Background
Methods
Estimation of the frequency of measles complications and their treatment
Complication | Consequence | Distribution | Mean | Minimum | Maximum |
---|---|---|---|---|---|
Uncomplicated measles case | |||||
% cases not seeking medical attention | Triangular | 22.5 | 0.0 | 45.0 | |
Cases not seeing a GP
| Number of antipyretics bought | Exponential | 0.2 | 0.0 | 1.5 |
Number of antitussives bought | Tirangular | 0.4 | 0.0 | 1.0 | |
Number of working hours missed | Uniform | 12 | 6.0 | 18.0 | |
Cases seeing a GP
| Number of visits to GP | Triangular | 1.5 | 1.0 | 2.0 |
Number of antibiotics bought | Uniform | 1.0 | 0.0 | 2.0 | |
Number of antipyretics bought | Triangular | 1.0 | 0.0 | 3.0 | |
Number of antitussives bought | Triangular | 1.3 | 0.0 | 4.0 | |
Number of working hours missed | Uniform | 16.0 | 8.0 | 24.0 | |
Complicated measles cases
| |||||
% complicated cases | Triangular | 7.5 | 4.0 | 12.5 | |
Hospitalised
| LoS hospital – all wards | Triangular | 4.0 | 2.0 | 6.0 |
LoS Intensive care Unit | Uniform | 5.7 | 1 | 10.4 | |
% of hospital time spent in intensive care | Triangular | 6.5 | 4.0 | 8.0 | |
Specific costs for hospitalised complicated cases
| |||||
Otitis media | Frequency (per 100) | Triangular | 3.5 | 2.0 | 6.0 |
% hospitalised | Triangular | 0.2 | 0.05 | 0.3 | |
LoS hospital | Triangular | 1.0 | 0.5 | 1.5 | |
Pneumonia and other severe RTI | Frequency (per 100) | Uniform | 4.3 | 1.0 | 8.0 |
% hospitalised | Uniform | 15.0 | 10.0 | 20.0 | |
LoS hospital | Triangular | 7.0 | 4.0 | 10.0 | |
Encephalitis | Frequency (per 100) | Triangular | 0.13 | 0.1 | 0.2 |
% hospitalised | Fixed | 100.0 | |||
LoS hospital | Triangular | 6.0 | 3.0 | 9.0 | |
Thrombocytopenia | Frequency (per 100) | Uniform | 2.1 | 0.4 | 5.0 |
% hospitalised | Fixed | 100.0 | |||
LoS hospital | Uniform | 3.8 | 2.0 | 5.6 | |
Convulsions | Frequency (per 100) | Triangular | 0.2 | 0.1 | 0.4 |
% hospitalised | Triangular | 20.0 | 10.0 | 40.0 | |
LoS hospital | Uniform | 2.6 | 1.0 | 4.2 | |
SSPE | Frequency (per 100,000) | Triangular | 3.0 | 2.0 | 6.0 |
Long term sequelae following acute encephalitis
| |||||
Proportion of cases with extra hospitalisation | Uniform | 35.0 | 20.0 | 50.0 | |
Proportion of cases with extra consultations with a physician | Uniform | 15.0 | 10.0 | 20.0 | |
Proportion of cases with chronic treatment for epilepsy | Uniform | 20.0 | 10.0 | 30.0 | |
Proportion of cases missing school from = week to < 1 month | Uniform | 12.5 | 5.0 | 20.0 | |
Proportion of cases missing school = 1 month | Uniform | 6.0 | 1.0 | 11.0 | |
Number of school days missed between 1 week and 1 month | Triangular | 11.7 | 5.0 | 20.0 | |
Number of school days missed during = 1 month | Triangular | 37.0 | 21.0 | 60.0 | |
Proportion of cases needing residential care | Uniform | 5.0 | 1.0 | 9.0 | |
Long term sequelae following acute febrile convulsions
| |||||
Proportion of cases with extra hospitalisation | Uniform | 35.0 | 25.0 | 45.0 | |
Proportion of cases with extra consultations with a physician | Uniform | 20.0 | 10.0 | 30.0 | |
Proportion of cases with chronic treatment for epilepsy | Uniform | 12.5 | 8.0 | 17.0 | |
Variables common to long term sequelae
| |||||
Average number of extra hospitalisation per year | Triangular | 0.33 | 0.1 | 0.6 | |
Average number of extra physician visits per year | Triangular | 3.0 | 1.0 | 6.0 |
Estimating the frequency of AEFI and their treatment
