Direct costs of dengue hospitalization in Brazil: public and private health care systems and use of WHO guidelines.

BACKGROUND: Dengue, an arboviral disease, is a public health problem in tropical and subtropical regions worldwide. In Brazil, epidemics have become increasingly important, with increases in the number of hospitalizations and the costs associated with the disease. This study aimed to describe the direct costs of hospitalized dengue cases, the financial impact of admissions and the use of blood products where current protocols for disease management were not followed. METHODS AND RESULTS: To analyze the direct costs of dengue illness and platelet transfusion in Brazil based on the World Health Organization (WHO) guidelines, we conducted a retrospective cross-sectional census study on hospitalized dengue patients in the public and private Brazilian health systems in Dourados City, Mato Grosso do Sul State, Brazil. The analysis involved cases that occurred from January through December during the 2010 outbreak. In total, we examined 8,226 mandatorily reported suspected dengue cases involving 507 hospitalized patients. The final sample comprised 288 laboratory-confirmed dengue patients, who accounted for 56.8% of all hospitalized cases. The overall cost of the hospitalized dengue cases was US $210,084.30, in 2010, which corresponded to 2.5% of the gross domestic product per capita in Dourados that year. In 35.2% of cases, blood products were used in patients who did not meet the blood transfusion criteria. The overall median hospitalization cost was higher (p = 0.002) in the group that received blood products (US $1,622.40) compared with the group that did not receive blood products (US $550.20). CONCLUSION: The comparative costs between the public and the private health systems show that both the hospitalization of and platelet transfusion in patients who do not meet the WHO and Brazilian dengue guidelines increase the direct costs, but not the quality, of health care.

Suplementação protéica e energética para bovinos de corte em pastagens tropicais / Suplemento proteico y energético para ganado de carne en pastos tropicales / Energetic and protein supplementation for beef cattle in tropical pasture

O abate de animais jovens, denominados precoces e superprecoces, com idade entre 12 e 24 meses, são os principais responsáveis pelo fornecimento de produtos de qualidade ao longo do ano. A pastagem é a forma mais prática e econômica para a alimentação de bovinos, sendo a pecuária brasileira sustentada desta forma. No entanto, animais mantidos a pasto não expressam todo o seu potencial, atingindo baixas taxas de ganho ao longo do ano, em função de vários fatores. Com isso, a suplementação de animais em pastagens se torna uma alternativa de manter o peso dos animais durante a seca. Os suplementos protéicos ou energéticos normalmente aumentam o desempenho dos bovinos a pasto. Quando as forrageiras são de baixa qualidade, o aumento é mais significativo. No entanto, a suplementação energética causa a diminuição do consumo de forragens.

Slaughtering young animals, assigned as young steers and super-young steers (12-24 months of age), are mostly responsible for the supply of quality products throughout the year. Forage is the most practical and economic way of feeding beef cattle. Brazilian beef cattle breeding are sustained this way; however, animals maintained in pastures do not express their full potential - presenting low gain rates throughout the year- for several reasons. Thus, supplementation of animals on pasture is a alternative for sustaining weight during dry season. Energetic and protein supplementation usually increase the performance of beef cattle maintained in pasture - when forages are low quality, the increase is more significant. However, energetic supplementation reduces forage intake.

El abate de animales jóvenes, denominados precoces y superprecoces, con edad entre 12 y 24 meses, son los principales responsables por el suministro de productos de calidad durante todo el año. Los pastos son la forma más práctica y económica para la alimentación de bovinos, siendo la pecuaria brasileña sostenida de esta forma. Sin embargo, animales mantenidos a pasto no expresan todo su potencial, llegando a bajas tasas de ganancia al largo del año, en función de varios factores. Por eso, el suplemento de animales en pastos se vuelve una alternativa de mantener el peso de los mismos durante el período de sequía. Los suplementos proteicos o energéticos normalmente aumentan el desempeño de los bovinos que pastan. Cuando los forrajes son de baja calidad, el aumento es más significativo. Sin embargo, el suplemento energético causa la disminución del consumo de forrajes.