Cost-effectiveness analysis of revised Integrated Management of Childhood Illness (IMCI) guidelines for childhood pneumonia in the Philippines

• Project/Area Number: 16K09123
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Hygiene and public health
• Research Institution: Nagasaki Women's Junior College (2018); Tohoku University (2016-2017)
• Principal Investigator: TAMAKI RAITA 長崎女子短期大学, その他部局等, 講師(移行) (40507919)
• Co-Investigator(Renkei-kenkyūsha): 神垣 太郎 東北大学, 大学院医学系研究科微生物学分野, 助教・統計解析アドバイザー ; 斉藤 繭子 東北大学, 大学院医学系研究科微生物学分野, 准教授・研究デザインアドバイザー ; 押谷 仁 東北大学, 大学院医学系研究科微生物学分野, 教授・研究推進アドバイザー
• Research Collaborator: Tallo Vicky RITM, 疫学部門長・研究推進アドバイザー ; Tan Alvin RITM, 疫学部門・データ管理サポート ; Alday Portia RITM, 疫学部門・フィールド活動サポート ; Lanbucho Jhoys RITM, 疫学部門・IMCIテクニカルサポート ; Donald Mark RITM, 疫学部門・論文執筆サポート ; 青年海外協力隊隊員
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000); Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2017: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2016: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
• Keywords: 包括的小児疾患管理 (IMCI) / 小児肺炎 / 費用効果分析 / ユニバーサルヘルスカバレッジ / 包括的小児疾患管理 / 費用効果 / IMCI / 陥没呼吸 / Catastrophic Expenditure

Outline of Final Research Achievements

Cost-effectiveness analysis of revised Integrated Management of Childhood Illness (IMCI) guidelines for childhood pneumonia was conducted in the Philippines. There was equal effectiveness between the revised IMCI and the original IMCI. The treatment cost of pneumonia with the revised IMCI was significantly reduced by 53%. The results were discussed with the department of health for possible implantation in the Philippines. The evidence can be utilized for resource poor settings in the low and middle income countries with high burden of childhood pneumonia, which may contribute to UHC.

Academic Significance and Societal Importance of the Research Achievements

小児肺炎はいまだに疾病負荷が高く、その98％が低・中所得国で発生している。その介入の一つとして、WHOはIMCIの肺炎の診断・治療ガイドラインを改訂したが、本研究において費用効果分析を実施し、その安全性の同等性を示した。IMCIに準拠した診断デジタルデバイスを開発し、途上国の地域において診断の標準化が可能となったが、そのコストを加えた上で、改訂前の症例にかかるコストと比較し、改定後において平均53％減となった。この改訂版IMCIにおいて、安全性およびコストの低減を確認し、これらの成果が国全体、あるいは低・中所得国で導入された場合、UHCの観点から非常に大きなインパクトとなる。

