ESTIMATING THE COSTS ASSOCIATED WITH MENINGOCOCCAL OUTBREAKS IN BRAZIL AND COLOMBIA
Neisseria meningitidis (NM) is a leading cause of bacterial meningitis and septicemia in infants, young children and adolescents, with considerable morbidity and mortality and outbreaks every two years in certain parts of the world. Public health costs associated with meningococcal outbreaks are not well known in Latin America. The aim of the study is to provide estimates of the economic burden of meningococcal outbreaks in two endemic countries of the region.
We developed an economic model to estimate the cost associated with meningococcal outbreaks in Brazil (Campinas, Sao Paulo) and Colombia (Cartagena and Sincelejo, Cartagena de Indias) from a societal perspective. Structured interviews were conducted by local health authorities to estimate the cost of the outbreaks. The interviews captured information about the use of resources, expenses allocated to case management (e.g. chemoprophylaxis), immunization campaigns and response activities during the outbreak and disease surveillance after the outbreak. Resource utilization and cost data associated with control of the outbreak (response phase) and monitoring of disease (disease surveillance phase) were collected retrospectively.
Costs associated with outbreaks of meningococcal disease were reported from two recent outbreaks: one in Brazil (Vila Brandina in 2011), and one in Colombia (Cartagena de Indias in 2012). The first outbreak that occurred in Vila Brandina, São Paulo, reported 3 cases that were associated with a total investigation and outbreak management cost of US$34,425 (US$11,475 per notified case), compared to US$735.10 (US$122.52 per notified case) for the 2012 outbreak, which reported 6 cases in Cartagena de Indias. These costs correspond to the disease response phase. For the disease surveillance phase, the costs ranged from US$3,935 (Cartagena outbreak) to US$6,667 (outbreak in Vila Brandina). The difference in cost between the two outbreaks was due to the number of cases of an outbreak, the size of the population, the area of exposure, and management practices.
Findings of this study underscore the importance of meningococcal disease in the region. Current study findings will be used to inform national health authorities about the economic burden of meningococcal outbreaks in endemic countries of the region.