scholarly journals Serostatus testing and dengue vaccine cost–benefit thresholds

2019 ◽  
Vol 16 (157) ◽  
pp. 20190234 ◽  
Author(s):  
Carl A. B. Pearson ◽  
Kaja M. Abbas ◽  
Samuel Clifford ◽  
Stefan Flasche ◽  
Thomas J. Hladish
Keyword(s):  
Intervention Strategy ◽  
Cost Benefit ◽  
R Package ◽  
World Health ◽  
Dengue Vaccine ◽  
Past Infection ◽  
Repeat Testing ◽  
Testing Cost ◽  
Net Benefits ◽  
Health Organization

The World Health Organization (WHO) currently recommends pre-screening for past infection prior to administration of the only licensed dengue vaccine, CYD-TDV. Using a threshold modelling analysis, we identify settings where this guidance prohibits positive net-benefits, and are thus unfavourable. Generally, however, our model shows test-then-vaccinate strategies can improve CYD-TDV economic viability: effective testing reduces unnecessary vaccination costs while increasing health benefits. With sufficiently low testing cost, those trends outweigh additional screening costs, expanding the range of settings with positive net-benefits. This work highlights two aspects for further analysis of test-then-vaccinate strategies. We found that starting routine testing at younger ages could increase benefits; if real tests are shown to sufficiently address safety concerns, the manufacturer, regulators and WHO should revisit guidance restricting use to 9-years-and-older recipients. We also found that repeat testing could improve return-on-investment (ROI), despite increasing intervention costs. Thus, more detailed analyses should address questions on repeat testing and testing periodicity, in addition to real test sensitivity and specificity. Our results follow from a mathematical model relating ROI to epidemiology, intervention strategy, and costs for testing, vaccination and dengue infections. We applied this model to a range of strategies, costs and epidemiological settings pertinent to CYD-TDV. However, general trends may not apply locally, so we provide our model and analyses as an R package available via CRAN, denvax. To apply to their setting, decision-makers need only local estimates of age-specific seroprevalence and costs for secondary infections.

scholarly journals Serostatus Testing & Dengue Vaccine Cost-Benefit Thresholds

2019 ◽  
Author(s):  
Carl A. B. Pearson ◽  
Samuel Clifford ◽  
Kaja M. Abbas ◽  
Stefan Flasche ◽  
Thomas J. Hladish
Keyword(s):  
Health Benefit ◽  
Cost Benefit ◽  
World Health Organisation ◽  
World Health ◽  
Dengue Vaccine ◽  
Routine Test ◽  
Past Infection ◽  
Additional Testing ◽  
Bounding Analysis ◽  
Price Thresholds

The World Health Organisation currently recommends pre-screening for past infection prior to administration of the only licensed dengue vaccine, CYD-TDV. Using a bounding analysis, we show that despite additional testing costs, this approach can improve the economic viability of CYD-TDV: effective testing reduces unnecessary vaccination costs while increasing the health benefit for vaccine recipients. When testing is cheap enough, those trends outweigh additional screening costs and make test-then-vaccinate strategies net-beneficial in many settings.We derived these results using a general approach for determining price thresholds for testing and vaccination, as well as indicating optimal start and end ages of routine test-then-vaccinate programs. This approach only requires age-specific seroprevalence and a cost estimate for second infections. We demonstrate this approach across settings commonly used to evaluate CYD-TDV economics, and highlight implications of our simple model for more detailed studies. We found trends showing test-then-vaccinate strategies are generally more beneficial starting at younger ages, and that in some settings multiple years of testing can be more beneficial than only testing once, despite increased investment in testing.

scholarly journals BABY FRIENDLY HOSPITAL INITIATIVE: 25 YEARS OF EXPERIENCE IN BRAZIL