Complication | Consequence | Distribution | Mean | Minimum | Maximum |
---|---|---|---|---|---|
Adverse events (per vaccinee) | |||||
Encephalitis | Frequency (per 100,000) | Triangular | 0.05 | 0 | 0.1 |
% hospitalised | Fixed | 100.0 | |||
LoS hospital | Triangular | 6.0 | 3.0 | 9.0 | |
Convulsions | Frequency (per 100,000) | Triangular | 28.0 | 17 | 34 |
% hospitalised | Triangular | 20.0 | 10.0 | 40.0 | |
LoS hospital | Uniform | 2.6 | 1.0 | 4.2 | |
% visiting a clinic | Fixed | 100.0 | |||
Number of antipyretics bought | Fixed | 1.0 | |||
Number of anticonvulsivants bought | Fixed | 1.0 | |||
Anaphylaxis | Frequency (per 100,000) | Triangular | 0.6 | 0.1 | 1.0 |
% hospitalised | Fixed | 100.0 | |||
LoS hospital | Uniform | 1.5 | 1.0 | 2.0 | |
Thrombocytopenia | Frequency (per 100,000) | Uniform | 3.3 | 3.1 | 3.5 |
% hospitalised | Fixed | 100.0 | |||
LoS hospital | Uniform | 3.8 | 2.0 | 5.6 | |
Fever | Frequency (per 100) | Triangular | 8.7 | 2.0 | 19.0 |
% visiting a clinic | Uniform | 10.0 | 0.0 | 20.0 | |
Number of antipyretics bought | Fixed | 1.0 | |||
Number of working hours missed | Uniform | 12 | 6.0 | 18.0 | |
SSPE | Frequency (per 100,000) | Uniform | 0.07 | 0 | 0.14 |
Estimating the cost of measles cases and AEFI
Uncertainty and sensitivity analyses
Item | Unit | Country | Cost | Reference (distribution) |
---|---|---|---|---|
Exchange rate (ro 2001 US$) | Per local currency | Netherlands | 0.42 | 48 |
UK | 1.45 | 48 | ||
Canada | 0.67 | 48 | ||
Hospitalisation – general ward | Per day | Netherlands | $ 232.35 | 64 |
UK | $ 332.97 | 38 | ||
Canada | $ 430.23 | 43 | ||
Hospitalisation – intensive care unit | Per day | Netherlands | $ 364.77 | 43 |
UK | $ 421.07 | 38 | ||
Canada | $ 548.76 | 43 | ||
Residential care | Per week | Netherlands | $ 645.81 | 64 |
UK | $ 406.00 | 38 (Triangular(267,415,535) | ||
Canada | $ 298.05 | 39 (Triangular (175.32, 298.05, 420.80) | ||
Visit to the physician | Per visit | Netherlands | $ 15.63 | 64 |
UK | $ 37.33 | 38 | ||
Canada | $ 19.85 | 39 | ||
Antipyretics | Per pack | Netherlands | $ 0.84 | 64 |
UK | $ 4.06 | 46 | ||
Canada | $ 2.98 | 44 (uniform(1.7, 4.1) | ||
Cough Syrup | Per bottle | Netherlands | $ 4.22 | 64 |
UK | $ 4.27 | 46 (uniform(3.9, 4.6) | ||
Canada | $ 4.13 | 44 (triangular(2.7, 4.1, 5.5)) | ||
Antibiotics for RTI | Per course | Netherlands | $ 9.29 | 64 |
UK | $ 4.85 | 52 (triangular (2.9, 4.4, 7.3)) | ||
Canada | $ 11.69 | 44 (triangular (6.8, 10.9, 17.1) | ||
Anticonvulsivant (diazepam for acute case) | Per dose | Netherlands | $ 0.78 | 64 (Uniform(0.52, 1.04) |
UK | $ 18.40 | 45 (Uniform (16.42, 19.41) | ||
Canada | $ 3.63 | 44 | ||
Anticonvulsivant (for epilepsy) | Per day | Netherlands | $ 3.53 | 47 (Triangular (0.6, 4.25, 5.75)) |
UK | $ 2.80 | 47 (Triangular (1.34, 3.73, 7.47)) | ||
Canada | $ 1.70 | 44 (Uniform(0.41, 2.98) | ||
Test to measure anticonvulsivant blood levels | Per test | Netherlands | $ 12.37 | 47 |
UK | $ 41.95 | 47 | ||
Canada | $ 26.00 | 47 (Uniform (12.00, 40.00)) | ||
SSPE – HCP costs | Per case | Netherlands | $ 50,000 | Assumed over 2.5 years§
|
UK | $ 50,000 | Assumed over 2.5 years§
| ||
Canada | $ 50,000 | Assumed over 2.5 years§
| ||
SSPE – other costs | Per case | Netherlands | $ 50,000 | Assumed over 2.5 years§
|
UK | $ 50,000 | Assumed over 2.5 years§
| ||
Canada | $ 50,000 | Assumed over 2.5 years§
| ||
Average wage for women | Per day | Netherlands | $ 68.07 | 40 |
UK | $ 73.06 | 41 | ||
Canada | $ 61.77 | 42 |