Polio inactivated vaccine costs into routine childhood immunization in Brazil

OBJECTIVE To analyze the costs of vaccination regimens for introducing inactivated polio vaccine in routine immunization in Brazil.METHODS A cost analysis was conducted for vaccines in five vaccination regimens, including inactivated polio vaccine, compared with the oral polio vaccine-only regimen. The costs of the vaccines were estimated for routine use and for the “National Immunization Days”, during when the oral polio vaccine is administered to children aged less than five years, independent of their vaccine status, and the strategic stock of inactivated polio vaccine. The presented estimated costs are of 2011.RESULTS The annual costs of the oral vaccine-only program (routine and two National Immunization Days) were estimated at US$19,873,170. The incremental costs of inclusion of the inactivated vaccine depended on the number of vaccine doses, presentation of the vaccine (bottles with single dose or ten doses), and number of “National Immunization Days” carried out. The cost of the regimen adopted with two doses of inactivated vaccine followed by three doses of oral vaccine and one “National Immunization Day” was estimated at US$29,653,539. The concomitant replacement of the DTPw/Hib and HepB vaccines with the pentavalent vaccine enabled the introduction of the inactivated polio without increasing the number of injections or number of visits needed to complete the vaccination.CONCLUSIONS The introduction of the inactivated vaccine increased the annual costs of the polio vaccines by 49.2% compared with the oral vaccine-only regimen. This increase represented 1.13% of the expenditure of the National Immunization Program on the purchase of vaccines in 2011.

COMMUNITY AWARENESS ABOUT LEPROSY IN A DISTRICT OF NEPAL

ABSTRACTNepal is one of the countries with high prevalence of leprosy. In general, the prevalence of the disease isrelatively higher in the plains than in the hills. We analyzed the knowledge of leprosy in the community bya structured questionnaires study. The sources of information from where they acquired the knowledgewere also studied. This study was done in Sunsari district of Nepal on National Immunization Day program.Out of 1647 respondents, 60% were female. The majority (74%) was between 20–40 years of the age group.Agricultural workers constituted 58%. One third of the respondents were illiterates. Approximately 60%of the respondents knew the cause and symptoms of leprosy. “Leprosy is curable” was felt by 81.8%.Although 75% of the respondents knew that drugs for leprosy were available free of cost, the goal ofelimination was understood by only 51% of respondents. The younger individuals had better knowledge ofthe cause and availability of the free treatment of leprosy. The females had equal knowledge about cure, buthad less knowledge of the cause, symptoms, availability of the free treatment and elimination goal. Illiterates,laborers and unemployed had significantly less knowledge of leprosy. There was no difference seen betweendifferent levels of education in literate groups. Radio was the single most effective means of providinginformation, education and communications about leprosy. A good knowledge of leprosy inculcates a positiveattitude towards leprosy. In general this may result in better case reporting and regularity of treatment aswell as fewer deformities.Key Words: Leprosy, Community Awareness.