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Costs of Meningitis Sequelae in Children in Dakar, Senegal

Griffiths, Ulla K. PhD*; Dieye, Yakou MD; Fleming, Jessica PhD; Hajjeh, Rana MD§; Edmond, Karen MB BS, PhD

The Pediatric Infectious Disease Journal: November 2012 - Volume 31 - Issue 11 - p e189–e195
doi: 10.1097/INF.0b013e3182615297
Original Studies

Background: Survivors of bacterial meningitis risk lifelong sequelae. In economic evaluations of vaccines protecting against meningitis, treatment and productivity costs due to meningitis sequelae are rarely included in studies from low-income countries, mainly due to lack of data. The aim of this study was to estimate the costs of meningitis sequelae in children in Senegal from the perspective of households.

Methods: Children who had suffered from bacterial meningitis were identified from a database at Albert Royer Hospital in Dakar. Sixty-eight children were located at their home and caregivers interviewed about costs during the acute meningitis episode and due to meningitis sequelae, including productivity loss from caring for a disabled child. Lifetime costs were predicted by assuming a life expectancy of 30 years for disabled children.

Results: Seventy-one percent of the children had either minor or major sequelae. Mean discounted lifetime sequelae costs amounted to US$ 34,895 (95% confidence interval: US$ 67–96,755) per child. Discounted childcare costs amounted to US$ 3158 (9%), treatment costs US$ 460 (1%) and productivity costs US$ 31,276 (90%). No children were receiving rehabilitation services by the time the study was conducted.

Conclusion: The present study is the first to present data on household costs from families with disabled children in a low-income country setting. Caring for a disabled child is a considerable financial as well as emotional burden for the individual family. None of the families could afford the treatment they desired for their child.

From the *Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom; Program for Appropriate Technologies in Health, Dakar, Senegal; Program for Appropriate Technologies in Health, Seattle, WA; §Centers for Disease Control and Prevention, Atlanta, GA; and Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Supported by the Hib Initiative, a project funded by the GAVI Alliance. The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Ulla K. Griffiths, PhD, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15–17 Tavistock Place, London WC1H 9SH, United Kingdom. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.