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Table 4 Estimated annual costs (in millions of 2014 US$) of influenza-associated illnesses in Kenya

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

Cost Item (per episode)

Hospitalized patients

Outpatients

Best-case scenario

Worst-case scenario

Best-case scenario

Worst-case scenario

Estimated cases

Cost (US$d Millions) (95% CIc)

Estimated cases

Cost (US$d Millions) (95% CIc)

Estimated cases

Cost (US$d Millions) (95% CIc)

Estimated cases

Cost (US$d Millions) (95% CIc)

Children < 5 yearsa

17,875

 

31,115

 

144,322

 

383,977

 

 Total direct costs

 

1.34 (1.10–1.63)

 

2.34 (1.92–2.84)

 

1.25 (1.09–1.41)

 

3.33 (2.89–3.76)

  Facility-based medical costs

 

1.08 (0.89–1.34)

 

1.87 (1.54–2.33)

 

0.62 (0.59–0.66)

 

1.65 (1.56–1.75)

  Transportation costs

 

0.08 (0.06–0.12)

 

0.15 (0.10–0.21)

 

0.07 (0.05–0.09)

 

0.18 (0.13–0.24)

  Other costsb

 

0.20 (0.13–0.27)

 

0.34 (0.23–0.47)

 

0.66 (0.48–0.85)

 

1.76 (1.27–2.25)

 Total indirect

 

0.70 (0.56–0.85)

 

1.21 (0.97–1.48)

 

2.01 (1.23–2.97)

 

5.35 (3.28–7.91)

 Total costs

 

2.04 (1.73–2.41)

 

3.55 (3.01–4.19)

 

3.09 (2.32–4.07)

 

8.23 (6.18–10.84)

Persons ≥5 yearsa

7279

 

14,557

 

156,491

 

946,223

 

 Total direct costs

 

0.55 (0.41–0.69)

 

1.10 (0.81–1.37)

 

0.93 (0.78–1.11)

 

5.64 (4.72–6.69)

  Facility-based medical costs

 

0.41 (0.32–0.53)

 

0.81 (0.63–1.07)

 

0.69 (0.64–0.75)

 

4.20 (3.89–4.55)

  Transportation costs

 

0.05 (0.02–0.09)

 

0.10 (0.04–0.18)

 

0.04 (0.01–0.08)

 

0.24 (0.05–0.50)

  Other costsb

 

0.07 (0.04–0.11)

 

0.15 (0.07–0.22)

 

0.23 (0.10–0.40)

 

1.42 (0.63–2.43)

 Total indirect

 

0.43 (0.26–0.65)

 

0.86 (0.51–1.30)

 

1.69 (1.09–2.40)

 

10.24 (6.61–14.49)

 Total costs

 

1.00 (0.71–1.30)

 

1.99 (1.42–2.59)

 

2.64 (1.99–3.38)

 

15.96 (12.02–20.43)

All ages

25,154

 

45,672

 

300,813

 

1,330,200

 

 Total direct costs

 

1.89 (1.60–2.25)

 

3.44 (2.90–4.09)

 

2.32 (2.08–2.58)

 

10.24 (9.18–11.40)

 Total indirect

 

1.06 (0.86–1.28)

 

1.92 (1.55–2.33)

 

3.87 (2.71–5.24)

 

17.11 (11.98–23.17)

 Total costs

 

2.96 (2.57–3.41)

 

5.37 (4.66–6.19)

 

5.96 (4.80–7.49)

 

26.35 (21.22–33.14)

  1. aEstimated using published rates of influenza-associated disease in Kenya [hospitalization rate (< 5 years = 2.7–4.7 per 1000; ≥5 years = 0.2–0.4 per 1000) and outpatient rate (< 5 years = 13.0–58.0 per 1000; ≥5 years = 4.3–26.0 per 1000)]; bCombines costs for childcare, and healthcare seeking prior and after hospitalization or outpatient visit; cMean cost and 95% confidence intervals estimated using 1000 bootstrap samples
  2. d1 US$ = 90 Kenya Shillings (2014)
  3. Best-case scenario: Assuming the lowest published incidence rate of influenza-associated illness
  4. Worst-case scenario: Assuming the highest published incidence rate of influenza-associated illness
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BMC Public Health

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