Dataset Information

The Rise of Valley Fever: Prevalence and Cost Burden of Coccidioidomycosis Infection in California.

ABSTRACT: Coccidioidomycosis (CM) is a fungal infection endemic in the southwestern United States (US). In California, CM incidence increased more than 213% (from 6.0/100,000 (2014) to 18.8/100,000 (2017)) and continues to increase as rates in the first half of 2018 are double that of 2017 during the same period. This cost-of-illness study provides essential information to be used in health planning and funding as CM infections continue to surge. We used a "bottom-up" approach to determine lifetime costs of 2017 reported incident CM cases in California. We defined CM natural history and used a societal approach to determine direct and discounted indirect costs using literature, national datasets, and expert interviews. The total lifetime cost burden of CM cases reported in 2017 in California is just under $700 million US dollars, with $429 million in direct costs and $271 million in indirect costs. Per person direct costs were highest for disseminated disease ($1,023,730), while per person direct costs were lowest for uncomplicated CM pneumonia ($22,039). Cost burden varied by county. This is the first study to estimate total costs of CM, demonstrating its huge cost burden for California.

SUBMITTER: Wilson L

PROVIDER: S-EPMC6480346 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Rise of Valley Fever: Prevalence and Cost Burden of Coccidioidomycosis Infection in California.

Wilson Leslie L Ting Jie J Lin Harold H Shah Rahil R MacLean Michael M Peterson Michael W MW Stockamp Nathan N Libke Robert R Brown Paul P

International journal of environmental research and public health 20190328 7

Coccidioidomycosis (CM) is a fungal infection endemic in the southwestern United States (US). In California, CM incidence increased more than 213% (from 6.0/100,000 (2014) to 18.8/100,000 (2017)) and continues to increase as rates in the first half of 2018 are double that of 2017 during the same period. This cost-of-illness study provides essential information to be used in health planning and funding as CM infections continue to surge. We used a "bottom-up" approach to determine lifetime costs ...[more]

PMID: 30925716

Similar Datasets

Project description:Introduction Coccidioidomycosis is a fungal infection endemic in the southwestern United States (US). Primary pulmonary coccidioidomycosis (PPC) is a leading cause of community-acquired pneumonia (CAP) in this region, although its diagnosis is often delayed, leading to lag in antifungal treatment and subsequent morbidity. The impact of early empiric antifungal therapy as part of treatment for CAP in endemic areas on clinical outcomes is unknown. Methods Phase IV randomized, double-blind, placebo-controlled trial in individuals aged 18 years or older with CAP who met all eligibility criteria in Coccidioides endemic regions in the US. Eligible participants with CAP were randomized to receive either fluconazole (400 mg daily) or matching placebo for 42 days and were subsequently monitored for clinical resolution of their illness. Objectives The primary objective was to assess the clinical response of early empiric antifungal therapy with fluconazole through Day 22 in subjects with PPC who were adherent to the study intervention. Secondary objectives included: assessments of the impact of early empiric antifungal therapy with fluconazole through Day 22 and 43 in subjects with PPC regardless of adherence, comparisons of the clinical response and its individual components over time by treatment group in subjects with PPC, assessments of days lost from work or school, hospitalization, and all-cause mortality. Discussion This trial was halted early due to slow enrollment (72 participants in one year, 33 received fluconazole and 39 received placebo). Of those enrolled, eight (11%) met the study definition of PPC. The study design and challenges are discussed. Highlights • Clinical impact of early antifungal therapy for pneumonia in Coccidioides endemic regions is unknown.• We designed a phase IV trial in adults with community-acquired pneumonia in regions endemic for Coccidioides.• Trial was halted early due to slow enrollment and low prevalence of coccidioidomycosis in the enrollment population.• Lost to follow-up and treatment discontinuation were common in this trial.

Dataset Information

The Rise of Valley Fever: Prevalence and Cost Burden of Coccidioidomycosis Infection in California.

Publications

The Rise of Valley Fever: Prevalence and Cost Burden of Coccidioidomycosis Infection in California.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets