Evidence map›Paper›PMID 35016628›Full record

ArticleBMC infectious diseases2022

A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa.

Jenna Patterson, Susan Cleary, Sheetal P Silal, Gregory D Hussey, Annabel Enoch, Stephen Korsman, Elizabeth Goddard, Mashiko Setshedi, Wendy C Spearman, Benjamin M Kagina and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 20% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

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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

11 authors at 4 institutions in 1 country.

Jenna PattersonDivision of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. pttjen005@myuct.ac.za.
Susan ClearyDivision of Health Economics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Sheetal P SilalModelling and Simulatio Hub Africa, Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa.
Gregory D HusseyVaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Annabel EnochNational Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa.
Stephen KorsmanNational Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa.
Elizabeth GoddardDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Mashiko SetshediDepartment of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Wendy C SpearmanDepartment of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Benjamin M KaginaDivision of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Rudzani MuloiwaVaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
University of Cape Town · ZAGroote Schuur Hospital · ZASouth African Tuberculosis Vaccine Initiative · ZARed Cross War Memorial Children's Hospital · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile some evidence has been demonstrated the cost-effectiveness of routine hepatitis A vaccination in middle-income countries, the evidence is still limited in other settings including in South Africa. Given this, the evidence base around the cost of care for hepatitis A needs to be developed towards considerations of introducing hepatitis A vaccines in the national immunisation schedule and guidelines.

objectivesTo describe the severity, clinical outcomes, and cost of hepatitis A cases presenting to two tertiary healthcare centers in Cape Town, South Africa.

methodsWe conducted a retrospective folder review of patients presenting with hepatitis A at two tertiary level hospitals providing care for urban communities of metropolitan Cape Town, South Africa. Patients included in this folder review tested positive for hepatitis A immunoglobulin M between 1 January 2008 and 1 March 2018.

resultsIn total, 239 folders of hepatitis A paediatric patients < 15 years old and 212 folders of hepatitis A adult patients [Formula: see text] 15 years old were included in the study. Before presenting for tertiary level care, more than half of patients presented for an initial consultation at either a community clinic or general physician. The mean length of hospital stay was 7.45 days for adult patients and 3.11 days for paediatric patients. Three adult patients in the study population died as a result of hepatitis A infection and 29 developed complicated hepatitis A. One paediatric patient in the study population died as a result of hepatitis A infection and 27 developed complicated hepatitis A, including 4 paediatric patients diagnosed with acute liver failure. The total cost per hepatitis A hospitalisation was $1935.41 for adult patients and $563.06 for paediatric patients, with overhead costs dictated by the length of stay being the largest cost driver.

conclusionMore than 1 in every 10 hepatitis A cases (13.3%) included in this study developed complicated hepatitis A or resulted in death. Given the severity of clinical outcomes and high costs associated with hepatitis A hospitalisation, it is important to consider the introduction of hepatitis A immunisation in the public sector in South Africa to potentially avert future morbidity, mortality, and healthcare spending.

Indexed as

Hepatitis AAdolescentAdultChildCost-Benefit AnalysisHumansRetrospective StudiesSouth AfricaVaccinationAcute liver failureEpidemiologyHealth economicsHepatitis AHepatologyImmunizationVaccine preventable disease

Identifiers

PMID35016628
PMCPMC8751253
OpenAlexW4206770682

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.