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 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 Smallpox in the Post-Eradication Era

Viruses ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 138 ◽  
Author(s):  
Hermann Meyer ◽  
Rosina Ehmann ◽  
Geoffrey L. Smith
Keyword(s):  
Public Health ◽  
Human Population ◽  
Health Benefit ◽  
World Health Organisation ◽  
World Health ◽  
Viral Spread ◽  
The World ◽  
The Usa ◽  
The Impact

Widespread vaccination programmes led to the global eradication of smallpox, which was certified by the World Health Organisation (WHO), and, since 1978, there has been no case of smallpox anywhere in the world. However, the viable variola virus (VARV), the causative agent of smallpox, is still kept in two maximum security laboratories in Russia and the USA. Despite the eradication of the disease smallpox, clandestine stocks of VARV may exist. In a rapidly changing world, the impact of an intentional VARV release in the human population would nowadays result in a public health emergency of global concern: vaccination programmes were abolished, the percentage of immunosuppressed individuals in the human population is higher, and an increased intercontinental air travel allows for the rapid viral spread of diseases around the world. The WHO has authorised the temporary retention of VARV to enable essential research for public health benefit to take place. This work aims to develop diagnostic tests, antiviral drugs, and safer vaccines. Advances in synthetic biology have made it possible to produce infectious poxvirus particles from chemicals in vitro so that it is now possible to reconstruct VARV. The status of smallpox in the post-eradication era is reviewed.

scholarly journals An exact method for quantifying the reliability of end-of-epidemic declarations in real time

2020 ◽  
Author(s):  
Kris V Parag ◽  
Christl A Donnelly ◽  
Rahul Jha ◽  
Robin N Thompson
Keyword(s):  
Real Time ◽  
Waiting Times ◽  
False Negative ◽  
World Health Organisation ◽  
World Health ◽  
Time Varying ◽  
Economic Sectors ◽  
Past Infection ◽  
Social Distancing ◽  
Intensive Surveillance

AbstractWe derive and validate a novel and analytic method for estimating the probability that an epidemic has been eliminated (i.e. that no future local cases will emerge) in real time. When this probability crosses 0.95 an outbreak can be declared over with 95% confidence. Our method is easy to compute, only requires knowledge of the incidence curve and the serial interval distribution, and evaluates the statistical lifetime of the outbreak of interest. Using this approach, we rigorously show how the time-varying under-reporting of infected cases will artificially inflate the inferred probability of elimination, leading to premature (false-positive) end-of-epidemic declarations. Contrastingly, we prove that incorrectly identifying imported cases as local will deceptively decrease this probability, resulting in delayed (false-negative) declarations. Failing to sustain intensive surveillance during the later phases of an epidemic can therefore substantially mislead policymakers on when it is safe to remove travel bans or relax quarantine and social distancing advisories. World Health Organisation guidelines recommend fixed (though disease-specific) waiting times for end-of-epidemic declarations that cannot accommodate these variations. Consequently, there is an unequivocal need for more active and specialised metrics for reliably identifying the conclusion of an epidemic.Author SummaryDeciding on when to declare an infectious disease epidemic over is an important and non-trivial problem. Early declarations can mean that interventions such as lockdowns, social distancing advisories and travel bans are relaxed prematurely, elevating the risk of additional waves of the disease. Late declarations can unnecessarily delay the re-opening of key economic sectors, for example trade, tourism and agriculture, potentially resulting in significant financial and livelihood losses. Here we develop and test a novel and exact data-driven method for optimising the timing of end-of-epidemic declarations. Our approach converts observations of infected cases up to any given time into a prediction of the likelihood that the epidemic is over at that time. Using this method, we quantify the reliability of end-of-epidemic declarations in real time, under ideal case surveillance, showing that it can depend strongly on past infection numbers. We then prove that failing to compensate for practical issues such as the time-varying under-reporting and importing of cases necessarily results in premature and delayed declarations, respectively. These variations and biases cannot be accommodated by current worldwide declaration guidelines. Sustained and intensive surveillance coupled with more adaptive declaration metrics are vital if informed end-of-epidemic declarations are to be made.

The Impact of Text Messaging in Adherence Programs

2015 ◽  
Vol 3 (1) ◽  
pp. 48
Author(s):  
Kevin Dolgin
Keyword(s):  
Text Messaging ◽  
Smart Phone ◽  
Cost Benefit ◽  
World Health Organisation ◽  
New Drugs ◽  
World Health ◽  
Advantages And Disadvantages ◽  
Adherence To Medication ◽  
Message Service ◽  
The Impact

Average adherence rates for chronic treatment average approximately 50%, leading the World Health Organisation (WHO) to state that increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments and new drugs per se. In this environment, programs designed to increase adherence to medication and to treatment in general have multiplied over the past several years. These programs generally include communication with patients to inform and influence behavior. This communication can take place via a number of channels, ranging from face-to-face contact to physical mail to smart phone apps. Each channel has its own advantages and disadvantages and each entails costs of its own. Short Message Service (SMS) or text messaging has proven in numerous studies to represent an advantageous cost / benefit profile, particularly when the messages are customized to individual patients. This is the case across a wide variety of patient types, ages, pathologies and geographies. The present article provides an overview of the challenges of treatment adherence and how these can be successfully addressed using text messaging interventions across a variety of chronic illness and within different geographical and cultural settings.