Research Products

• [Int'l Joint Research] Research Institute for Tropical Medicine(フィリピン)
• [Int'l Joint Research] Research Institute of Tropical Medicine(フィリピン)
• [Journal Article] Aetiology and risks factors associated with the fatal outcomes of childhood pneumonia among hospitalised children in the Philippines from 2008 to 2016: a case series study. (2019)
  • Author(s): Dembele BPP, Kamigaki T, Dapat C, Tamaki R, Saito M, Saito M, Okamoto M, Igoy MAU, Mercado ES, Mondoy M, Tallo VL, Lupisan SP, Egawa S, Oshitani H.
  • Journal Title: BMJ Open. Volume: 9 Issue: 3 Pages: e026895-e026895
  • DOI: 10.1136/bmjopen-2018-026895
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Age-specific incidence rates and risk factors for respiratory syncytial virus-associated lower respiratory tract illness in cohort children under 5 years old in the Philippines. (2019)
  • Author(s): Ueno F, Tamaki R, Saito M, Okamoto M, Saito-Obata M, Kamigaki T, Suzuki A, Segubre-Mercado E, Aloyon HD, Tallo V, Lupisan SP, Oshitani H; RSV Working Group in the Philippines.
  • Journal Title: Influenza Other Respir Viruses. Volume: 00 Issue: 4 Pages: 1-15
  • DOI: 10.1111/irv.12639
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Transmission of Respiratory Syncytial Virus Among Children Under 5 Years in Households of Rural Communities, the Philippines. (2019)
  • Author(s): Otomaru H, Kamigaki T, Tamaki R, Okamoto M, Alday PP, Tan AG, Manalo JI, Segubre-Mercado E, Inobaya MT, Tallo V, Lupisan S, Oshitani H.
  • Journal Title: Open Forum Infect Dis. Volume: 6 Issue: 3
  • DOI: 10.1093/ofid/ofz045
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Association Between Preceding Viral Respiratory Infection and Subsequent Respiratory Illnesses Among Children: A Prospective Cohort Study in the Philippines. (2019)
  • Author(s): Furuse Y, Tamaki R, Okamoto M, Saito-Obata M, Suzuki A, Saito M, Imamura T, Khandaker I, Dapat I, Ueno F, Alday PP, Tan AG, Inobaya MT, Segubre-Mercado E, Tallo V, Lupisan S, Oshitani H.
  • Journal Title: J Infect Dis. Volume: 219 Issue: 2 Pages: 197-205
  • DOI: 10.1093/infdis/jiy515
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Comprehensive Etiological and Epidemiological Study on Acute Respiratory Infections in Children: Providing Evidence for the Prevention and Control of Childhood Pneumonia in the Philippines (2018)
  • Author(s): Tamaki Raita、Tallo Veronica L.、Tan Alvin G.、Reosa Mark Donald C.、Alday Portia P.、Landicho Jhoys M.、Inobaya Marianette T.、Saito Mayuko、Kamigaki Taro、Okamoto Michiko、Saito Mariko、Dapat Clyde、Dembele Bindongo P. P.、Mationg Mary Lorraine S.、Mondoy Melisa U.、Lupisan Socorro P.、Oshitani Hitoshi
  • Journal Title: Journal of Disaster Research Volume: 13 Issue: 4 Pages: 740-750
  • DOI: 10.20965/jdr.2018.p0740
  • NAID: 130007429457
  • ISSN: 1881-2473, 1883-8030
  • Year and Date: 2018-08-01
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Complete Genome Sequences of 12 Human Respiratory Syncytial Virus (Human Orthopneumovirus) Strains Detected in Children with Repeated Subgroup B Infections in the Philippines. (2018)
  • Author(s): Okamoto M, Sakamoto M, Dapat C, Saito M, Saito-Obata M, Tamaki R, Lupisan SP, Oshitani H.
  • Journal Title: Microbiol Resour Announc. Volume: 7 Issue: 22
  • DOI: 10.1128/mra.01017-18
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Father’s roles and perspectives on healthcare seeking for children with pneumonia: findings of a qualitative study in a rural community of the Philippines (2018)
  • Author(s): Sato Mari、Oshitani Hitoshi、Tamaki Raita、Oyamada Nobuko、Sato Kineko、Nadra Alkaff Raihana、Landicho Jhoys、Alday Portia P、Lupisan Socorro、Tallo Veronica L
  • Journal Title: BMJ Open Volume: 8 Issue: 11 Pages: e023857-e023857
  • DOI: 10.1136/bmjopen-2018-023857
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Molecular Characterization of Respiratory Syncytial Virus in Children With Repeated Infections With Subgroup B in the Philippines. (2018)
  • Author(s): Okamoto M, Dapat CP, Sandagon AMD, Batangan-Nacion LP, Lirio IC, Tamaki R, Saito M, Saito-Obata M, Lupisan SP, Oshitani H.
  • Journal Title: J Infect Dis. Volume: 218 Issue: 7 Pages: 1045-1053
  • DOI: 10.1093/infdis/jiy256
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Complete Genome Sequences of 13 Human Respiratory Syncytial Virus Subgroup A Strains of Genotypes NA1 and ON1 Isolated in the Philippines. (2018)
  • Author(s): Malasao R, Furuse Y, Okamoto M, Dapat C, Saito M, Saito-Obata M, Tamaki R, Segubre-Mercado E, Lupisan S, Oshitani H.
  • Journal Title: Genome Announcements Volume: 6 Issue: 10 Pages: 10-10
  • DOI: 10.1128/genomea.00151-18
  • NAID: 120006466607
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Presentation] Incidence, etiology and severity of childhood pneumonia in a Filipino cohort (2017)
  • Author(s): 玉記雷太
  • Organizer: Joint Conference of Global Health 2017 (Tokyo)
  • Int'l Joint Research
• [Presentation] Incidence, Etiology and Severity of Childhood Pneumonia in a Filipino Cohort (2017)
  • Author(s): 玉記雷太
  • Organizer: 17th Conference of the Science Council of Asia
  • Int'l Joint Research
• [Presentation] Intervention for The New WHO IMCI guidance on Childhood pneumonia (2016)
  • Author(s): Raita Tamaki
  • Organizer: Scientific Meeting on Childhood Pneumonia SATREPS
  • Place of Presentation: Manila, Philippines
• [Book] 新入門食品衛生学 改訂第4版 (in press, 2019年11月発刊） (2019)
  • Author(s): 松岡麻男、小田隆弘、富田雅弘、池田光壱、玉記雷太、藤原永年、伊藤裕才、津村有紀
  • Total Pages: 268
  • Publisher: 南江堂
• [Book] Impact (in press) (2019)
  • Author(s): Raita Tamaki
  • Total Pages: 2
  • Publisher: Science Impact Ltd.