The Association between Influenza Treatment and Hospitalization-Associated Outcomes among Korean Children with Laboratory-Confirmed Influenza

Jacqueline K. Lim,김태희,Paul E. Kilgore,Allison E. Aiello,최병민,이광철,유기환,송영환,김윤경 대한의학회 2014 Journal of Korean medical science Vol.29 No.4

There are limited data evaluating the relationship between influenza treatment andhospitalization duration. Our purpose assessed the association between differenttreatments and hospital stay among Korean pediatric influenza patients. Total 770 children≤ 15 yr-of-age hospitalized with community-acquired laboratory-confirmed influenza atthree large urban tertiary care hospitals were identified through a retrospective medicalchart review. Demographic, clinical, and cost data were extracted and a multivariablelinear regression model was used to assess the associations between influenza treatmenttypes and hospital stay. Overall, there were 81% of the patients hospitalized withlaboratory-confirmed influenza who received antibiotic monotherapy whereas only 4% ofthe patients received oseltamivir monotherapy. The mean treatment-related charges forhospitalizations treated with antibiotics, alone or with oseltamivir, were significantlyhigher than those treated with oseltamivir-only (P < 0.001). Influenza patients treatedwith antibiotics-only and antibiotics/oseltamivir combination therapy showed 44.9% and28.2%, respectively, longer duration of hospitalization compared to those treated withoseltamivir-only. Patients treated with antibiotics, alone or combined with oseltamivir,were associated with longer hospitalization and significantly higher medical charges,compared to patients treated with oseltamivir alone. In Korea, there is a need for morejudicious use of antibiotics, appropriate use of influenza rapid testing.

The Association between Influenza Treatment and Hospitalization-Associated Outcomes among Korean Children with Laboratory-Confirmed Influenza

Lim, Jacqueline K.,Kim, Tae Hee,Kilgore, Paul E.,Aiello, Allison E.,Choi, Byung Min,Lee, Kwang Chul,Yoo, Kee Hwan,Song, Young-Hwan,Kim, Yun-Kyung The Korean Academy of Medical Sciences 2014 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.29 No.4

<P>There are limited data evaluating the relationship between influenza treatment and hospitalization duration. Our purpose assessed the association between different treatments and hospital stay among Korean pediatric influenza patients. Total 770 children 15 yr-of-age hospitalized with community-acquired laboratory-confirmed influenza at three large urban tertiary care hospitals were identified through a retrospective medical chart review. Demographic, clinical, and cost data were extracted and a multivariable linear regression model was used to assess the associations between influenza treatment types and hospital stay. Overall, there were 81% of the patients hospitalized with laboratory-confirmed influenza who received antibiotic monotherapy whereas only 4% of the patients received oseltamivir monotherapy. The mean treatment-related charges for hospitalizations treated with antibiotics, alone or with oseltamivir, were significantly higher than those treated with oseltamivir-only (P < 0.001). Influenza patients treated with antibiotics-only and antibiotics/oseltamivir combination therapy showed 44.9% and 28.2%, respectively, longer duration of hospitalization compared to those treated with oseltamivir-only. Patients treated with antibiotics, alone or combined with oseltamivir, were associated with longer hospitalization and significantly higher medical charges, compared to patients treated with oseltamivir alone. In Korea, there is a need for more judicious use of antibiotics, appropriate use of influenza rapid testing.</P>

Burden of dengue among febrile patients at the time of chikungunya introduction in Piedecuesta, Colombia

Carabali, Mabel,Lim, Jacqueline K.,Palencia, Diana C.,Lozano‐,Parra, Anyela,Gelvez, Rosa Margarita,Lee, Kang Sung,Florez, Janeth P.,Herrera, Victor Mauricio,Kaufman, Jay S.,Rojas, Elsa M.,Villar John Wiley and Sons Inc. 2018 Tropical medicine & international health Vol.23 No.11