A Collaborative Study to Establish the Second International Standard for Streptokinase

1990 ◽  
Vol 64 (02) ◽  
pp. 267-269 ◽  
Author(s):  
A B Heath ◽  
P J Gaffney
Keyword(s):  
High Purity ◽  
Collaborative Study ◽  
World Health Organisation ◽  
World Health ◽  
Clot Lysis ◽  
Current Standard ◽  
International Standard ◽  
Accelerated Degradation ◽  
The World ◽  
International Collaborative Study

SummaryAn International Standard for Streptokinase - Streptodomase (62/7) has been used to calibrate high purity clinical batches of SK since 1965. An international collaborative study, involving six laboratories, was undertaken to replace this standard with a high purity standard for SK. Two candidate preparations (88/826 and 88/824) were compared by a clot lysis assay with the current standard (62/7). Potencies of 671 i.u. and 461 i.u. were established for preparations A (88/826) and B (88/824), respectively.Either preparation appeared suitable to serve as a standard for SK. However, each ampoule of preparation A (88/826) contains a more appropriate amount of SK activity for potency testing, and is therefore preferred. Accelerated degradation tests indicate that preparation A (88/826) is very stable.The high purity streptokinase preparation, coded 88/826, has been established by the World Health Organisation as the 2nd International Standard for Streptokinase, with an assigned potency of 700 i.u. per ampoule.

A Collaborative Study to Establish an International Standard for Alpha-Thrombin

1992 ◽  
Vol 67 (04) ◽  
pp. 424-427 ◽  
Author(s):  
P J Gaffney ◽  
A B Heath ◽  
J W Fenton II
Keyword(s):  
Elevated Temperatures ◽  
Collaborative Study ◽  
World Health Organisation ◽  
Significant Loss ◽  
Thrombin Inhibitors ◽  
World Health ◽  
Expert Committee ◽  
International Standard ◽  
Assay Procedure ◽  
And Control

SummarySince 1975 an International Standard for Thrombin of low purity has been used. While this standard was stable and of value for calibrating thrombins of unknown potency the need for a pure a-thrombin standard arose both for accurate calibration and for precise measurement of thrombin inhibitors, notably hirudin. An international collaborative study was undertaken to establish the potency and stability of an ampouled pure a-thrombin preparation. A potency of 97.5 international units (95% confidence limits 86.5-98.5) was established for the new a-thrombin standard (89/ 588) using a clotting-assay procedure. Stability data at various elevated temperatures indicated that the standard could be transported and stored with no significant loss of potency.Ampoules of lyophilised a-thrombin (coded 89/588) have been recommended as an International Standard for a-thrombin with an assigned potency of 100 international units per ampoule by the International Society for Thrombosis and Haemostasis (Thrombin and its Inhibitors Sub-Committee) in Barcelona, Spain in July 1990 while the Expert Committee on Biological Standardisation and Control of the World Health Organisation will consider its status at its next meeting in Geneva in 1991.

ANTARA SUNNAH DAN TRADISI (Khitan Muallaf Perempuan Baligh di Jayapura, Papua)

1970 ◽  
Vol 9 (2) ◽  
pp. 271-284
Author(s):  
Hendra Yulia Rahman
Keyword(s):  
World Health Organisation ◽  
World Health

Masyarakat Indonesia pada umumnya khususnya yang bergama Islam, memiliki kebiasaan mengkhitankan anak perempuannya dan memandang ini sebagai sunnah, hal ini juga dilakukan masyarakat di negara-negara lain yang memiliki penduduk pemeluk agama Islam. Pada umumnya masyarakat megkhitankan anak perempuannya, ketika masih bayi dan meyakininya sebagai bentuk kewajiban dari perintah agama. Badan kesehatan dunia World Health Organisation (WHO) melakukan pelarangan segala bentuk khitan pada perempuan, karena dianggap sebagai bentuk kekerasan pada perempuan dengan menyakiti dan merusak alat reproduksi perempuan. Khitan perempuan dianggap sebagai tradisi yang sudah lama ada tengah-tengah masyarakat baik yang muslim maupun yang non muslim, yang dalam pelaksanaannya lebih dimaksudkan sebagai upaya pengontrolan seksualitas perempuan. Muallaf perempuan baligh khususnya di wilayah kota Jayapura, Papua rata-rata melakukan khitan, yang menurut mereka merupakan bagian dari perintah agama. Bahwasanya khitan muallaf perempuan baligh di kota Jayapaura merupakan sebuah tradisi yang terus berlangsung, dan tradisi tersebut sejalan dengan sunnah.

