scholarly journals Risk and Prevention of Meningococcal Disease among Education Workers: A Review

2004 ◽  
Vol 15 (2) ◽  
pp. 89-93 ◽  
Author(s):  
Philippe De Wals ◽  
Pierre Deshaies ◽  
Gaston De Serres ◽  
Bernard Duval ◽  
Lise Goulet ◽  
...  
Keyword(s):  
United Kingdom ◽  
Pregnant Women ◽  
Meningococcal Disease ◽  
Disease Risk ◽  
The United States ◽  
Population Based ◽  
Work Place ◽  
Societal Benefit ◽  
The United Kingdom ◽  
The Cost

The aims of the present study were to review the risk of invasive meningococcal disease (IMD) among education workers, particularly pregnant women, and to evaluate preventive measures, in a context of endemicity, outbreak or epidemic as observed in the province of Quebec. The literature was reviewed and persons in charge of IMD surveillance in France, Quebec, the United Kingdom and the United States were interviewed. Surveys of asymptomatic carriage ofNeisseria meningitidisshow that transmission among students is higher than transmission between students and teachers. IMD incidence among education workers was analyzed in Cheshire (United Kingdom) in the period from 1997 to 1999, and the results indicated a risk six times higher than that in the general population. Overestimation of the magnitude of the risk is possible because the analysis focused on a cluster. None of the population-based studies of IMD mentioned a risk of secondary cases among education workers. Six IMD cases in education workers were identified in five clusters in schools in the United Kingdom, but not in the other countries. There is no epidemiological study on IMD risk among pregnant women, and this factor was not mentioned in any published review of IMD. Immunization of education workers at the beginning of their employment, using serogroup C glycoconjugate vaccine or a combined A, C, W-135, and Y conjugate vaccine (still under development), could reduce IMD risk, but the cost effectiveness of this measure should be evaluated. The societal benefit of excluding pregnant women from the work place during an outbreak seems to be very low, even if disease risk could be decreased for this specific group. When chemoprophylaxis is indicated for the control of an outbreak in an educational setting, treatment should be offered both to students and teachers in the group at risk.

Expanded Function Orthodontic Auxiliaries; a Proposal for their Introduction in the UK

1988 ◽  
Vol 15 (4) ◽  
pp. 281-286 ◽  
Author(s):  
K. D. O'Brien ◽  
W. C. Shaw
Keyword(s):  
United States ◽  
United Kingdom ◽  
Cost Effectiveness ◽  
Orthodontic Treatment ◽  
The United States ◽  
The United Kingdom ◽  
Treatment Provision ◽  
The Uk ◽  
The Cost

The role of dental and orthodontic auxiliaries in Europe and the United States is reviewed, and the advantages of their employment in the United Kingdom are discussed in terms of increasing the cost-effectiveness of orthodontic treatment provision. A three-stage programme for the evaluation of Orthodontic Auxiliaries in the UK is proposed.

scholarly journals Vaccination in pregnancy against pertussis and seasonal influenza: key learnings and components from high-performing vaccine programmes in three countries: the United Kingdom, the United States and Spain

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Théophile Baïssas ◽  
Florence Boisnard ◽  
Inmaculada Cuesta Esteve ◽  
Marta Garcia Sánchez ◽  
Christine E. Jones ◽  
...  
Keyword(s):  
United States ◽  
United Kingdom ◽  
Influenza Vaccination ◽  
Pregnant Women ◽  
Seasonal Influenza ◽  
The United States ◽  
Seasonal Influenza Vaccination ◽  
High Performing ◽  
The United Kingdom ◽  
In Pregnancy