<P><B>Abstract</B></P><P><B>Objective</B></P><P>To estimate the age‐specific incidence of symptomatic dengue and chikungunya in Colombia.</P><P><B>Method</B></P><P>A passive facility‐based fever surveillance study was conducted among individuals with undifferentiated fever. Confirmatory diagnostics included serological and molecular tests in paired samples, and surveillance's underreporting was assessed using capture–recapture methods.</P><P><B>Results</B></P><P>Of 839 febrile participants 686 completed the study. There were 33.2% (295/839) dengue infections (51% primary infections), and 35.9% (191/532) of negative dengue cases there were chikungunya cases. On average, dengue cases were younger (median = 18 years) than chikungunya cases (median = 25 years). Thrombocytopaenia and abdominal pain were the main dengue predictors, while presence of rash was the main predictor for chikungunya diagnosis. Underreporting of dengue was 31%; the estimated expansion factors indicate an underreporting rate of dengue cases of threefold for all cases and of almost sixfold for inpatients.</P><P><B>Conclusions</B></P><P>These findings highlight the ongoing coexistence of both arboviruses, a distinct clinical profile of each condition in the study area that could be used by clinicians to generate a differential diagnosis, and the presence of underreporting, mostly among hospitalised cases.</P>

Prospects for dengue vaccines for travelers

Sl-Ki Lim,이용석,남궁석,Jacqueline K Lim,윤인규 대한백신학회 2016 Clinical and Experimental Vaccine Research Vol.5 No.2

Travel-acquired dengue cases have been increasing as the overall global dengue burden has expanded. In Korea, imported dengue cases have been reported since 2000 when it first became a notifiable disease. During the first four months of 2016, three times more dengue cases were reported in Korea than during the same period the previous year. A safe and efficacious vaccine for travelers would be beneficial to prevent dengue disease in individual travelers and potentially decrease the risk of virus spread to non-endemic areas. Here, we summarize the characteristics of dengue vaccines for travelers and review dengue vaccines currently licensed or in clinical development.

A multi-country study of the economic burden of dengue fever: Vietnam, Thailand, and Colombia

Lee, Jung-Seok,Mogasale, Vittal,Lim, Jacqueline K.,Carabali, Mabel,Lee, Kang-Sung,Sirivichayakul, Chukiat,Dang, Duc Anh,Palencia-Florez, Diana Cristina,Nguyen, Thi Hien Anh,Riewpaiboon, Arthorn,Chanth Public Library of Science 2017 PLoS neglected tropical diseases Vol.11 No.10

<▼1><P><B>Background</B></P><P>Dengue fever is a major public health concern in many parts of the tropics and subtropics. The first dengue vaccine has already been licensed in six countries. Given the growing interests in the effective use of the vaccine, it is critical to understand the economic burden of dengue fever to guide decision-makers in setting health policy priorities.</P><P><B>Methods/Principal findings</B></P><P>A standardized cost-of-illness study was conducted in three dengue endemic countries: Vietnam, Thailand, and Colombia. In order to capture all costs during the entire period of illness, patients were tested with rapid diagnostic tests on the first day of their clinical visits, and multiple interviews were scheduled until the patients recovered from the current illness. Various cost items were collected such as direct medical and non-medical costs, indirect costs, and non-out-of-pocket costs. In addition, socio-economic factors affecting disease severity were also identified by adopting a logit model. We found that total cost per episode ranges from $141 to $385 for inpatient and from $40 to $158 outpatient, with Colombia having the highest and Thailand having the lowest. The percentage of the private economic burden of dengue fever was highest in the low-income group and lowest in the high-income group. The logit analyses showed that early treatment, higher education, and better knowledge of dengue disease would reduce the probability of developing more severe illness.</P><P><B>Conclusions/Significance</B></P><P>The cost of dengue fever is substantial in the three dengue endemic countries. Our study findings can be used to consider accelerated introduction of vaccines into the public and private sector programs and prioritize alternative health interventions among competing health problems. In addition, a community would be better off by propagating the socio-economic factors identified in this study, which may prevent its members from developing severe illness in the long run.</P></▼1><▼2><P><B>Author summary</B></P><P>Dengue fever has been prevalent in South-East Asia and South America. Despite the increase of dengue fever cases, there continues to be a lack of economic assessment partly due to the absence of vaccines until recent times. Many of the previous economic burden studies for dengue fever were not standardized, making them difficult to compare. We implemented the standardized economic burden survey for dengue fever in a multi-country setting: Vietnam, Thailand, and Colombia. We found that the economic burden of dengue fever is substantial in all three dengue endemic countries. Our study also identified socio-economic factors which are related to the probability of experiencing severe illness. The first live attenuated, tetravalent dengue vaccine (CYD-TDV) has been already licensed in some dengue-endemic countries. As three countries will soon face decisions on whether and how to incorporate current and future vaccine candidates within their budget constraints, the updated economic burden estimates can be used to develop sustainable financing plans.</P></▼2>

