The cost of community-managed viral respiratory illnesses in a cohort of healthy preschool-aged children

Background : Acute respiratory illnesses (ARIs) during childhood are often caused by respiratory viruses, result in significant morbidity, and have associated costs for families and society. Despite their ubiquity, there is a lack of interdisciplinary epidemiologic and economic research that has collected primary impact data, particularly associated with indirect costs, from families during ARIs in children.Methods : We conducted a 12-month cohort study in 234 preschool children with impact diary recording and PCR testing of nose-throat swabs for viruses during an ARI. We used applied values to estimate a virus-specific mean cost of ARIs.Results : Impact diaries were available for 72% (523/725) of community-managed illnesses between January 2003 and January 2004. The mean cost of ARIs was AU$309 (95$263 to $354). Influenza illnesses had a mean cost of$904, compared with RSV, $304, the next most expensive single-virus illness, although confidence intervals overlapped. Mean carer time away from usual activity per day was two hours for influenza ARIs and between 30 and 45 minutes for all other ARI categories.Conclusion : From a societal perspective, community-managed ARIs are a significant cost burden on families and society. The point estimate of the mean cost of community-managed influenza illnesses in healthy preschool aged children is three times greater than those illnesses caused by RSV and other respiratory viruses. Indirect costs, particularly carer time away from usual activity, are the key cost drivers for ARIs in children. The use of parent-collected specimens may enhance ARI surveillance and reduce any potential Hawthorne effect caused by compliance with study procedures. These findings reinforce the need for further integrated epidemiologic and economic research of ARIs in children to allow for comprehensive cost-effectiveness assessments of preventive and therapeutic options.<br /

Chronic Diseases in North-West Tanzania and Southern Uganda. Public Perceptions of Terminologies, Aetiologies, Symptoms and Preferred Management

Research outputs produced to support a quantitative population survey, quantitative health facility survey, focus groups and in-depth interviews performed by the projec

Habitat monitoring in Europe: a description of current practices

Monitoring of biodiversity at the level of habitats is becoming increasingly common. Here we describe current practices in habitat monitoring based on 150 schemes in Europe. Most schemes were initiated after 1990 in response to EU nature directives or habitat management/restoration actions, with funding mostly from European or national sources. Schemes usually monitor both the spatial distribution and the quality of the habitats, and they frequently collect data on environmental parameters and potential causes of changes. Many schemes are local or regional rather than national or international in scope, and sampling effort varies greatly across spatial and temporal scales. Experimental design is used in half of the schemes, however, data are rarely analysed by advanced statistics. Most schemes require two months or less per year in manpower and are typically run by professionals rather than by volunteers. Estimated salaries plus equipment costs average 650,000 Euro per year per scheme, and add up to 80 million Euros annually. Costs are particularly high for schemes based on European or international law and for schemes funded by European or national sources. Costs are also high in schemes in which sampling sites are selected subjectively rather than based on sampling theory, and in schemes that do not use field mapping or remote sensing to document spatial variation in habitats. Our survey demonstrates promising developments in European habitat monitoring but also underlines the need for better spatial coverage, documentation of spatial variaton, improved sampling design and advanced data analysis. Such improvements are essential if we are to judge progress towards the 2010 biodiversity targets