Pediatric Prevention Research Center, Wayne State University, 4707 St. Antoine Street, Suite W534, Detroit, MI 48201, USA.
Vaccine. 2013 Jun 24;31(29):2994-9. doi: 10.1016/j.vaccine.2013.04.058. Epub 2013 May 9.
Surveillance data indicate that Salmonella enterica serotype Typhi (S. Typhi) is a significant cause of morbidity and mortality in Africa. With limited anticipated short-term improvements in sanitation and water infrastructure, targeted vaccination campaigns may be an important prevention tool for typhoid fever.
A cross-sectional survey was conducted with 435 randomly selected households in four rural villages on Pemba Island, Tanzania. A dichotomous 'readiness to pay' variable was created to assess vaccine desirability. Data analyses included univariate and bivariate descriptive statistics and binary logistic regression. Bivariate outcomes (ANOVA, t-tests, and chi-square) and odds ratios with 95% confidence intervals are reported.
A total of 66% respondents stated that they would pay for a typhoid fever vaccine in the future. Readiness to pay was not significantly associated with household expenditures. Readiness to pay was associated with use of local Primary Health Care Units (PHCUs) compared to use of cottage or district hospitals (OR 1.8 [95% CI, 1.2-2.7]: p=.007) and with knowledge of someone being sick from typhoid fever (OR 2.2 [95% CI, 1.0-4.5]: p=.039). Respondents perceiving prevention measures as more effective (OR 1.0 [95% CI, 1.0-1.2]: p=.009) were also more likely ready to pay. Preferred methods of communication of information about a typhoid fever vaccine included broadcasting via microphone ('miking'), radio, and door-to-door visits.
With rapid increase in numbers of licensed and promising vaccines, policy makers and health administrators are faced with decisions regarding allocation of scarce health resources for competing interventions. Community residents need to be informed about diseases which may not be readily recognized, diagnosed, and treated. Perceived vulnerability to the disease may increase likelihood of vaccine desirability. A better local understanding of typhoid fever is needed for general prevention measures, increasing treatment access, and future vaccination campaigns.
监测数据表明，伤寒沙门氏菌血清型 Typhi（S. Typhi）是非洲发病率和死亡率的重要原因。由于卫生和水基础设施的预期短期内改善有限，有针对性的疫苗接种运动可能是伤寒的重要预防工具。
在坦桑尼亚奔巴岛的四个农村村庄，对 435 户随机抽取的家庭进行了横断面调查。创建了一个二分“支付意愿”变量来评估疫苗的可取性。数据分析包括单变量和双变量描述性统计和二项逻辑回归。报告了双变量结果（方差分析、t 检验和卡方检验）和 95%置信区间的优势比。
共有 66%的受访者表示他们将来会为伤寒疫苗付费。支付意愿与家庭支出无显著关联。与使用乡村初级保健单位（PHCU）相比，支付意愿与使用私人诊所或地区医院相关（比值比 1.8 [95%置信区间，1.2-2.7]：p=.007），与知道有人因伤寒而患病相关（比值比 2.2 [95%置信区间，1.0-4.5]：p=.039）。认为预防措施更有效的受访者（比值比 1.0 [95%置信区间，1.0-1.2]：p=.009）也更有可能准备支付。关于伤寒疫苗信息的首选沟通方式包括通过麦克风（“miking”）广播、广播和挨家挨户访问。
随着越来越多的许可和有前途的疫苗数量增加，政策制定者和卫生管理人员面临着为竞争干预措施分配稀缺卫生资源的决策。需要向社区居民通报可能不易识别、诊断和治疗的疾病。对疾病的易感性可能会增加疫苗的可取性。需要对伤寒有更好的本地了解，以进行一般预防措施、增加治疗机会和未来的疫苗接种运动。
