A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa

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dc.contributor.authorPatterson, Jenna
dc.contributor.authorCleary, Susan
dc.contributor.authorSilal, Sheetal P
dc.contributor.authorHussey, Gregory D
dc.contributor.authorEnoch, Annabel
dc.contributor.authorKorsman, Stephen
dc.contributor.authorGoddard, Elizabeth
dc.contributor.authorSetshedi, Mashiko
dc.contributor.authorSpearman, Wendy C
dc.contributor.authorKagina, Benjamin M
dc.contributor.authorMuloiwa, Rudzani
dc.date.accessioned2022-04-06T07:41:56Z
dc.date.available2022-04-06T07:41:56Z
dc.date.issued2022-01-11
dc.date.updated2022-01-16T05:06:07Z
dc.description.abstractBackground While some evidence has been demonstrated the cost-effectiveness of routine hepatitis A vaccination in middle-income countries, the evidence is still limited in other settings including in South Africa. Given this, the evidence base around the cost of care for hepatitis A needs to be developed towards considerations of introducing hepatitis A vaccines in the national immunisation schedule and guidelines. Objectives To describe the severity, clinical outcomes, and cost of hepatitis A cases presenting to two tertiary healthcare centers in Cape Town, South Africa. Methods We conducted a retrospective folder review of patients presenting with hepatitis A at two tertiary level hospitals providing care for urban communities of metropolitan Cape Town, South Africa. Patients included in this folder review tested positive for hepatitis A immunoglobulin M between 1 January 2008 and 1 March 2018. Results In total, 239 folders of hepatitis A paediatric patients < 15 years old and 212 folders of hepatitis A adult patients $$\ge$$ ≥ 15 years old were included in the study. Before presenting for tertiary level care, more than half of patients presented for an initial consultation at either a community clinic or general physician. The mean length of hospital stay was 7.45 days for adult patients and 3.11 days for paediatric patients. Three adult patients in the study population died as a result of hepatitis A infection and 29 developed complicated hepatitis A. One paediatric patient in the study population died as a result of hepatitis A infection and 27 developed complicated hepatitis A, including 4 paediatric patients diagnosed with acute liver failure. The total cost per hepatitis A hospitalisation was $1935.41 for adult patients and $563.06 for paediatric patients, with overhead costs dictated by the length of stay being the largest cost driver. Conclusion More than 1 in every 10 hepatitis A cases (13.3%) included in this study developed complicated hepatitis A or resulted in death. Given the severity of clinical outcomes and high costs associated with hepatitis A hospitalisation, it is important to consider the introduction of hepatitis A immunisation in the public sector in South Africa to potentially avert future morbidity, mortality, and healthcare spending.en_US
dc.identifier.apacitationPatterson, J., Cleary, S., Silal, S. P., Hussey, G. D., Enoch, A., Korsman, S., ... Muloiwa, R. (2022). A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa. <i>BMC Infectious Disease</i>, 22(1), 45. http://hdl.handle.net/11427/36276en_ZA
dc.identifier.chicagocitationPatterson, Jenna, Susan Cleary, Sheetal P Silal, Gregory D Hussey, Annabel Enoch, Stephen Korsman, Elizabeth Goddard, et al "A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa." <i>BMC Infectious Disease</i> 22, 1. (2022): 45. http://hdl.handle.net/11427/36276en_ZA
dc.identifier.citationPatterson, J., Cleary, S., Silal, S.P., Hussey, G.D., Enoch, A., Korsman, S., Goddard, E. & Setshedi, M. et al. 2022. A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa. <i>BMC Infectious Disease.</i> 22(1):45. http://hdl.handle.net/11427/36276en_ZA
dc.identifier.ris TY - Journal Article AU - Patterson, Jenna AU - Cleary, Susan AU - Silal, Sheetal P AU - Hussey, Gregory D AU - Enoch, Annabel AU - Korsman, Stephen AU - Goddard, Elizabeth AU - Setshedi, Mashiko AU - Spearman, Wendy C AU - Kagina, Benjamin M AU - Muloiwa, Rudzani AB - Background While some evidence has been demonstrated the cost-effectiveness of routine hepatitis A vaccination in middle-income countries, the evidence is still limited in other settings including in South Africa. Given this, the evidence base around the cost of care for hepatitis A needs to be developed towards considerations of introducing hepatitis A vaccines in the national immunisation schedule and guidelines. Objectives To describe the severity, clinical outcomes, and cost of hepatitis A cases presenting to two tertiary healthcare centers in Cape Town, South Africa. Methods We conducted a retrospective folder review of patients presenting with hepatitis A at two tertiary level hospitals providing care for urban communities of metropolitan Cape Town, South Africa. Patients included in this folder review tested positive for hepatitis A immunoglobulin M between 1 January 2008 and 1 March 2018. Results In total, 239 folders of hepatitis A paediatric patients < 15 years old and 212 folders of hepatitis A adult patients $$\ge$$ ≥ 15 years old were included in the study. Before presenting for tertiary level care, more than half of patients presented for an initial consultation at either a community clinic or general physician. The mean length of hospital stay was 7.45 days for adult patients and 3.11 days for paediatric patients. Three adult patients in the study population died as a result of hepatitis A infection and 29 developed complicated hepatitis A. One paediatric patient in the study population died as a result of hepatitis A infection and 27 developed complicated hepatitis A, including 4 paediatric patients diagnosed with acute liver failure. The total cost per hepatitis A hospitalisation was $1935.41 for adult patients and $563.06 for paediatric patients, with overhead costs dictated by the length of stay being the largest cost driver. Conclusion More than 1 in every 10 hepatitis A cases (13.3%) included in this study developed complicated hepatitis A or resulted in death. Given the severity of clinical outcomes and high costs associated with hepatitis A hospitalisation, it is important to consider the introduction of hepatitis A immunisation in the public sector in South Africa to potentially avert future morbidity, mortality, and healthcare spending. DA - 2022-01-11 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Infectious Disease KW - Epidemiology KW - Health economics KW - Vaccine preventable disease KW - Immunization KW - Hepatology KW - Hepatitis A KW - Acute liver failure LK - https://open.uct.ac.za PY - 2022 T1 - A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa TI - A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa UR - http://hdl.handle.net/11427/36276 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12879-021-06993-w
dc.identifier.urihttp://hdl.handle.net/11427/36276
dc.identifier.vancouvercitationPatterson J, Cleary S, Silal SP, Hussey GD, Enoch A, Korsman S, et al. A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa. BMC Infectious Disease. 2022;22(1):45. http://hdl.handle.net/11427/36276.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDepartment of Public Health and Family Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Infectious Diseaseen_US
dc.source.journalissue1en_US
dc.source.journalvolume22en_US
dc.source.pagination45en_US
dc.source.urihttps://bmcinfectdis.biomedcentral.com/
dc.subjectEpidemiologyen_US
dc.subjectHealth economicsen_US
dc.subjectVaccine preventable diseaseen_US
dc.subjectImmunizationen_US
dc.subjectHepatologyen_US
dc.subjectHepatitis Aen_US
dc.subjectAcute liver failureen_US
dc.titleA retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africaen_US
dc.typeJournal Articleen_US
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