The Chikungunya Epidemic on La Réunion Island in 2005–2006: A Cost-of-Illness Study

For a long time, studies of chikungunya virus infection have been neglected, but since its resurgence in the south-western Indian Ocean and on La Réunion Island, this disease has been paid greater amounts of attention. The economic and social impacts of chikungunya epidemics are poorly documented, including in developed countries. This study estimated the cost-of-illness associated with the 2005–2006 chikungunya epidemics on La Réunion Island, a French overseas department with an economy and health care system of a developed country. “Cost-of-illness” studies measure the amount that would have been saved in the absence of a disease. We found that the epidemic incurred substantial medical expenses estimated at €43.9 million, of which 60% were attributable to direct medical costs related, in particular, to expenditure on medical consultations (47%), hospitalization (32%) and drugs (19%). The costs related to care in ambulatory and hospitalized cases were €90 and €2000 per case, respectively. This study provides the basic inputs for conducting cost-effectiveness and cost-benefit evaluations of chikungunya prevention strategies

Algorithm for the scale of charges for hospital stays associated with Chikungunya.

<p>Algorithm for the scale of charges for hospital stays associated with Chikungunya.</p

Consultations, drug reimbursements and absenteeism from work due to the Chikungunya epidemic, La Réunion, 2005–2006.

<p>*Compared to consumption outside the epidemic, calculated by a periodic regression model.</p

Excess sales of analgesics observed during the Chikungunya epidemic on La Réunion, 2005–2006.

<p>The black curve represents the observed number of boxes sold, and the green curve the expected number of boxes sold. The red curve represents the upper limit of the 95% prediction interval. Excesses are represented by the areas painted in blue (source of the data: IMS Health).</p

Qualité des fromages fermiers lactiques : locaux et maitrise de l’affinage (LACTAFF)

Le programme LACTAFF (2012 – 2015) a eu pour objectif d’améliorer la maîtrise de l’affinage des fromages fermiers lactiques, technologie la plus couramment utilisée à la ferme, en fournissant des outils et des références aux producteurs et aux techniciens qui les accompagnent. Des enquêtes menées dans 49 fermes des 6 principales régions produisant ce type de fromage ont permis de caractériser la grande diversité des fromages fabriqués, des locaux, des équipements et des pratiques et d’établir des liens entre les grandes catégories de fromages et les pratiques, locaux et conditions d’ambiance. Par ailleurs, au laboratoire et en fromageries expérimentales, le rôle clé de l’hygrométrie a été quantifié en affinage, ainsi qu’au séchage où la vitesse d’air joue un rôle encore plus important. Les effets des paramètres d’ambiance sur la composition physico-chimique et les caractéristiques sensorielles des fromages ont été quantifiés pour un type de fromage donné.The « LACTAFF » program (2012-2015) aimed at improving the control of goat lactic farmhouse cheese ripening, a technology frequently used by farmers, by producing tools and references for producers and the technicians guiding them. Surveys conducted in 49 farms in the 6 main regions producing this kind of cheeses allowed to characterize the great diversity of cheeses, premises, equipment and practices, and to link cheese categories with practices, premises characteristics and air production conditions. In laboratory and experimental dairies, the key role of humidity was quantified during ripening and during drying, in which air speed is even more important. Atmospheric parameters effects on cheeses physicochemical composition and sensory characteristics were quantified for one type of cheeses. Specialist experience of cheese technology, premises design and climate control equipment and technician experience were capitalized at the same time. This project led to the writing of technical documents available online and a book about lactic farmhouse cheeses ripening

Medical costs related to the Chikungunya epidemic, La Réunion, 2005–2006.

<p>Medical costs related to the Chikungunya epidemic, La Réunion, 2005–2006.</p

Excess reimbursement of analgesics during the Chikungunya epidemic on La Réunion, 2005–2006.

<p>The black curve represents the observed reimbursement costs in Euros, and the green curve the “expected” reimbursement cost in the absence of epidemic, derived from the fit of a periodic regression model to observed costs outside the epidemic period. The red curve represents the upper limit of the 95% prediction interval for monthly costs in the absence of epidemic. Excess periods are defined when the observed costs are above the threshold (area in blue) and quantified by the cumulated difference between observed and expected costs over such periods.</p

ICD-10 codes of signs that may be related to Chikungunya virus infection.

<p>*The International Statistical Classification of Diseases and Related Health Problems 10th Revision.</p><p>**Where the code A92.0 was the only AD.</p><p>This list of manifestations was compiled following a review of all of the ICD-10 codes by two of the authors (MKS and TH), based on the symptoms reported in the acute phase of the disease. <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001197#pntd.0001197-Pialoux1" target="_blank">[4]</a>, <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001197#pntd.0001197-Borgherini1" target="_blank">[16]</a>, <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001197#pntd.0001197-Peters1" target="_blank">[53]</a>.</p