dc.contributor.author | Osano, B Ombaba | |
dc.date.accessioned | 2013-05-23T13:16:33Z | |
dc.date.available | 2013-05-23T13:16:33Z | |
dc.date.issued | 2009 | |
dc.identifier.citation | Master of Medicine, Paediatrics and Child Health | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/24936 | |
dc.description.abstract | Background
Rotavirus infection is the single most common cause of acute gastroenteritis in children
under five years of age. Rotavirus gastroenteritis (RVG) has a high morbidity and mortality in
children in Kenya. The costs of care and treatment for rotavirus gastroenteritis are high.
Comprehensive data on the outcomes and cost of care of RVG in Kenya are lacking.
Objective
To determine the short term clinical outcomes and compute average cost of care for children
admitted to Kenyatta National Hospital (KNH) with rotavirus gastroenteritis.
Methodology
A short longitudinal survey at Kenyatta National Hospital, Nairobi, Kenya from February to
May 2008. A minimum sample size of 165 was sufficient for both primary and secondary
objectives of this study. This samples size was calculated using mortality as the worst
outcome with a mortality rate of 11.6%. Children less than 3 years of age admitted to the
paediatric wards with a diagnosis of acute gastroenteritis were tested for rotavirus in stool
samples using a rapid antigen detection kit and ELISA. Those found positive for rotavirus
and gave consent were recruited into the study. A full clinical evaluation was done and a predesigned
questionnaire administered. The recruited patients were followed up till discharge
or death. Their outcomes, costs incurred and the bills they paid were entered into the
questionnaire. The average costs were then calculated.
Results
Five hundred of the children admitted to KNH with acute gastroenteritis were screened for
rotavirus. One hundred and ninety one (38.2%) of them tested positive for rotavirus in stool
and 172 children were recruited into the study. Of the 172 children, 87.8% were discharged
within one week, 8.1% stayed for more than 7 days while 4.1% died. The average cost of
care per child admitted with rotavirus gastroenteritis was Kshs 6,505.79 to the patient, Kshs.
14,178.21 and Kshs. 16,556.08 to the hospital and economy/society respectively using the
National Hospital Insurance Fund bed charge rates. Children who had co-morbidities had
worse outcomes in comparison to those who did not have any co-morbidity.
Conclusion
Rotavirus gastroenteritis has a significant impact on young children and their families in
terms of long hospital stay, high morbidity and mortality. It incurs considerable resource
utilization in health care settings, substantial costs for national health care and lost work
days to the economy.
Recommendation
A cost benefit analysis for the whole country should be done to guide in policy making for
routine rotavirus vaccination | en |
dc.description.sponsorship | University of Nairobi | en |
dc.language.iso | en | en |
dc.title | Short term outcome and cost analysis of children admitted with rotavirus gastroenteritis | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |