Indirect costs associated with deaths from the Ebola virus disease in West Africa

Background:By 28 June 2015,there were a total of 11,234 deaths from the Ebola virus disease(EVD)in five West African countries(Guinea,Liberia,Mali,Nigeria and Sierra Leone).The objective of this study was to estimate the future productivity losses associated with EVD deaths in these West African countries,in order to encourage increased investments in national health systems.Methods:A cost-of-illness method was employed to calculate future non-health(NH)gross domestic product(GDP)(NHGDP)losses associated with EVD deaths.The future non-health GDP loss(NHGDPLoss)was discounted at 3%.Separate analyses were done for three different age groups(<=14 years,15–44 years and=>45 years)for the five countries(Guinea,Liberia,Mali,Nigeria,and Sierra Leone)affected by EVD.We also conducted a one-way sensitivity analysis at 5 and 10%discount rates to gauge their impacts on expected NHGDPLoss.Results:The discounted value of future NHGDPLoss due to the 11,234 deaths associated with EVD was estimated to be Int$(international dollars)155,663,244.About 27.86%of the loss would be borne by Guinea,34.84%by Liberia,0.10%by Mali,0.24%by Nigeria and 36.96%by Sierra Leone.About 27.27%of the loss is attributed to those aged under 14 years,66.27%to those aged 15–44 years and 6.46%to those aged over 45 years.The average NHGDPLoss per EVD death was estimated to be Int$17,473 for Guinea,Int$11,283 for Liberia,Int$25,126 for Mali,Int$47,364 for Nigeria and Int$14,633 for Sierra Leone.Conclusion:In spite of alluded limitations,the estimates of human and economic losses reported in this paper,in addition to those projected by the World Bank,show that EVD imposes a significant economic burden on the affected West African countries.That heavy burden,coupled with human rights and global security concerns,underscores the urgent need for increased domestic and external investments to enable Guinea,Liberia and Sierra Leone(and other vulnerable African countries)to develop resilient health systems,including core capacities to detect,assess,notify,verify and report events,and to respond to public health risks and emergencies.

生产率损失测量工具的比较研究

目的 比较可用于卫生技术评估中的生产率损失测量工具,厘清可用于卫生技术评估中的生产率损失测量工具的应用条件,以期为相关研究者在选择生产率损失的测量工具时提供参考。方法 检索PubMed、Web of Science、中国知网、万方、维普等中外数据库,检索时间从数据库建库至2021年11月,由2名研究者按照纳入与排除标准独立筛选文献、识别生产率损失测量工具、提取资料。结果 共识别出5种可用于卫生技术评估领域中的生产率损失测量工具,包括工作能力和活动受损量表(work productivity activity and impairment,WPAI)、工作能力局限调查问卷(work limitations questionnaire,WLQ)、健康与工作绩效问卷(Health and Work Performance Questionnaire,HPQ)、损失产能的估值(Valuation of Lost Productivity Questionnaire,VOLP)和医疗技术评估研究院(Institute for Medical Technology Assessment,IMTA)的生产力成本问卷(IMTA Productivity Questionnaire,IPCQ)。其中WPAI和WLQ是测量属性证据最为充足的工具;VOLP是成本涵盖最全的工具;WLQ是数据敏感性最强的工具;IPCQ是货币转化方法最多的工具;WPAI是获取使用最方便的工具。结论 对于卫生技术评估中的生产率损失测量的标准工具尚未存在统一共识,研究者可根据自身研究选取生产率损失测量工具。

Economic cost analysis of malaria case management at the household level during the malaria elimination phase in The People’s Republic of China

Background:In China,malaria has been posing a significant economic burden on households.To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of malaria elimination program in China.Methods:A number of study sites(eight counties in five provinces)were selected from the malaria endemic area in China,representing the different levels of malaria incidence,risk classification,economic development.A number of households with malaria cases(n=923)were surveyed during the May to December in 2012 to collect information on malaria economic burden.Descriptive statistics were used to characterize the basic profiles of selected malaria cases in terms of their gender,age group,occupation and malaria type.The malaria economic costs were evaluated by direct and indirect costs.Comparisons were carried out by using the chi-square test(or Z-test)and the Mann-Whitney U test among malaria cases with reference to local/imported malaria patients,hospitalized/out patients,and treatment hospitals.Results:The average cost of malaria per case was 1691.23 CNY(direct cost was 735.41 CNY and indirect cost was 955.82 CNY),which accounted for 11.1%of a household’s total income.The average costs per case for local and imported malaria were 1087.58 CNY and 4271.93 CNY,respectively.The average cost of a malaria patient being diagnosed and treated in a hospital at the county level or above(3975.43 CNY)was 4.23 times higher than that of malaria patient being diagnosed and treated at a village or township hospital(938.80 CNY).Conclusion:This study found that malaria has been posing a significant economic burden on households in terms of direct and indirect costs.There is a need to improve the effectiveness of interventions in order to reduce the impact costs of malaria,especially of imported infections,in order to eliminate the disease in China.