Investigation and comparison of G6PD enzyme screening test costs for all newborns with treatment costs of patients with favism admitted due to hemolysis from 2014 to 2015 in Isfahan governmental hospitals

Morteza Sadinejad; Hamed Motevalli Pour; Saeed Yousefian; Roham Nik Khah

doi:10.5937/mckg54-26551

Morteza Sadinejad Assistant Professor of Pediatrics, Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran
Hamed Motevalli Pour Medical Student Research Committee, School of Medicine, Isfahan University of Medical Sciences
Saeed Yousefian Assistant Professor of Pediatric Hematology-Oncology, Children and Adolescent Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Roham Nik Khah General Practitioner, Medical Student Research Committee, School of Medicine, Isfahan University of Medical Sciences

DOI: https://doi.org/10.5937/mckg54-26551

Sažetak

Introduction:

The purpose of this study was to determine the costs of glucose-6-phosphate dehydrogenase (G6PD) deficiency screening tests in neonates and the cost of treatment for patients with favism who referred to the government hospitals of Isfahan with acute hemolysis and their comparison.

Materials and methods:

In this retrospective study, 116 patients with favism were selected, and their clinical data and treatment costs were recorded. Costs of neonatal G6PD screening tests were estimated based on quantitative and qualitative screening kits by referring to the laboratories of each hospital. The number of births in Isfahan province from October 2014 to October 2015 was 84760 individuals.

Findings:

Based on our results, 73 patients (62.9%) were males, and 43 of them (37.1%) were females. The causes for hemolysis were the consumption of broad beans in 78.4%, infection in 19.8% and drugs (Erythromycin and Keflin) in 1.7% of patients. The majority of patients (46.6%) received blood transfusion once, and 18.9% received 2 or more transfusions, while 34.5% had received no blood transfusions. The mean and standard deviation of patients' medical expenses were 7,472,005±7,329,847 Rials. The total cost of treatment for patients was 869,162,324 Rials. The screening cost for the whole newborns from October 2014 to October 2015 with qualitative kits was 754,364,000 Rials and with the qualitative kits was 960,330,800 Rials.

Conclusion:

The cost of the qualitative screening test for G6PD deficiency is lower than the costs of treatments of favism patients in Isfahan.

Reference

1. Ley B, Bancone G, Von Seidlein L, Thriemer K, Richards JS, Domingo GJ, et al. Methods for the field evaluation of quantitative G6PD diagnostics: a review. Malaria journal. 2017;16(1):361.
2. Elella SA, Tawfik M, Barseem N, Moustafa W. Prevalence of glucose-6-phosphate dehydrogenase deficiency in neonates in Egypt. Annals of Saudi medicine. 2017;37(5):362-5.
3. Bubp J, Jen M, Matuszewski K. Caring for Glucose-6-Phosphate Dehydrogenase (G6PD)-Deficient Patients: Implications for Pharmacy. P & T : a peer-reviewed journal for formulary management. 2015;40(9):572-4.
4. Moosazadeh M, Amiresmaili M, Aliramezany M. Prevalence of G6PD deficiency in Iran, a mata-analysis. Acta Med Iran. 2014;52(4):256-64.
5. Iranpour R, Hashemipour M, Talaei SM, Soroshnia M, Amini A. Newborn screening for glucose-6-phosphate dehydrogenase deficiency in Isfahan, Iran: a quantitative assay. Journal of medical screening. 2008;15(2):62-4.
6. Beutler E. Glucose-6-phosphate dehydrogenase deficiency: a historical perspective. Blood. 2008;111(1):16-24.
7. Luzzatto L, Seneca E. G6PD deficiency: a classic example of pharmacogenetics with on-going clinical implications. British journal of haematology. 2014;164(4):469-80.
8. Espino FE, Bibit JA, Sornillo JB, Tan A, von Seidlein L, Ley B. Comparison of Three Screening Test Kits for G6PD Enzyme Deficiency: Implications for Its Use in the Radical Cure of Vivax Malaria in Remote and Resource-Poor Areas in the Philippines. PLoS One. 2016;11(2):e0148172.
9. Glader B. Hereditary hemolytic anemias due to red blood cell enzyme disorders. Wintrobes’ Clinical hematology 12th ed Wolters Kluwer Health. 2009.
10. Liu H, Liu W, Tang X, Wang T. Association between G6PD deficiency and hyperbilirubinemia in neonates: a meta-analysis. Pediatric hematology and oncology. 2015;32(2):92-8.
11. LaRue N, Kahn M, Murray M, Leader BT, Bansil P, McGray S, et al. Comparison of quantitative and qualitative tests for glucose-6-phosphate dehydrogenase deficiency. The American journal of tropical medicine and hygiene. 2014;91(4):854-61.
12. Kosaryan M, Mahdavi MR, Jalali H, Roshan P. Why does the Iranian national program of screening newborns for G6PD enzyme deficiency miss a large number of affected infants? Pediatric hematology and oncology. 2014;31(1):95-100.
13. Mahmoudi F, Mohmmad K, Eftekhar H, Mansouri K, Garibnavaz H, Ershadi A, et al. Causes of Inadequate Coverage of Screening Programs for Congenital Diseases in Infants Born in North Health Center Area, Tehran. Hakim Health Systems Research Journal. 2013;15(4):281-7.
14. Rezaie M, khaleghian A. Blood and blood PRODUCT utilization and causes of wastage in Semnan hospitals. 2016.
15. Darbandi B, Noghbaei M, Mehrabian F, Jafroodi M. Medical expenses of patients with Favism admitted to 17th Shahrivar Hospital compared to G6PD enzyme screening cost, in north of Iran. Iranian journal of pediatric hematology and oncology. 2014;4(2):53-6.
16. Hatam N, Shirvani S, Javanbakht M, Askarian M, Rastegar M. Cost-utility analysis of neonatal screening program, shiraz university of medical sciences, shiraz, iran, 2010. Iran J Pediatr. 2013;23(5):493-500.
17. Cohan N, Karimi M, Khalili AH, Falahzadeh MH, Samadi B, Mahdavi RM. The efficacy of a neonatal screening programme in decreasing the hospitalization rate of patients with G6PD deficiency in southern Iran. Journal of medical screening. 2010;17(2):66-7.
18. Khneisser I, Adib SM, Loiselet J, Megarbane A. Cost-benefit analysis of G6PD screening in Lebanese newborn males. Le Journal medical libanais The Lebanese medical journal. 2007;55(3):129-32.