Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Rm. W5519, Baltimore, MD 25101, United States; Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799, United States.
Department of Internal Medicine, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23518, United States.
Vaccine. 2020 Feb 28;38(10):2292-2297. doi: 10.1016/j.vaccine.2020.01.075. Epub 2020 Feb 1.
Vaccine implementation planning in low- and middle-income countries (LMIC) often focuses on children without considering special adult populations. We adapted an economic model developed by the United States Department of Defense (DoD) to evaluate the cost-effectiveness of vaccine acquisition strategies for Campylobacter-, ETEC-, Shigella-, and norovirus-associated gastroenteritis. We compared implementation costs with current medical management in the Peruvian armed forces, a special population of low- and middle-income (LMIC) adults with a high incidence of infectious gastroenteritis. Pathogen-specific vaccine implementation resulted in calculated cost-effectiveness ratio (CER) per duty day lost averted (CER) of $13,741; $1,272; $301; and $803, and a CER per diarrhea day averted of $2,130; $215; $51; and $199 for Campylobacter, ETEC, Shigella, and norovirus, respectively. These estimates compare favorably to CER estimates from high-income military population and suggest that implementing vaccines gastroenteritis may be cost-effective in the Peruvian military population.
在中低收入国家(LMIC),疫苗实施计划通常侧重于儿童,而不考虑特殊的成年人群体。我们改编了美国国防部(DoD)开发的经济模型,以评估弯曲菌、肠产毒性大肠杆菌、志贺氏菌和诺如病毒相关肠胃炎疫苗获取策略的成本效益。我们将实施成本与秘鲁武装部队的现行医疗管理进行了比较,秘鲁武装部队是中低收入(LMIC)成年人中的一个特殊群体,他们患有传染性肠胃炎的发病率很高。针对特定病原体的疫苗实施导致每失去一个工作日的成本效益比(CER)分别为 13741 美元、1272 美元、301 美元和 803 美元,以及每避免一天腹泻的 CER 分别为 2130 美元、215 美元、51 美元和 199 美元,分别针对弯曲菌、肠产毒性大肠杆菌、志贺氏菌和诺如病毒。这些估计值与高收入军事人群的 CER 估计值相比具有优势,并表明在秘鲁军事人群中实施肠胃炎疫苗可能具有成本效益。