Correction: A Multi-country Study of the Household Willingness-to-Pay for Dengue Vaccines: Household Surveys in Vietnam, Thailand, and Colombia

Lee, Jung-Seok,Mogasale, Vittal,Lim, Jacqueline K.,Carabali, Mabel,Sirivichayakul, Chukiat,Anh, Dang Duc,Lee, Kang-Sung,Thiem, Vu Dinh,Limkittikul, Kriengsak,Tho, Le Huu,Velez, Ivan D.,Osorio, Jorge E Public Library of Science 2015 PLoS neglected tropical diseases Vol.9 No.6

A multi-country study of the economic burden of dengue fever based on patient-specific field surveys in Burkina Faso, Kenya, and Cambodia

Lee, Jung-Seok,Mogasale, Vittal,Lim, Jacqueline K.,Ly, Sowath,Lee, Kang Sung,Sorn, Sopheak,Andia, Esther,Carabali, Mabel,Namkung, Suk,Lim, Sl-Ki,Ridde, Valé,ry,Njenga, Sammy M.,Yaro, Seydou,Yoon Public Library of Science 2019 PLoS neglected tropical diseases Vol.13 No.2

<▼1><P><B>Background</B></P><P>Dengue fever is a rapidly growing public health problem in many parts of the tropics and sub-tropics in the world. While there are existing studies on the economic burden of dengue fever in some of dengue-endemic countries, cost components are often not standardized, making cross-country comparisons challenging. Furthermore, no such studies have been available in Africa.</P><P><B>Methods/Principal findings</B></P><P>A patient-specific survey questionnaire was developed and applied in Burkina Faso, Kenya, and Cambodia in a standardized format. Multiple interviews were carried out in order to capture the entire cost incurred during the period of dengue illness. Both private (patient’s out-of-pocket) and public (non-private) expenditure were accessed to understand how the economic burden of dengue is distributed between private and non-private payers.</P><P>A substantial number of dengue-confirmed patients were identified in all three countries: 414 in Burkina Faso, 149 in Kenya, and 254 in Cambodia. The average cost of illness for dengue fever was $26 (95% CI $23-$29) and $134 (95% CI $119-$152) per inpatient in Burkina Faso and Cambodia, respectively. In the case of outpatients, the average economic burden per episode was $13 (95% CI $23-$29) in Burkina Faso and $23 (95% CI $19-$28) in Kenya. Compared to Cambodia, public contributions were trivial in Burkina Faso and Kenya, reflecting that a majority of medical costs had to be directly borne by patients in the two countries.</P><P><B>Conclusions/Significance</B></P><P>The cost of illness for dengue fever is significant in the three countries. In particular, the current study sheds light on the potential economic burden of the disease in Burkina Faso and Kenya where existing evidence is sparse in the context of dengue fever, and underscores the need to achieve Universal Health Coverage. Given the availability of the current (CYD-TDV) and second-generation dengue vaccines in the near future, our study outcomes can be used to guide decision makers in setting health policy priorities.</P></▼1><▼2><P><B>Author summary</B></P><P>Dengue fever is a major public health concern in many parts of South-East Asia and South America. In addition to countries where dengue has been highly prevalent for many years, there is a growing concern on the undocumented burden of dengue in Africa. Following the successful execution of the first-round economic burden study in Vietnam, Thailand, and Colombia by the Dengue Vaccine Initiative, the second-round economic burden study was implemented in Burkina Faso, Kenya and Cambodia using the same standardized methodology. In particular, the second-round study targeted GAVI eligible countries for future vaccine introductions and included two African countries where the burden of dengue was relatively unknown. Our study outcomes show that the economic burden of dengue fever is significant in all three countries. The dengue vaccination era began in 2016 with the first dengue vaccine (CYD-TDV) although its public use should be carefully determined due to the safety concerns related to the vaccine. Considering that there are other second-generation dengue vaccines in development, the current study outcomes provide an important step to estimate the economic benefits of vaccination in the three countries.</P></▼2>