Abstract Background Pertussis and seasonal influenza are responsible for significant maternal, neonatal, and infant morbidity and mortality, but vaccine coverage rates (VCR) for both pertussis (administered as a tetanus, diphtheria, acellular pertussis [Tdap] vaccination) and seasonal influenza in pregnancy remain generally low. Only a small number of countries, including Spain, the United Kingdom (UK), and the United States (US), have high Tdap and seasonal influenza VCRs in pregnancy. The purpose of this study was to identify the key factors that contributed to the high VCRs observed in these countries. Methods The experience from both Tdap and seasonal influenza vaccination programmes during pregnancy were documented in Spain, the UK, and the US using a three-step approach. A literature review yielded 157 publications, and a further 117 documents were selected through desk research. A published five-pillar VCR framework for influenza was amended to evaluate the specific contributing factors leading to high Tdap and seasonal influenza VCRs among pregnant women. Results The analysis identified components that contributed to higher VCR in pregnant women across three different healthcare systems in Spain, UK, and US. The combination of several key interventions in each country led to a rapid increase in VCR that reached near-optimal levels (i.e. 75% for seasonal influenza) within a few years. As well as inclusion in national immunisation programme and vaccine reimbursement, key components that were identified included the mobilisation of health authorities, prenatal care Healthcare Professionals (HCP) and scientific societies, the inclusion of vaccination in antenatal medical guidance, the provision of educational material to HCPs, and a strong disease awareness driven by recent pertussis outbreaks in each country. Conclusions Although there is no simple, universal solution to improving sub-optimal VCRs, the list of components identified in this study from three countries with high-performing Tdap and seasonal influenza vaccination programmes provides a basis for public health and medical stakeholders in other countries to define strategies to successfully implement national vaccination programmes for pregnant women.

The cost of epilepsy in the United Kingdom: An estimation based on the results of two population-based studies

1994 ◽  
Vol 18 (3) ◽  
pp. 249-260 ◽  
Author(s):  
Oliver C. Cockerell ◽  
Yvonne M. Hart ◽  
Josemir W.A.S. Sander ◽  
Simon D. Shorvon
Keyword(s):  
United Kingdom ◽  
Population Based ◽  
The United Kingdom ◽  
The Cost

scholarly journals The cost-effectiveness of accelerated partner therapy (APT) compared to standard contact tracing for people with chlamydia: an economic evaluation based on the LUSTRUM population-based chlamydia transmission model

2021 ◽  
Author(s):  
Eleanor V. Williams ◽  
Chidubem B. Okeke Ogwulu ◽  
Claudia S. Estcourt ◽  
Alison R. Howarth ◽  
Andrew Copas ◽  
...  
Keyword(s):  
United Kingdom ◽  
Cost Effectiveness ◽  
Population Based ◽  
Contact Tracing ◽  
Chlamydia Infection ◽  
The United Kingdom ◽  
Intervention Cost ◽  
Standard Contact ◽  
The Cost ◽  
The Impact

Objective: To investigate the cost-effectiveness of accelerated partner therapy (APT) compared with standard contact tracing for people with sexually transmitted chlamydia infection in the United Kingdom Design: Economic evaluation using a model consisting of two components: a population-based chlamydia transmission component, to estimate the impact of APT on chlamydia prevalence, and an economic component, to estimate the impact of APT on healthcare costs and health outcomes. Setting: United Kingdom Participants: Hypothetical heterosexual population of 50,000 men and 50,000 women aged 16-34 years. Main Outcome Measures: Cost-effectiveness based on quality-adjusted life years (QALYs) gained and major outcomes averted (MOA), defined as mild pelvic inflammatory disease (PID), severe PID, chronic pelvic pain, ectopic pregnancy, tubal factor infertility and epididymitis. Results: For a model population of 50,000 men and 50,000 women and an APT intervention lasting 5 years, the intervention cost of APT (&pound135,201) is greater than the intervention cost of standard contact tracing (&pound116,334). When the costs of complications arising from chlamydia are considered, the total cost of APT (&pound370,657) is lower than standard contact tracing (&pound379,597). Thus, APT yields a total cost saving of approximately &pound9000 and leads to 73 fewer major outcomes and 21 fewer QALYs lost. Hence, APT is the dominant PN strategy. APT remained cost-effective across the full range of sensitivity analyses. Conclusions: Based on cost-effectiveness grounds APT is likely to be recommended as an alternative to standard contact tracing for chlamydia infection in the United Kingdom

scholarly journals Use of levothyroxine among pregnant women with subclinical hypothyroidism in the United Kingdom: A population‐based assessment

2021 ◽  
Vol 9 (5) ◽  
Author(s):  
Ya‐Hui Yu ◽  
Kristian B. Filion ◽  
Pauline Reynier ◽  
Robert W. Platt ◽  
Oriana H. Y. Yu ◽  
...  
Keyword(s):  
United Kingdom ◽  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Population Based ◽  
The United Kingdom

Cost-Effectiveness of a Targeted Disinfection Program in Household Kitchens To Prevent Foodborne Illnesses in the United States, Canada, and the United Kingdom

