Marzo 2011 - Volume XXX - numero 3
Pagine elettroniche ; Ricerca
1Dipartimento di Pediatria, Università di Pisa
2Post-Graduate Nucleus
of Medicine, Federal University of Sergipe, Aracaju, Brasile
3Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA,
Liverpool, Regno Unito
4Current address: UNICEF/UNDP/World
Bank/WHO Special Programme for Research and Training in Tropical
Diseases
Indirizzo per corrispondenza: c.centenari@tin.it
Key words: Vaccine, Rotavirus, Diarrhoea, Cost
The present “budget impact” study assessed the family and health system costs due to diarrhoea in children < 2 years old, before/after the introduction of a rotavirus vaccine in Brazil in 2006. This kind of evaluations plays a crucial role in the assessment of a health intervention and may help reimbursement decision. This is important especially in Countries with low children’s diarrhoea mortality and high morbidity. In these settings the vaccine is mainly introduced to contain the health and economic burden more than to reduce deaths. The study was made possible by an international collaboration involving the University of Pisa (Italy), the Liverpool School of Tropical Medicine (UK) and the Federal University of Sergipe (Brazil). Information on diarrhoea health care costs and morbidity was obtained from the primary health care system, the National Public Health database (2004- 2008) and care-givers. Diarrhoea ambulatory consultations and hospitalisations had a declining trend during the entire period, with additional steeper reductions after vaccine introduction. Therefore, the vaccine was associated with reduced diarrhoea consultations and hospitalization costs and families’ out-of-pocket expenses. Despite these gains, the overall health system costs have increased.
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Pagine elettroniche ; Caso Contributivo
Unità Operativa Complessa di Pediatria - TIN, Ospedale “Umberto I”, Nocera Inferiore, Salerno
Indirizzo per corrispondenza: aurinoanna@hotmail.com
Key words: Infantile pyknocytosis, Erythropoiesis, Flow cytometry, Erythropoietin, Haemolytic anaemia
The diagnosis and treatment of six patients with infantile pyknocytosis are reported. The clinical course and the diagnostic work-up are shown. All the patients necessitated therapy: phototherapy in five patients and one red blood cell transfusion in all of them; in two patients, because of the persistence of haemolysis and pyknocytosis with inadequate erythropoiesis, a brief course of erythropoietin treatment was undertaken with an excellent response and no side effects. Infantile pyknocytosis is a rare but not infrequent disease: physicians caring for a neonate with haemolytic anaemia should not forget this disease in the differential diagnosis.
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