Estimating Costs Associated with a Community Outbreak of Meningococcal Disease in a Colombian Caribbean City.
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Date
2014-09
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Abstract
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.
Description
Keywords
Chemoprophylaxis, Cost, Invasive meningococcal disease, Outbreak
Citation
Pinzón-Redondo Hernando, Coronell-Rodriguez Wilfrido, Díaz-Martinez Inés, Guzmán-Corena Ángel, Constenla Dagna, Alvis-Guzmán Nelson. Estimating Costs Associated with a Community Outbreak of Meningococcal Disease in a Colombian Caribbean City. Journal of Health, Population and Nutrition. 2014 Sep; 32(3): 539-548.