatitis A hospitalisation, it is important to consider the introduction of hepatitis A immunisation in the public sector in South Africa to potentially avert future morbidity, mortality, and healthcare spending.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa
- Date Crossref
- 11/01/2022
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Cape Town Department of Statistical Sciences University of Cape Town, Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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South African Tuberculosis Vaccine Initiative Afrique du Sud (code pays fourni par la source)Établissement de santé
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Institute of Infectious Disease and Molecular Medicine Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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National Health Laboratory Service Cape Town, Afrique du Sud (code pays fourni par la source)Organisme public
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Groote Schuur Hospital Afrique du Sud (code pays fourni par la source)Établissement de santé
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Red Cross War Memorial Children's Hospital Afrique du Sud (code pays fourni par la source)Établissement de santé
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School of Public Health and Family Medicine Division of Epidemiology and Biostatistics University of Cape Town, Afrique du Sud (pays nommé en fin d’affiliation)Université ou école supérieure
Department of Statistical Sciences — University of Cape Town (University of Cape Town, Afrique du Sud), South African Tuberculosis Vaccine Initiative (Afrique du Sud) et Institute of Infectious Disease and Molecular Medicine (Afrique du Sud), avec 4 autres affiliations. Pays d’affiliation : Afrique du Sud.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.