THE EFFECT OF MEASLES ON HEALTH-RELATED QUALITY OF LIFE: A PATIENT-BASED SURVEY

Monday, 15th of September 2014

[source]PLoS One[|source]

Previous measles outbreak reports focus on the epidemiology of the disease, rather than the overall disease burden in terms of health-related quality of life (HRQoL). The impact of infectious diseases on HRQoL is a developing field of research, whose aim is to express the burden of disease not only in number of cases but also in disease days and the impact of these disease days. Doing so enables a comparison between diseases and helps in the fair allocation of resources. A standard method to measure the disease burden is the use of quality-adjusted life years (QALYs).

In this study, the authors gather health utilities specific to measles during the 2012-13 regional measles epidemics in England, as well as other direct and indirect effects of a measles epidemic on a population including symptoms during infection; disruption at home due to time off work or school for individuals with confirmed measles; hospitalizations and carer time off work. The report documents QALY-loss due to measles at a population level, and provides important parameters to guide future intervention and control measures. Detailed findings and recommendations are accessible at: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0105153

 

ABSTRACT

BACKGROUND: Measles is a highly contagious and potentially fatal illness preventable through vaccination. Outbreaks in the UK and many other European countries have been increasing over recent years, with over 3,207 laboratory-confirmed cases reported by Public Health England from January 2012 to the end of June 2013. To aid rational decision making regarding measles control versus other use of healthcare resources, it is important to measure the severity of measles in units that are comparable to other diseases. The standard metric for this in the UK is the quality-adjust life year (QALY). To our knowledge, the impact of measles on health-related quality of life (HRQoL) in terms of QALYs has not been quantified.

METHODS AND FINDINGS: Individuals with confirmed measles were sent questionnaires requesting information on the short-term impact of the illness on their HRQoL using the EuroQol EQ-5D-3L questionnaire. HRQoL was reported for the day the questionnaire was received, the worst day of infection and at follow-up three weeks later. 507 questionnaires were sent to individuals with confirmed measles with 203 returned (40%). The majority of respondents were not vaccinated. The mean time off work or school was 9.6 days. The mean duration of perceived illness was 13.8 days. The mean number of QALYs lost was 0.019 (equivalent to 6.9 days). The overall burden of disease in terms of QALYs lost in England based on the total number of confirmed cases in the twelve month period from 1^st June 2012 was estimated to be 44.2 QALYs.

CONCLUSION: The short-term impact of measles infection on HRQoL is substantial, both at the level of the individual patient and in terms of the overall disease burden. This is the first attempt to quantify QALY-loss due to measles at a population level, and provides important parameters to guide future intervention and control measures.