Estimating the costs of responding to a measles outbreak: Buvuma Islands, Lake Victoria, Uganda, February-May 2017

Abstract

Introduction: Despite the strong prevention efforts by the Uganda Ministry of Health (MOH), measles outbreaks continue to occur. The MOH responded to a measles outbreak in the hard to reach areas of Buvuma Islands, identifying 54 case-patients, 4 of whom developed complications and were hospitalized. We defined a measles case as; Any suspected case with a positive measles IgM antibodies or detection of measles viral RNA by PCR in a suspected case. We estimated the provider cost of responding to this outbreak, cost of prevention, and the cost the government would have saved with effective prevention. Methods: We interviewed health facility in charges, record clerks, and measles cases to collect information on patient management and days of illness. Using an itemized form, we systematically collected data on quantities and unit costs of all the resource inputs for both direct and indirect costs at national, district, and facility levels. Medical costs referred to hospital and clinic costs for medications, supplies, utilities, transport, and personnel; non-medical costs included those associated with person-hours spent on the outbreak investigation and control effort. Results: The overall cost of investigating and controlling this outbreak was $16,459.50 (including $5,526.30) of medical costs, $10,733.20 of non-medical costs) and the cost per capita of number of children 6months-5years was $117.80 (16,259.5/138 (number of children 6months-5years. This is the target for measles intensified immunization following an outbreak). Conclusion: The total cost incurred in this outbreak is four fold the amount needed to vaccinate all children in Buvuma which would have averted the outbreak. We recommended strengthening vaccination services in the entire country, especially hard-to-reach areas, to enable the government forego the extra cost and morbidity associated with outbreak control.