2019 ◽  
Vol 37 (4) ◽  
pp. 486-493
Author(s):  
Joel Alves Lamounier ◽  
Roberto Gomes Chaves ◽  
Maria Albertina Santiago Rego ◽  
Maria Cândida Ferrarez Bouzada
Keyword(s):  
Hospital Care ◽  
Positive Impact ◽  
Intervention Strategy ◽  
World Health ◽  
Baby Friendly Hospital Initiative ◽  
Hospital Beds ◽  
The World ◽  
Accredited Institutions ◽  
Health Organization ◽  
Emergency Fund

ABSTRACT Objective: To describe the experience of the 25-year-old trajectory of the Baby Friendly Hospital Initiative (BFHI) in Brazil. The first unit was implemented in 1992. Methods: Information and data were collected from publications on the World Health Organization (WHO), the United Nations International Children’s Emergency Fund (UNICEF) and the Ministry of Health websites and in national and international journals, about the period 1990-2017. The descriptors used were: “iniciativa hospital amigo da criança”, “hospital amigo da criança”, “baby friendly initiative hospital”, “aleitamento materno” and “breastfeeding”. The number of hospitals in the 25 years, the course of the BFHI and its repercussions on breastfeeding in Brazil were evaluated. Results: The BFHI is an intervention strategy in hospital care at birth focused on the implementation of practices that promote exclusive breastfeeding from the first hours of life and with the support, among other measures of positive impact on breastfeeding, of the International Code of Marketing of Breastmilk Substitutes. Currently, the initiative has been revised, updated and expanded to integrate care for newborns in neonatal units and care for women since prenatal care. It can be concluded that, during these 25 years, the quantity of hospitals varied greatly, with numbers still below the capacity of hospital beds. BFHI shows higher rates of breastfeeding than non-accredited hospitals. However, the number of hospitals are still few when compared to other countries. Conclusions: The BFHI has contributed to breastfeeding in Brazil in recent decades. Greater support for public policies is needed to expand the number of accredited institutions in the country.

scholarly journals Population Perspectives and World Health Organization Recommendations for CYD-TDV Dengue Vaccine

2016 ◽  
Vol 214 (12) ◽  
pp. 1796-1799 ◽  
Author(s):  
Annelies Wilder-Smith ◽  
Kirsten S. Vannice ◽  
Joachim Hombach ◽  
Jeremy Farrar ◽  
Terry Nolan
Keyword(s):  
World Health Organization ◽  
World Health ◽  
Dengue Vaccine ◽  
Health Organization

scholarly journals BioRssay: An R Package for Analyses of Bioassays and Probit Graphs

2021 ◽  
Author(s):  
Piyal Karunarathne ◽  
Nicolas Pocquet ◽  
Pierrick Labbé ◽  
Pascal Milesi
Keyword(s):  
Public Health ◽  
Dose Response ◽  
Software Package ◽  
R Package ◽  
World Health ◽  
Research Areas ◽  
Exposure Response ◽  
The World ◽  
Health Organization ◽  
User Friendly

Abstract Dose-response relationships reflect the effects of a substance on organisms, and are widely used in broad research areas, from medicine and physiology, to vector control and pest management in agronomy. Furthermore, reporting on the response of organisms to stressors is an essential component of many public policies (e.g. public health, environment), and assessment of xenobiotic responses is an integral part of the World Health Organization recommendations. Building upon an R script that we previously made available, and considering its popularity, we have now developed a software package in the R environment, BioRssay, to efficiently analyze dose-response relationships. It has more user-friendly functions, more flexibility, and proposes an easy interpretation of the results. The functions in the BioRssay package are built on robust statistical analyses to compare the dose/exposure-response of various bioassays and effectively visualize them in probit-graphs.

scholarly journals Is scaling-up COVID-19 testing cost-saving?

