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Healthcare costs attributable to congenital cytomegalovirus infection
  1. Marjolein J Korndewal1,2,
  2. Marlies Weltevrede1,
  3. M Elske van den Akker-van Marle3,
  4. Anne Marie Oudesluys-Murphy4,
  5. Hester E de Melker1,
  6. Ann C T M Vossen2
  1. 1 Center for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
  2. 2 Department of Medical Microbiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
  3. 3 Department of Medical Decision Making, Leiden University Medical Center (LUMC), Leiden, The Netherlands
  4. 4 Willem-Alexander Children’s Hospital, Leiden University Medical Center (LUMC), Leiden, The Netherlands
  1. Correspondence to Marjolein J Korndewal, Center for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, BA 3720, The Netherlands; m.korndewal{at}, a.c.t.m.vossen{at},{at}


Objective Congenital cytomegalovirus infection (cCMV) can cause symptoms at birth as well as long-term impairment. This study estimates cCMV-related healthcare costs in the Netherlands in early childhood.

Design, setting and patients In a nationwide retrospective cohort study, 156 children with cCMV were identified by testing 31 484 neonatal dried blood spots for cCMV. Use of healthcare resources in the first 6 years of life by children with cCMV and a matched cCMV-negative control group were analysed. Mean costs per child were calculated by multiplying healthcare resource use by its reference prices.

Exposure Children with cCMV were compared with cCMV-negative children.

Main outcome measures The average total healthcare costs per child were based on the average costs for hospital admissions and consultations by healthcare providers.

Results Mean healthcare costs of children with cCMV (€6113, n=133) were higher than children without cCMV (€3570, n=274), although statistically not significant, with a mean difference of €2544 (95% CI €-451 to €5538). The costs of children with long-term impairment were two times higher in children with cCMV (€17 205) compared with children without cCMV (€8332).

Conclusions Children with cCMV, especially those with long-term impairment and those symptomatic at birth, accrue higher healthcare costs than cCMV-negative children in the first 6 years of life, although this is not statistically significant. This economic impact is of importance in the evaluation of preventive measures against cCMV.

Trial registration number NTR3582.

  • costing
  • health economics
  • infectious diseases
  • virology

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  • HEM and ACTMV contributed equally.

  • Contributors Study concept and design: HEdM, MJK, AMO-M and ACTMV. Acquisition, analysis or interpretation of data: MJK, MW, MEvdA-vM, HEdM and ACTMV. Drafting of the manuscript: MJK and MW. Critical revision of the manuscript for important intellectual content: MJK, MW, MEvdA-vM, AMO-M, HEdM and ACTMV. Statistical analysis: MJK, MW and MEvdA-vM. Obtaining funding: HEdM. Administrative, technical or material support: MJK and MW. Supervision: HEdM, AMO-M and ACTMV.

  • Funding This study was funded by Strategic Research of the National Institute of Public Health and the Environment.

  • Competing interests None declared.

  • Ethics approval This study was approved by the medical ethics committee of the Leiden University Medical Center in Leiden

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