scholarly journals A Meta-Analysis of the Effect of Bacillus Calmette-Guérin Vaccination Against Bovine Tuberculosis: Is Perfect the Enemy of Good?

2021 ◽  
Vol 8 ◽  
Author(s):  
Sreenidhi Srinivasan ◽  
Andrew J. K. Conlan ◽  
Laurel A. Easterling ◽  
Christian Herrera ◽  
Premanshu Dandapat ◽  
...  
Keyword(s):  
Bovine Tuberculosis ◽  
Dynamic Models ◽  
Control Strategies ◽  
Meta Analysis ◽  
Herd Immunity ◽  
Bacillus Calmette Guerin ◽  
Middle Income ◽  
Bcg Vaccination ◽  
Control Programs ◽  
Scenario Analyses

More than 50 million cattle are likely exposed to bovine tuberculosis (bTB) worldwide, highlighting an urgent need for bTB control strategies in low- and middle-income countries (LMICs) and other regions where the disease remains endemic and test-and-slaughter approaches are unfeasible. While Bacillus Calmette-Guérin (BCG) was first developed as a vaccine for use in cattle even before its widespread use in humans, its efficacy against bTB remains poorly understood. To address this important knowledge gap, we conducted a systematic review and meta-analysis to determine the direct efficacy of BCG against bTB challenge in cattle, and performed scenario analyses with transmission dynamic models incorporating direct and indirect vaccinal effects (“herd-immunity”) to assess potential impact on herd level disease control. The analysis shows a relative risk of infection of 0.75 (95% CI: 0.68, 0.82) in 1,902 vaccinates as compared with 1,667 controls, corresponding to a direct vaccine efficacy of 25% (95% CI: 18, 32). Importantly, scenario analyses considering both direct and indirect effects suggest that disease prevalence could be driven down close to Officially TB-Free (OTF) status (<0.1%), if BCG were introduced in the next 10-year time period in low to moderate (<15%) prevalence settings, and that 50–95% of cumulative cases may be averted over the next 50 years even in high (20–40%) disease burden settings with immediate implementation of BCG vaccination. Taken together, the analyses suggest that BCG vaccination may help accelerate control of bTB in endemic settings, particularly with early implementation in the face of dairy intensification in regions that currently lack effective bTB control programs.

Using disease dynamics and modeling to inform control strategies in low-income countries

2018 ◽  
Author(s):  
Matthew Ferrari
Keyword(s):  
Infectious Disease ◽  
Low Income ◽  
Dynamic Models ◽  
Control Strategies ◽  
Disease Incidence ◽  
Herd Immunity ◽  
Unintended Consequences ◽  
Low Income Countries ◽  
Disease Dynamics ◽  
The Impact

The incidence infectious disease is inherently dynamic in time and space. Mathematical models that account for the dynamic processes that give rise to fluctuations in disease incidence are powerful tools in disease management and control. We describe the use of dynamic models for surveillance, evaluation and prediction of disease control efforts in low-income countries. Dynamic models can help to anticipate trends owing to intrinsic (e.g., herd immunity) or extrinsic (e.g., seasonality) forces that may confound efforts to isolate the impact of specific interventions. Infectious disease dynamics are frequently nonlinear, meaning that future outcomes are difficult to predict through simple extrapolation of present conditions. Thus, dynamic models can help to explore the potential consequences of proposed interventions. These projections can alert managers to the potential for unintended consequences of control and help to define effect sizes for the design of conventional studies of the impact of interventions.

Association between Bacillus Calmette-Guerin (BCG) vaccination and lymphoma risk: A systematic review and meta-analysis

2020 ◽  
Vol 65 ◽  
pp. 101696 ◽  
Author(s):  
Charlotte Salmon ◽  
Florence Conus ◽  
Marie-Élise Parent ◽  
Andrea Benedetti ◽  
Marie-Claude Rousseau
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Bacillus Calmette Guerin ◽  
Bcg Vaccination ◽  
Lymphoma Risk

scholarly journals Corrigendum: A Meta-Analysis of the Effect of Bacillus Calmette-Guérin Vaccination Against Bovine Tuberculosis: Is Perfect the Enemy of Good?

