Costs of meningitis sequelae in children in Dakar, Senegal.

BACKGROUND: Survivors of bacterial meningitis risk lifelong sequelae. In economic evaluations of vaccines protecting against meningitis, treatment and productivity costs due to meningitis sequelae are rarely included in studies from low-income countries, mainly due to lack of data. The aim of this study was to estimate the costs of meningitis sequelae in children in Senegal from the perspective of households. METHODS: Children who had suffered from bacterial meningitis were identified from a database at Albert Royer Hospital in Dakar. Sixty-eight children were located at their home and caregivers interviewed about costs during the acute meningitis episode and due to meningitis sequelae, including productivity loss from caring for a disabled child. Lifetime costs were predicted by assuming a life expectancy of 30 years for disabled children. RESULTS: Seventy-one percent of the children had either minor or major sequelae. Mean discounted lifetime sequelae costs amounted to US$ 34,895 (95% confidence interval: US$ 67-96,755) per child. Discounted childcare costs amounted to US$ 3158 (9%), treatment costs US$ 460 (1%) and productivity costs US$ 31,276 (90%). No children were receiving rehabilitation services by the time the study was conducted. CONCLUSION: The present study is the first to present data on household costs from families with disabled children in a low-income country setting. Caring for a disabled child is a considerable financial as well as emotional burden for the individual family. None of the families could afford the treatment they desired for their child.