2020 ◽  
Author(s):  
Bernardo Sousa-Pinto ◽  
João Almeida Fonseca ◽  
Altamiro Costa-Pereira ◽  
Francisco Nuno Rocha-Gonçalves
Keyword(s):  
Cost Saving ◽  
Large Scale ◽  
Scale Up ◽  
Scaling Up ◽  
World Health ◽  
Hospitalization Costs ◽  
Testing Cost ◽  
Additional Costs ◽  
Economic Analyses ◽  
Health Organization

The World Health Organization currently recommends that governments scale up testing for COVID-19 infection. We performed health economic analyses projecting whether the additional costs from screening would be offset by the avoided costs with hospitalizations. We analysed Portuguese COVID-19 data up until the 22nd March 2020, and estimated the additional number of cases that would be detected if different testing rates and frequencies of positive results would have been observed. We projected that, in most scenarios, the costs with scaling up COVID-19 tests would be lower than savings with hospitalization costs, rendering large scale testing cost-saving.

scholarly journals Mathematical Modelling to Assess the Impact of Lockdown on COVID-19 Transmission in India: Model Development and Validation

10.2196/19368 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e19368 ◽  
Author(s):  
Bakiya Ambikapathy ◽  
Kamalanand Krishnamurthy
Keyword(s):  
Mathematical Model ◽  
Model Development ◽  
Intervention Strategy ◽  
World Health ◽  
Sudden Increase ◽  
Heavy Burden ◽  
Novel Coronavirus ◽  
Health Organization ◽  
In Transit ◽  
The Impact

Background The World Health Organization has declared the novel coronavirus disease (COVID-19) to be a public health emergency; at present, India is facing a major threat of community spread. We developed a mathematical model for investigating and predicting the effects of lockdown on future COVID-19 cases with a specific focus on India. Objective The objective of this work was to develop and validate a mathematical model and to assess the impact of various lockdown scenarios on COVID-19 transmission in India. Methods A model consisting of a framework of ordinary differential equations was developed by incorporating the actual reported cases in 14 countries. After validation, the model was applied to predict COVID-19 transmission in India for different intervention scenarios in terms of lockdown for 4, 14, 21, 42, and 60 days. We also assessed the situations of enhanced exposure due to aggregation of individuals in transit stations and shopping malls before the lockdown. Results The developed model is efficient in predicting the number of COVID-19 cases compared to the actual reported cases in 14 countries. For India, the model predicted marked reductions in cases for the intervention periods of 14 and 21 days of lockdown and significant reduction for 42 days of lockdown. Such intervention exceeding 42 days does not result in measurable improvement. Finally, for the scenario of “panic shopping” or situations where there is a sudden increase in the factors leading to higher exposure to infection, the model predicted an exponential transmission, resulting in failure of the considered intervention strategy. Conclusions Implementation of a strict lockdown for a period of at least 21 days is expected to reduce the transmission of COVID-19. However, a further extension of up to 42 days is required to significantly reduce the transmission of COVID-19 in India. Any relaxation in the lockdown may lead to exponential transmission, resulting in a heavy burden on the health care system in the country.

scholarly journals A Dengue Vaccine: Will It be Accepted and Is It Feasible? Lessons from Barranquilla, Colombia, and Merida, Venezuela

2019 ◽  
Vol 7 (10) ◽  
pp. 458
Author(s):  
Elizabeth McMahon ◽  
Liliana Encinales ◽  
Carlos Navarro Encinales ◽  
Silvana Vielma ◽  
Nelly Pacheco ◽  
...  
Keyword(s):  
Disease Burden ◽  
World Health ◽  
Dengue Vaccine ◽  
Government Officials ◽  
Policy Makers ◽  
Severe Problem ◽  
Social Unrest ◽  
Vaccination Programs ◽  
Vaccine Introduction ◽  
Health Organization

With one vaccine on the market and others in clinical trials, policy makers in dengue endemic regions face the decision of whether to introduce a dengue vaccine in their communities. The World Health Organization (WHO) recommends that individualized assessments be conducted before any vaccine introduction to evaluate disease burden and the strength of current vaccination programs. This study seeks to aid in that decision-making process by examining the acceptability and feasibility of dengue vaccine introduction in Barranquilla, Colombia, and Merida, Venezuela. Surveys were administered February–June of 2018 for three groups: patients (n = 351), health professionals (n = 197), and government officials (n = 26). In Barranquilla, most respondents reported dengue to be a moderate-severe problem, that a dengue vaccine would be useful in their communities, and that their current vaccination programs could handle the addition of a new vaccine. In Venezuela, respondents were less likely to view dengue as a major concern and listed multiple barriers to not just dengue vaccine introduction, but to providing current vaccines as well. Further work is needed in Colombia to more objectively assess the country’s readiness as a whole for a future dengue vaccine. As political and social unrest continues in Venezuela, however, future initiatives should focus on trust and capacity building. This study can serve as a framework for future assessments of the acceptability and feasibility of a dengue vaccine in both targeted areas and on larger scales.

