Whole-cell Pertussis (wcPertussis) vaccines combined with diphtheria and tetanus toxoids are effective in preventing clinical pertussis. The study aimed at determining the cost of managing fever and convulsions and cost of adverse events associated with wcPertussis. Parents who brought their children to health clinics and parents of children who were admitted for febrile convulsions were interviewed using structured questionnaire and the information were used to determine the cost of managing adverse events. Mean cost of managing mild fever per case was RM249, mean cost of managing high fever per case was RM1,036 and mean cost of managing convulsions was RM1,225. Total cost of managing adverse events was RM261 million for mild fever, RM66.7 million for high fever and RM1.3 million for convulsions. Costs of managing mild and high fever were less than the cost of managing convulsions. Total cost of managing mild fever was highest at RM261 million compared with RM66.7 million for high fever and RM1.3 million for convulsions. Thus, lower risk of adverse events actually contributed to higher costs of managing the adverse event.

Life expectancy from birth is increasing dramatically. Due to this increase, the population of elderly people will increase. Consequently, geriatric related illnesses will increase leading to increased necessity to build up comprehensive and coordinated cost effective health care services appropriate for elderly people. Frailty is not a disease, but rather considered as a syndrome requiring comprehensive and multidisciplinary care approach. It is a prevalent reversible pathological transitional stage between healthy aging and disability. Frailty is associated significantly with increased health care utilization, mortality, and comorbidities such falls, hospitalizations, physical dependence, and poor perception of health. The aim of this review is to compile existing literature on the economic cost of frailty syndrome among elderly people in the recent years. Search queries were constructed to look for articles related to the economic cost of frailty in the electronic databases available at the National University of Malaysia library for articles published between the years 2011 and 2019. The accessed electronic database included New England journal of medicine, Science Direct, SCOPUS, BMJ, Cochrane, and Wiley Online Library. Articles included in this review when they were original research, participants were defined as frail elderly, manuscripts written in English language, and involved clearly described measures of frailty cost. Among the literature, twenty one articles were found to satisfy the inclusion criteria of the review process. The cost of care for frail elderly was ranging from US $ 8,620 to 29,910 per patient per year. The cost of health care was ranging from US $ 2,540 to 221,400. The health care cost was accounting for 40% to 76% of the total care cost. Hospitalization cost was the highest, it was ranging from US $ 806 to 152,726. Outpatient cost was ranging from US $ 200 to 18,000. Medications cost was ranging from US $ 7 to 3,434 per frail elderly patient per year. Home help cost was ranging from US $ 804 to 19,728 per frail elderly patient per year. In conclusion, frailty is a costly syndrome. It can be considered as a cost effective target for health promoting interventions to contain future elderly cost.

Falls are the most common injury causing death or long term disability particularly among children. This study aimed to identify the risk factors of the unintentional injuries due to falls in children aged less than five years in Yemen. This cross sectional study enrolled a total of 439 children under five years old from the emergency department of 6 hospitals in Sana'a city. Multistage sampling was used to select six hospitals from public and private sectors in Sana'a city. Face to face interviews were conducted by using a structured questionnaire. Simple logistic regression and multiple logistic regression were used in the analysis. The prevalence of falls among children under five years old was 21.2%. In the multivariate analysis, factors associated with falls among children were young mother (aOR= 0.9, 95% CI 0.81-0.91), working of mother (aOR= 4.5 95% CI 2.40-7.65), frequent family social gatherings (aOR= 2.7, 95% CI 1.54-4.61), number of children at home (aOR= 2.6, 95% CI 1.43-4.64), chewing khat by father (aOR= 2.4, 95% CI 1.38-4.10), presence of staircase in the house (aOR= 2.1, 95% CI 1.24-3.70), number of rooms at home (aOR= 2.2, 95% CI 1.17-3.99) and disabled children (aOR= 3.3, 95% CI 1.20-9.27). In the study, socio-economic and cultural factors such as family gathering and chewing khat were associated with home fall injury among children under 5 years old in Yemen. Health promotion program should take place to reduce the occurrence of fall injury.
Accidental Falls ; Child Welfare ; Accidents, Home ; Child

As the Malaysian population ages, the burden of age-related cognitive disorders such as dementia and Alzheimer’s disease will increase concomitantly. This is one of the sub-study under a research project titled by quantify the cost of age-related cognitive impairment in Malaysia, which was undertaken to develop a clinical pathway for Mild Cognitive Impairment (MCI) and Dementia. The clinical pathway (CP) will be used to support the costing studies of MCI and Dementia. An expert group discussion (EGD) was conducted among selected experts from six (6) government hospitals from different states of Malaysia, Ministry of Health, and United Nations University, International Institute for Global Health, UKM and UPM. The expert group includes psychiatrist specialists and public health medicine specialists. A total of 15 participants took part in the EGD. The group was presented with the different approach in managing MCI and Dementia. Finally, the group came to the consensus agreement on the most appropriate and efficient ways of managing the two conditions. In the EGD, an operational definition for MCI and Dementia was agreed upon and a pathway was developed for the usual practice in the Malaysian health system. A typical case used, as a reference is a 60-year-old patient referred to a memory clinic with complaint of “forgetfulness”. After three outpatient visits in the clinic, the diagnosis of MCI and Dementia could be clinically established. The clinical pathways covered all active clinical and non-clinical management of the patient over a period of one year. The experts identified the additional resources required to manage these patients for the whole spectrum of lifetime based on the expected life expectancy. The Clinical pathway (CP) for MCI and Dementia was successfully developed in EGD with strong support from practitioners in the health system. The findings will help the researchers to identify all-important clinical activities and interventions that will be included in the costing study.