2003 ◽  
Vol 66 (11) ◽  
pp. 2103-2115 ◽  
Author(s):  
STEVEN B. DUFF ◽  
ELIZABETH A. SCOTT ◽  
MICHAEL S. MAFILIOS ◽  
EWEN C. TODD ◽  
LEONARD R. KRILOV ◽  
...  
Keyword(s):  
United States ◽  
United Kingdom ◽  
Cost Effectiveness ◽  
High Risk ◽  
The United States ◽  
Foodborne Illnesses ◽  
Cost Effectiveness Ratio ◽  
The United Kingdom ◽  
The Cost

Foodborne illnesses impose a substantial economic and quality-of-life burden on society by way of acute morbidity and chronic sequelae. We developed an economic model to evaluate the potential cost-effectiveness of a disinfection program that targets high-risk food preparation activities in household kitchens. For the United States, Canada, and the United Kingdom, we used published literature and expert opinion to estimate the cost of the program (excluding the educational component); the number of cases of Salmonella, Campylobacter, and Escherichia coli O157:H7 infections prevented; and the economic and quality-of-life outcomes. In our primary analysis, the model estimated that approximately 80,000 infections could be prevented annually in U.S. households, resulting in $138 million in direct medical cost savings (e.g., physician office visits and hospitalizations avoided), 15,845 quality-adjusted life-years (QALYs) gained, $788 million in program costs, and a favorable cost-effectiveness ratio of $41,021/QALY gained. Results were similar for households in Canada and the United Kingdom (Can $21,950/QALY gained and £86,341/QALY gained, respectively). When we evaluated implementing the program only in U.S. households with high-risk members (those less than 5 years of age, greater than 65 years of age, or immunocompromised), the cost-effectiveness ratio was more favorable ($10,163/QALY gained). Results were similar for high-risk households in Canada and the United Kingdom (Can$1,915/QALY gained and £28,158/QALY gained, respectively). Implementing a targeted disinfection program in household kitchens in the United States, Canada, and the United Kingdom appears to be a cost-effective strategy, falling within the range generally considered to warrant adoption and diffusion (<$100,000/QALY gained).

scholarly journals Strategic options for antenatal screening for syphilis in the United Kingdom: a cost effectiveness analysis

2000 ◽  
Vol 7 (1) ◽  
pp. 7-13 ◽  
Author(s):  
N. Connor ◽  
J. Roberts ◽  
A. Nicoll
Keyword(s):  
United Kingdom ◽  
Cost Effectiveness ◽  
Pregnant Women ◽  
Screening Programme ◽  
Number Needed To Treat ◽  
Antenatal Screening ◽  
The United Kingdom ◽  
Increased Risk ◽  
Strategic Options ◽  
The Cost

Objective Antenatal screening for syphilis is well established in the United Kingdom. The prevalence of syphilis is now very low, prompting the question as to whether this screening programme is still necessary. This paper aims at identifying possible screening strategy options for the programme and comparing their effectiveness and cost effectiveness. Methods The cost of the screening programme in the United Kingdom was estimated. This was based on the cost of screening tests, treatment, and follow up of infected women and their infants. This information was obtained from laboratories, antenatal clinics, and genitourinary medicine clinics. Epidemiological data from a survey of women treated for syphilis in pregnancy were analysed to identify groups at increased risk of syphilis. Strategic options for the screening programme were then identified. The effectiveness, number needed to treat, and cost effectiveness of these options were compared. Results Antenatal screening in the United Kingdom detected at least 40 pregnant women who need treatment for syphilis every year. This means that 18 602 women are screened for every woman detected who needs treatment for syphilis. The marginal annual cost of this screening programme in the United Kingdom is £672 366. This is equivalent to 90p per woman screened, or £16 670 to detect one woman who needs treatment for syphilis. The screening programme could be targeted geographically at pregnant women in the Thames regions. This option has the potential to save £482 185. Other strategic options are to target pregnant women in non-white ethnic groups, or those born outside the United Kingdom. These targeted options would each detect between 70% and 77% of women needing treatment for syphilis. These options could potentially save £592 938 and £562 691 respectively. Conclusions Targeting or stopping the screening programme would save relatively little money. Although selectively screening groups by country of birth or by ethnic group could detect at least 70% of cases, this would be politically and practically difficult. Targeting by region would also be effective, but would pose similar ethical and medicolegal problems. These facts and the changing international epidemiology of syphilis lead us to recommend that the current universal antenatal screening for syphilis should continue.

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