2021 ◽  
Vol 8 ◽  
Author(s):  
Sreenidhi Srinivasan ◽  
Andrew J. K. Conlan ◽  
Laurel A. Easterling ◽  
Christian Herrera ◽  
Premanshu Dandapat ◽  
...  
Keyword(s):  
Bovine Tuberculosis ◽  
Meta Analysis ◽  
Bacillus Calmette Guerin

Interventions to Reduce Alcohol Harms in Low and Middle Income Countries: a Systematic Review and Meta Analysis

2018 ◽  
Author(s):  
Joao Ricardo Nickenig Vissoci
Keyword(s):  
Systematic Review ◽  
Alcohol Use ◽  
Randomized Controlled Trials ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
World Health ◽  
Controlled Trials ◽  
Middle Income ◽  
Brief Motivational Intervention ◽  
Randomized Controlled

BackgroundHarmful alcohol use leads to a large burden of disease and disability which disportionately impacts LMICs. The World Health Organization and the Lancet have issued calls for this burden to be addressed, but issues remain, primarily due to gaps in information. While a variety of interventions have been shown to be effective at reducing alcohol use in HICs, their efficacy in LMICs have yet to be assessed. This systematic review describes the current published literature on alcohol interventions in LMICs and conducts a meta analysis of clinical trials evaluating interventions to reduce alcohol use and harms in LMICs.MethodsIn accordance with PRISMA guidelines we searched the electronic databases Pubmed, EMBASE, Scopus,Web of Science, Cochrane, and Psych Info. Articles were eligible if they evaluated an intervention targeting alcohol-related harm in LMICs. After a reference and citation analysis, we conducted a quality assessment per PRISMA protocol. A meta-analysis was performed on the 39 randomized controlled trials that evaluated an alcohol-related outcome.ResultsOf the 3,801 articles from the literature search, 87 articles from 25 LMICs fit the eligibility and inclusion criteria. Of these studies, 39 randomized controlled trials were included in the meta-analysis. Nine of these studies focused specifically on medication, while the others focused on brief motivational intervention, brain stimulation, AUDIT-based brief interventions, WHO ASSIST-based interventions, group based education, basic screening and interventions, brief psychological or counseling, dyadic relapse prevention, group counseling, CBT, motivational + PTSD based interview, and health promotion/awareness. Conclusion Issues in determining feasible options specific to LMICs arise from unstandardized interventions, unequal geographic distribution of intervention implementation, and uncertain effectiveness over time. Current research shows that brain stimulation, psychotherapy, and brief motivational interviews have the potential to be effective in LMIC settings, but further feasibility testing and efforts to standardize results are necessary to accurately assess their effectiveness.

scholarly journals Cost-Effectiveness Analysis of BCG Vaccination against Tuberculosis in Indonesia: A Model-Based Study

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 707
Author(s):  
Afifah Machlaurin ◽  
Franklin Christiaan Karel Dolk ◽  
Didik Setiawan ◽  
Tjipke Sytse van der Werf ◽  
Maarten J. Postma
Keyword(s):  
Cost Effectiveness ◽  
Univariate Analysis ◽  
Cost Effective ◽  
Epidemiological Data ◽  
Control Programme ◽  
Detection Rates ◽  
Middle Income ◽  
Bcg Vaccination ◽  
Life Years ◽  
The Cost

Bacillus Calmette–Guerin (BCG), the only available vaccine for tuberculosis (TB), has been applied for decades. The Indonesian government recently introduced a national TB disease control programme that includes several action plans, notably enhanced vaccination coverage, which can be strengthened through underpinning its favourable cost-effectiveness. We designed a Markov model to assess the cost-effectiveness of Indonesia’s current BCG vaccination programme. Incremental cost-effectiveness ratios (ICERs) were evaluated from the perspectives of both society and healthcare. The robustness of the analysis was confirmed through univariate and probabilistic sensitivity analysis (PSA). Using epidemiological data compiled for Indonesia, BCG vaccination at a price US$14 was estimated to be a cost-effective strategy in controlling TB disease. From societal and healthcare perspectives, ICERs were US$104 and US$112 per quality-adjusted life years (QALYs), respectively. The results were robust for variations of most variables in the univariate analysis. Notably, the vaccine’s effectiveness regarding disease protection, vaccination costs, and case detection rates were key drivers for cost-effectiveness. The PSA results indicated that vaccination was cost-effective even at US$175 threshold in 95% of cases, approximating the monthly GDP per capita. Our findings suggest that this strategy was highly cost-effective and merits prioritization and extension within the national TB programme. Our results may be relevant for other high endemic low- and middle-income countries.

scholarly journals Estimating the prevalence of hepatitis C among intravenous drug users in upper middle income countries: A systematic review and meta-analysis

PLoS ONE ◽  
2019 ◽  
Vol 14 (2) ◽  
pp. e0212558 ◽  
Author(s):  
Víctor Granados-García ◽  
Yvonne N. Flores ◽  
Lizbeth I. Díaz-Trejo ◽  
Lucia Méndez-Sánchez ◽  
Stephanie Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hepatitis C ◽  
Drug Users ◽  
Meta Analysis ◽  
Intravenous Drug ◽  
Intravenous Drug Users ◽  
Middle Income ◽  
Middle Income Countries
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