scholarly journals Economic Impact of Health Intervention by Telemedicine during Covid 19 Pandemic at Nicaragua, June – July 2020

2021 ◽  
pp. 1-7
Author(s):  
Francisco Medrano ◽  
◽  
Patricia Castro ◽  
Jose Antonio Vásquez ◽  
Américo Gámez ◽  
...  
Keyword(s):  
Economic Impact ◽  
Cost Benefit ◽  
Growth Period ◽  
Health Impact ◽  
Primary Objective ◽  
World Health ◽  
Middle Income ◽  
Health Strategy ◽  
Health Organization ◽  
June July

SARS-CoV-2 its infectious diseases was named coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO) a really pandemic. The first report on prevalence of SARS-Cov2 at Nicaragua, showed the first cases March 2020 and during the months of June and July began exponential growth period. The telemedicine can provide rapid access, efficient and immediately available person. This approach has been explored most fully in the context of Covid 19 stroke. The estimates of intervention costs are really challenge, particularly for low- and middle-income countries. Create a health strategy during a health emergency with the lowest cost investment but great population health impact are the primary objective. The gold of this study is decide the economic impact, through of the cost benefit of medical advice through mobile phone during the COVID-19 pandemia , as health strategy at Nicaragua

scholarly journals Mathematical Modelling to Assess the Impact of Lockdown on COVID-19 Transmission in India: Model Development and Validation (Preprint)

2020 ◽  
Author(s):  
Bakiya Ambikapathy ◽  
Kamalanand Krishnamurthy
Keyword(s):  
Mathematical Model ◽  
Model Development ◽  
Intervention Strategy ◽  
World Health ◽  
Sudden Increase ◽  
Heavy Burden ◽  
Novel Coronavirus ◽  
Health Organization ◽  
In Transit ◽  
The Impact

BACKGROUND The World Health Organization has declared the novel coronavirus disease (COVID-19) to be a public health emergency; at present, India is facing a major threat of community spread. We developed a mathematical model for investigating and predicting the effects of lockdown on future COVID-19 cases with a specific focus on India. OBJECTIVE The objective of this work was to develop and validate a mathematical model and to assess the impact of various lockdown scenarios on COVID-19 transmission in India. METHODS A model consisting of a framework of ordinary differential equations was developed by incorporating the actual reported cases in 14 countries. After validation, the model was applied to predict COVID-19 transmission in India for different intervention scenarios in terms of lockdown for 4, 14, 21, 42, and 60 days. We also assessed the situations of enhanced exposure due to aggregation of individuals in transit stations and shopping malls before the lockdown. RESULTS The developed model is efficient in predicting the number of COVID-19 cases compared to the actual reported cases in 14 countries. For India, the model predicted marked reductions in cases for the intervention periods of 14 and 21 days of lockdown and significant reduction for 42 days of lockdown. Such intervention exceeding 42 days does not result in measurable improvement. Finally, for the scenario of “panic shopping” or situations where there is a sudden increase in the factors leading to higher exposure to infection, the model predicted an exponential transmission, resulting in failure of the considered intervention strategy. CONCLUSIONS Implementation of a strict lockdown for a period of at least 21 days is expected to reduce the transmission of COVID-19. However, a further extension of up to 42 days is required to significantly reduce the transmission of COVID-19 in India. Any relaxation in the lockdown may lead to exponential transmission, resulting in a heavy burden on the health care system in the country.

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