Epidemiology and direct medical costs of human Leishmaniasis in Italy

A. Mannocci, Giuseppe La Torre, G. Chiaradia, C. De Waure, M. T. Mainelli, A. Cernigliaro, S. Bruno, W. Ricciardi

Research output: Contribution to journalArticle

Abstract

Introduction. In the last decades, visceral Leishmaniasis infection rate has increased in Western Mediterranean areas. Epidemiological data show that in Italy, especially in some regions, the prevalence of canine form is high. The aim of this study is to evaluate the epidemiological setting of Leishmaniasis in Italy, according to age groups and geographical areas, and to estimate the associated direct medical costs. Methods. The study examined the ordinary and day-hospital discharges and the respective mean of hospital length of stay for Leishmaniasis and visceral Leishmaniasis in Italy, during the period 1999-2003. Moreover, we collected data about notifications of Leishmaniasis, from 1993 to 2004, and mortality due to this infectious disease, from 1993 to 1998. We evaluated the prevalence rates of discharges, the visceral and cutaneous Leishmaniasis notifications incidence rates and the mortality rates from disease, per 1,000,000 residents. Costs analysis was performed getting DRG number 423 rate, which corresponds to "other diagnosis related to infectious and parasitary diseases". Results. Ordinary discharges decreased in the study period, while day-hospital discharges increased. Sicilia, Campania and Lazio regions showed the highest number of ordinary hospital discharges for Leishmaniasis (prevalence rates were respectively 16.29, 15.02 and 12.83 per 1,000,000 residents, in 2003). Campania and Sicilia showed also the highest prevalence rates of day-hospital discharges (respectively 17.29 and 35.39 per 1,000,000 residents in 2003). The analysis of incidence rates of notifications showed a cyclic trend of the visceral form of the disease, with the highest rates observed in the group aged 0-14 years (incidence rates per 1,000,000: 7.46 in 1996 and 8.59 in 2000). The highest mortality rates were observed in the group aged over 65 years; low but constant mortality rates for Leishmaniasis were seen in the age group 25-64 years. Direct costs for both ordinary and day-hospital admissions were: 1,561,218.46 € in 1999; 1,637,256.44 € in 2000; 1,459,892.92 € in 2001, 1,468,983.58 € in 2002 and 1,370,227.80 € in 2003. Discussion. Discharges for Leishmaniasis showed non-homogeneous trend in Italy, especially in coastal Regions. Leishmaniasis notifications have slowly increased after 1993 and a high number of notifications was observed in the 0-14 years old group. The highest mortality rates were reported in the extreme age-groups: mortality was relevant for patients over 65 years. Moreover, cost analysis showed that health care of human Leishmaniasis requires long time of hospitalization with consequent high costs. Conclusion. Preventive measures have to be turned to extreme age groups. For future studies issues such as high costs of treating disease, cost-effectiveness evaluation of the current therapeutic approach compared to preventive interventions on dogs and vector insects would be of interest.

Original languageEnglish
Pages (from-to)27-36
Number of pages10
JournalJournal of Preventive Medicine and Hygiene
Volume48
Issue number1
Publication statusPublished - Mar 2007

Keywords

  • Epidemiology
  • Human Leishmaniasis
  • Italy
  • Medical costs

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Mannocci, A., La Torre, G., Chiaradia, G., De Waure, C., Mainelli, M. T., Cernigliaro, A., Bruno, S., & Ricciardi, W. (2007). Epidemiology and direct medical costs of human Leishmaniasis in Italy. Journal of Preventive Medicine and Hygiene, 48(1), 27-36.