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Economic burden of neonatal sepsis in sub-Saharan Africa
  1. Sylvia L Ranjeva1,2,
  2. Benjamin C Warf3,4,
  3. Steven J Schiff2,5
  1. 1 Medical Scientist Training Program, Pritzker School of Medicine, and Department of Ecology & Evolution, University of Chicago, Chicago, Illinois, USA
  2. 2 Department of Engineering Science and Mechanics, Center for Neural Engineering, The Pennsylvania State University, University Park, Pennsylvania, USA
  3. 3 Department of Neurosurgery, Boston Children’s Hospital, Boston, Massachusetts, USA
  4. 4 Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
  5. 5 Departments of Neurosurgery and Physics, The Pennsylvania State University, University Park, Pennsylvania, USA
  1. Correspondence to Dr Steven J Schiff; sschiff{at}


Background and significance The third Sustainable Development Goal for child health, which aims to end preventable deaths of newborns and children less than 5 years of age by 2030, cannot be met without substantial reduction of infection-specific neonatal mortality in the developing world. Neonatal infections are estimated to account for 26% of annual neonatal deaths, with mortality rates highest in sub-Saharan Africa (SSA). Reliable and comprehensive estimates of the incidence and aetiology surrounding neonatal sepsis in SSA remain incompletely available. We estimate the economic burden of neonatal sepsis in SSA.

Methods Data available through global health agencies and in the medical literature were used to determine population demographics in SSA, as well as to determine the incidence, disease burden, mortality and resulting disabilities associated with neonatal sepsis. The disability-adjusted life years (DALY) associated with successful treatment or prevention of neonatal sepsis in SSA for 1 year were calculated. The value of a statistical life (VSL) methodology was estimated to evaluate the economic burden of untreated neonatal sepsis in SSA.

Results We conservatively estimate that 5.29–8.73 million DALYs are lost annually in SSA due to neonatal sepsis. Corresponding VSL estimates predict an annual economic burden ranging from $10 billion to $469 billion.

Conclusions Our results highlight and quantify the scope of the public health and economic burden posed by neonatal sepsis in SSA. We quantify the substantial potential impact of more successful treatment and prevention strategies, and we highlight the need for greater investment in strategies to characterise, diagnose, prevent and manage neonatal sepsis and its long-term sequelae in SSA.

  • neonatal sepsis
  • africa
  • economic
  • global burden of disease

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  • Handling editor Seye Abimbola

  • Contributors Substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work: SJS, BCW, SLR. Drafting the work or revising it critically for important intellectual content: SJS, BCW, SLR. Final approval of the version to be published: SJS, BCW, SLR. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: SJS, BCW, SLR.

  • Funding This work received the support of the Penn State University endowment funds of Harvey F Brush, and NIH Director’s Pioneer Award 5DP1HD086071 (SJS).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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