Evidence map›Paper›PMID 27231544›Full record

SynthesisJournal of global health2016

Cost of management of severe pneumonia in young children: systematic analysis.

Shanshan Zhang, Peter M Sammon, Isobel King, Ana Lucia Andrade, Cristiana M Toscano, Sheila N Araujo, Anushua Sinha, Shabir A Madhi, Gulam Khandaker, Jiehui Kevin Yin and 19 more

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of global health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05239104 (Laos Out-Of-Pocket Costs), which is not on this map. Cited by 70 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05239104 completednot on this mapstarted 2022, after this paper: background citation

Laos Out-Of-Pocket Costs: an Observational Study on the Impact of Severe Childhood Illness on the Health, Wealth and Wellbeing of Household Members in Lao People's Democratic Republic

TypeobservationalSponsorMurdoch Childrens Research InstituteRan2022 to 2024Enrolled400ConditionsHealth Care Economics, Child Health, Cost of Illness, Burden of IllnessArmsNo intervention
3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  14. Randomized Trial of Amoxicillin for Pneumonia in Pakistan.The New England journal of medicine · 2020
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10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Shanshan ZhangUsher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK; Department of Preventive Dentistry, Peking University, School and Hospital of Stomatology, Beijing, PR China.
Peter M SammonUsher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Isobel KingUsher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK; NHS Grampian, UK.
Ana Lucia AndradeDepartment of Community Health, Federal University of Goias, Brazil.
Cristiana M ToscanoDepartment of Community Health, Federal University of Goias, Brazil.
Sheila N AraujoDepartment of Community Health, Federal University of Goias, Brazil; State University of Maranhăo, Brazil.
Anushua SinhaNew Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey USA.
Shabir A MadhiMedical Research Council, Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa.
Gulam KhandakerNational Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, NSW, Australia; Sydney School of Public Health, Faculty of Medicine, The University of Sydney, NSW, Australia.
Jiehui Kevin YinNational Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, NSW, Australia; Sydney School of Public Health, Faculty of Medicine, The University of Sydney, NSW, Australia.
Robert BooyNational Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, NSW, Australia; Sydney School of Public Health, Faculty of Medicine, The University of Sydney, NSW, Australia.
Tanvir M HudaCentre for Child and Adolescent Health, icddr,b, Dhaka, Bangladesh; School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia.
Qazi S RahmanCentre for Child and Adolescent Health, icddr,b, Dhaka, Bangladesh.
Shams El ArifeenCentre for Child and Adolescent Health, icddr,b, Dhaka, Bangladesh.
Angela GentileEpidemiology Department, Ricardo Gutierrez Children Hospital, University of Buenos Aires, Argentina.
Norberto GiglioEpidemiology Department, Ricardo Gutierrez Children Hospital, University of Buenos Aires, Argentina.
Mejbah U BhuiyanCentre for Communicable Diseases, icddr,b, Dhaka, Bangladesh.
Katharine Sturm-RamirezCentre for Communicable Diseases, icddr,b, Dhaka, Bangladesh; Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Bradford D GessnerAgence de Médicine Préventive, Paris, France.
Mardiati NadjibFaculty of Public Health, University of Indonesia, Jakarta, Indonesia.
Phyllis J Carosone-LinkDepartment of Pediatrics, Section of Infectious Diseases, University of Colorado Denver School of Medicine, Denver, CO, USA.
Eric Af SimõesDepartment of Pediatrics, Section of Infectious Diseases, University of Colorado Denver School of Medicine, Denver, CO, USA; Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.
Jason A ChildPharmacy Department, Children's Hospital Colorado, Aurora, CO, USA.
Imran AhmedCenter of Excellence in Women and Child Health, the Aga Khan University, Karachi, Pakistan.
Zulfiqar A BhuttaCenter of Excellence in Women and Child Health, the Aga Khan University, Karachi, Pakistan.
Sajid B SoofiDepartment of Paediatrics & Child Health, The Aga Khan University, Karachi, Pakistan.
Rumana J KhanJames P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
Harry CampbellUsher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Harish NairUsher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK; Public Health Foundation of India, New Delhi, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildhood pneumonia is a major cause of childhood illness and the second leading cause of child death globally. Understanding the costs associated with the management of childhood pneumonia is essential for resource allocation and priority setting for child health.

methodsWe conducted a systematic review to identify studies reporting data on the cost of management of pneumonia in children younger than 5 years old. We collected unpublished cost data on non-severe, severe and very severe pneumonia through collaboration with an international working group. We extracted data on cost per episode, duration of hospital stay and unit cost of interventions for the management of pneumonia. The mean (95% confidence interval, CI) and median (interquartile range, IQR) treatment costs were estimated and reported where appropriate.

resultsWe identified 24 published studies eligible for inclusion and supplemented these with data from 10 unpublished studies. The 34 studies included in the cost analysis contained data on more than 95 000 children with pneumonia from both low- and-middle income countries (LMIC) and high-income countries (HIC) covering all 6 WHO regions. The total cost (per episode) for management of severe pneumonia was US$ 4.3 (95% CI 1.5-8.7), US$ 51.7 (95% CI 17.4-91.0) and US$ 242.7 (95% CI 153.6-341.4)-559.4 (95% CI 268.9-886.3) in community, out-patient facilities and different levels of hospital in-patient settings in LMIC. Direct medical cost for severe pneumonia in hospital inpatient settings was estimated to be 26.6%-115.8% of patients' monthly household income in LMIC. The mean direct non-medical cost and indirect cost for severe pneumonia management accounted for 0.5-31% of weekly household income. The mean length of stay (LOS) in hospital for children with severe pneumonia was 5.8 (IQR 5.3-6.4) and 7.7 (IQR 5.5-9.9) days in LMIC and HIC respectively for these children.

conclusionThis is the most comprehensive review to date of cost data from studies on the management of childhood pneumonia and these data should be helpful for health services planning and priority setting by national programmes and international agencies.

Indexed as

Cost of IllnessChild, PreschoolFemaleHealth Care CostsHumansInfantInfant, NewbornMalePneumonia

Identifiers

PMID27231544
PMCPMC4871066

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.