Cost-Effectiveness of Surveillance for Bloodstream Infections for Sepsis Management in Low-Resource Settings
Year: 2015
Type: article
Abstract: Bacterial sepsis is a leading cause of mortality among febrile patients in low- and middle-income countries, but blood culture services are not widely available. Consequently, empiric antimicrobial management of suspected bloodstream infection is based on generic guidelines that are rarely informed by local data on etiology and patterns of antimicrobial resistance. To evaluate the cost-effectiveness of surveillance for bloodstream infections to inform empiric management of suspected sepsis in low-resource areas, we compared costs and outcomes of generic antimicrobial management with management informed by local data on etiology and patterns of antimicrobial resistance. We applied a decision tree model to a hypothetical population of febrile patients presenting at the district hospital level in Africa. We found that the evidence-based regimen saved 534 more lives per 100,000 patients at an additional cost of $25.35 per patient, resulting in an incremental cost-effectiveness ratio of $4,739. This ratio compares favorably to standard cost-effectiveness thresholds, but should ultimately be compared with other policy-relevant alternatives to determine whether routine surveillance for bloodstream infections is a cost-effective strategy in the African context.
Authors: Erin C. Penno, Sarah J. Baird, John A. Crump
Institutions: George Washington University, University of Otago
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: Social, Economic and Environmental Drivers of Zoonoses in Tanzania (SEEDZ), G1886633764, G3028693477, G3168060087, G3204045353, The impact and social ecology of bacterial zoonoses in northern Tanzania, G5156098791, The Impact and Society Ecology of Bacterial Zoonoses in Northern Tanzania: Under, G5443035086, Molecular epidemiology of brucellosis in northern Tanzania
OpenAlex ID: W2269050013