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The cost of influenza-associated hospitalizations and outpatient visits in Kenya.

Emukule, G.O., Ndegwa, L.K., Washington, M.L., Paget, J.W., Duque, J., Chaves, S.S., Otieno, N.A., Wamburu, K., Ndigirigi, I.W., Muthoka, P.M., Velden, K. van der, Mott, J.A. The cost of influenza-associated hospitalizations and outpatient visits in Kenya. BMC Public Health: 2019, 19(suppl. 3), 471
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Background
We estimated the cost-per-episode and the annual economic burden associated with influenza in Kenya.

Methods
From July 2013–August 2014, we recruited patients with severe acute respiratory illness (SARI) or influenza-like illness (ILI) associated with laboratory-confirmed influenza from 5 health facilities. A structured questionnaire was used to collect direct costs (medications, laboratory investigations, hospital bed fees, hospital management costs, transportation) and indirect costs (productivity losses) associated with an episode of influenza. We used published incidence of laboratory-confirmed influenza associated with SARI and ILI, and the national population census data from 2014, to estimate the annual national number of influenza-associated hospitalizations and outpatient visits and calculated the annual economic burden by multiplying cases by the mean cost.

Results
We enrolled 275 patients (105 inpatients and 170 outpatients). The mean cost-per-episode of influenza was US$117.86 (standard deviation [SD], 88.04) among inpatients; US$114.25 (SD, 90.03) for children < 5 years, and US$137. 45 (SD, 76.24) for persons aged ≥5 years. Among outpatients, the mean cost-per-episode of influenza was US$19.82 (SD, 27.29); US$21.49 (SD, 31.42) for children < 5 years, and US$16.79 (SD, 17.30) for persons aged ≥5 years. National annual influenza-associated cost estimates ranged from US$2.96–5.37 million for inpatients and US$5.96–26.35 million for outpatients.

Conclusions
Our findings highlight influenza as causing substantial economic burden in Kenya. Further studies may be warranted to assess the potential benefit of targeted influenza vaccination strategies.