Oral Presentation 20th Lancefield International Symposium on Streptococci and Streptococcal Diseases 2017

The economic and health burden of disease caused by group A streptococcus in Australia and New Zealand (#76)

Jeffrey W Cannon 1 2 , Susan Jack 3 , Jane Zhang 4 , Yue Wu 1 , Michael G Baker 4 , Elizabeth Geelhoed 2 , John Fraser 5 , Jonathan Carapetis 1 2
  1. Telethon Kids Institute, Subiaco, WA, Australia
  2. University of Western Australia, Perth
  3. University of Otago, Dunedin
  4. University of Otago, Wellington
  5. University of Auckland, Auckland

Background: Group A streptococcus (GAS) causes a high burden of severe invasive and immune-mediated diseases as well as superficial infections. The World Health Organization has highlighted that a vaccine could offer major health and economic benefits, however, these effects have never been studied. We aimed to establish the potential benefits of preventing GAS infections in Australia and New Zealand by estimating the economic and health burden of GAS diseases. 

Methods: We synthesised and modelled over 65 data sources including; nationally-representative survey and administrative data on healthcare episodes; pathology and observational studies of disease outcomes; public reimbursement data and costing studies; and disability weightings from the Global Burden of Disease. Outcomes included estimates of the average annual incidence of healthcare episodes, direct healthcare cost, and disability-adjusted life years (DALYs) lost, in total and stratified by disease type and age.

Results: GAS affects an estimated 3.4% of the Australian population each year, with an associated direct cost of AUD 182.9 million (AUD 8.19 per person), and health burden of 23,334 DALYs (104.4 per 100,000 population). For New Zealand, an estimated 1.5% of the population is affected each year, with a direct cost of NZD 29.2 million (NZD 6.89 per person), and health burden of 2,373 (55.9 per 100,000 population) DALYs.

Throat and skin infections were the most commonly presenting healthcare episodes, however cellulitis was the most substantial contributor to the total direct cost and health burden of GAS disease.

Conclusions: Preventing GAS disease, particularly cellulitis, would have substantial economic and health benefits.