Cost of Illness Due to Typhoid Fever in Pemba, Zanzibar, East Africa


Arthorn Riewpaiboon, Moritz Piatti, Benedikt Ley, Jacqueline Deen, Kamala Thriemer, Lorenz von Seidlein, Mohammad SalehJiddawi, Clara Jana-Lui Busch, Wolfgang H. Schmied, Said Mohammed Ali,The Typhoid Economic Study Group (GiDeok Pak, Leon R. Ochiai, Mahesh K. Puri, Na Yoon Chang, Thomas F. Wierzba, and John D. Clemens. All were affiliated to the International Vaccine Institute, Seoul, Korea).


The aim of this study was to estimate the economic burden of typhoid fever in Pemba, Zanzibar, East Africa. This study was an incidence-based cost-of-illness analysis from a societal perspective. It covered new episodes of blood culture-confirmed typhoid fever in patients presenting to the outpatient or inpatientdepartments of three district hospitals between May 2010 and December 2010. Cost of illness was the sumof direct costs and costs for productivity loss. Direct costs covered treatment, travel, and meals. Productivitycosts were loss of income by patients and caregivers. The analysis included 17 episodes. The mean age of the patients, was 23 years (range=5-65, median=22). Thirty-five percent were inpatients, with a mean of 4.75 days of hospital stay (range=3-7, median=4.50). The mean cost for treatment alone during hospital care was US$ 21.97 at 2010 prices (US$ 1=1,430.50 Tanzanian Shilling─TSH). The average societal cost was US$ 154.47 per typhoid episode. The major expenditure was productivity cost due to lost wages of US$ 128.02 (83%). Our results contribute to the further economic evaluation of typhoid fever vaccination in Zanzibar and other sub-Saharan African countries.


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