Comparative docking of SARS-CoV-2 receptors antagonists from repurposing drugs

2020 ◽  
Author(s):  
Micael Davi Lima de Oliveira ◽  
Kelson Mota Teixeira de Oliveira
Keyword(s):  
World Health Organisation ◽  
World Health ◽  
Lung Cells ◽  
The Novel ◽  
High Modulation ◽  
Main Protease ◽  
The World ◽  
Novel Coronavirus ◽  
Viral Receptors ◽  
Theoretical Results

According to the World Health Organisation, until 16 June, 2020, the number of confirmed and notified cases of COVID-19 has already exceeded 7.9 million with approximately 434 thousand deaths worldwide. This research aimed to find repurposing antagonists, that may inhibit the activity of the main protease (Mpro) of the SARS-CoV-2 virus, as well as partially modulate the ACE2 receptors largely found in lung cells, and reduce viral replication by inhibiting Nsp12 RNA polymerase. Docking molecular simulations were performed among a total of 60 structures, most of all, published in the literature against the novel coronavirus. The theoretical results indicated that, in comparative terms, paritaprevir, ivermectin, ledipasvir, and simeprevir, are among the most theoretical promising drugs in remission of symptoms from the disease. Furthermore, also corroborate indinavir to the high modulation in viral receptors. The second group of promising drugs includes remdesivir and azithromycin. The repurposing drugs HCQ and chloroquine were not effective in comparative terms to other drugs, as monotherapies, against SARS-CoV-2 infection.

Osseointegrated Implants: A Comprehensive Review

2021 ◽  
Vol 2 (1) ◽  
pp. 24-30
Author(s):  
Matheus Marquez Cruvinel Santos ◽  
◽  
Flávio Barros da Silva ◽  
Idiberto José Zotarelli-Filho ◽  
Elias Naim Kassis ◽  
...  
Keyword(s):  
Dental Implants ◽  
Pharmacological Action ◽  
World Health Organisation ◽  
World Health ◽  
Density Level ◽  
Mineral Density ◽  
Osseointegrated Implants ◽  
Bone Mineral Density Level ◽  
The Mean ◽  
Normal Women

The most common bone disorder found by implant dentists is osteoporosis, which is a systemic skeletal disorder associated with aging, which is characterized by loss of bone mass, making bones fragile and more susceptible to fractures. The World Health Organisation has defined osteoporosis as a bone mineral density level greater than 2.5 standard deviations below the mean of young normal women. After 60 years of age, a third of the population have this disorder, it occurs twice as often in women than in men. It is estimated that 1.3 million fractures and 133,000 all hip fractures occur every year as a result of osteoporosis. This study aimed to discuss aspects of the pharmacological action of Bisphosphonates (BP) and their influence on the bone tissue when associated with treatment with dental implants. There are several types of treatments that prevent or prevent the progression of osteoporosis. So, BP, such as alendronate, are inhibitors of bone resorption. Act as controlling the development of osteoporosis by increasing the process of bone density and decrease its reabsorption, often acting as supporting the process of osseointegration of dental implants.

Use of Phosphatidylcholine in the Treatment of Localized Fat Deposits. Results and expectations

2017 ◽  
Vol 68 (7) ◽  
pp. 1438-1441 ◽  
Author(s):  
Sorin Berbece ◽  
Dan Iliescu ◽  
Valeriu Ardeleanu ◽  
Alexandru Nicolau ◽  
Radu Cristian Jecan
Keyword(s):  
World Health Organisation ◽  
Normal Weight ◽  
World Health ◽  
Basic Substance ◽  
Physical Exercises ◽  
Fat Deposits ◽  
The World ◽  
The Common ◽  
Global Health Problem ◽  
Over Time

Obesity represents a global health problem. According to the latest studies released by the World Health Organisation (WHO), 1.7 billion currently in excess of normal weight individuals, of which approx. 75% are overweight (body mass index - BMI 25 to 30). The common form of excess adipose tissue manifestation in overweight individuals is localized fat deposits with high (abdominal) or low (buttocks and thighs) disposition. Although the overweight can be corrected relatively easy by changing behavioral habits or food, a constant physical exercises program or following a diet food are not accessible to all through the efforts of will, financial and time involved. Several methods have been studied and tested over time to eliminate more or less invasive fat deposits with varying efficacy and adverse effects. Chemical lipolysis using phosphatidylcholine as the basic substance was initially used in hypercholesterolemia and its complications and was rapidly adopted in mesotherapy techniques for the treatment of fat deposits. This study reveals the results obtained using Dermastabilon on a sample of 16 patients, the time allocated to treatment and discomfort being minimal, and rapid and notable results. There were no side effects.

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