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Use of controlled temperature chain and compact prefilled auto-disable devices to reach 2030 hepatitis B birth dose vaccination targets in LMICs: a modelling and cost-optimisation study.

التفاصيل البيبلوغرافية
العنوان: Use of controlled temperature chain and compact prefilled auto-disable devices to reach 2030 hepatitis B birth dose vaccination targets in LMICs: a modelling and cost-optimisation study.
المؤلفون: Seaman CP; Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia., Morgan C; Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia., Howell J; Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Department of Medicine, University of Melbourne, Parkville, VIC, Australia; Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia., Xiao Y; Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia; Department of Medicine, University of Melbourne, Parkville, VIC, Australia; Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia., Spearman CW; Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Sonderup M; Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Lesi O; Gastroenterology and Hepatology Unit, Lagos University Teaching Hospital, Lagos, Nigeria., Andersson MI; Oxford University Hospitals National Health Service Foundation Trust, Oxford, UK; Division of Medical Virology, University of Stellenbosch, Stellenbosch, South Africa., Hellard ME; Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia; Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia; Department of Infectious Disease, Alfred Hospital, Melbourne, VIC, Australia., Scott N; Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: nick.scott@burnet.edu.au.
المصدر: The Lancet. Global health [Lancet Glob Health] 2020 Jul; Vol. 8 (7), pp. e931-e941.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101613665 Publication Model: Print Cited Medium: Internet ISSN: 2214-109X (Electronic) Linking ISSN: 2214109X NLM ISO Abbreviation: Lancet Glob Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [England] : Elsevier Ltd. 2013-
مواضيع طبية MeSH: Developing Countries*, Drug Storage/*methods , Hepatitis B/*prevention & control , Hepatitis B Vaccines/*administration & dosage , Vaccination Coverage/*statistics & numerical data, Costs and Cost Analysis ; Drug Storage/economics ; Female ; Goals ; Healthy People Programs ; Hepatitis B/epidemiology ; Hepatitis B/transmission ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical/prevention & control ; Models, Theoretical ; Pregnancy ; Temperature
مستخلص: Background: Hepatitis B causes more than 800 000 deaths globally each year. Perinatal infections are a major driver of this burden but can be prevented by vaccination within 24 h of birth. Currently, only 44% of newborn babies in low-income and middle-income countries (LMICs) receive a timely birth dose. We investigated the effects and cost-effectiveness of implementing ambient storage of hepatitis B vaccines under a controlled temperature chain (CTC) protocol and the use of compact prefilled auto-disable (CPAD) devices for community births.
Methods: In this mathematical modelling study of perinatal hepatitis B transmission and disease progression, we estimated the coverage impact and cost-effectiveness of implementing CTC and CPAD interventions in the six Global Burden of Disease (GBD) regions containing LMICs. Combinations of four different scenarios of birth dose delivery strategies (cold chain, CTC) and interventions (needle and syringe, CPAD) were modelled across facility or community birth locations. We also estimated the minimum cost and most cost-effective strategy to achieve the WHO 90% hepatitis B birth dose coverage target in GBD regions and in 46 LMICs with a reported coverage of less than 90%.
Findings: Current delivery protocols achieved a maximum coverage of 65% (IQR 64-65) across GBD regions. Reaching 90% hepatitis B birth dose coverage across all GBD regions was estimated to cost a minimum of US$687·5 million per annum ($494·0 million more than the estimated current expenditure), of which $516·5 million (75%) was required for CTC and CPAD interventions. Reaching 90% coverage in this way was estimated to be cost saving in five of the six regions (and in 40 of 46 LMICs individually assessed) due to the disease costs averted, with the cost per disability-adjusted life-years averted being less than $83·27 otherwise.
Interpretation: Hepatitis B birth dose coverage of 90% is unlikely to be reached under current protocols. CTC and CPAD vaccine strategies present cost-effective solutions to overcome coverage barriers.
Funding: The Burnet Institute.
(Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
التعليقات: Comment in: Lancet Glob Health. 2020 Jul;8(7):e869-e870. (PMID: 32562641)
المشرفين على المادة: 0 (Hepatitis B Vaccines)
تواريخ الأحداث: Date Created: 20200621 Date Completed: 20200831 Latest Revision: 20200831
رمز التحديث: 20231215
DOI: 10.1016/S2214-109X(20)30231-X
PMID: 32562649
قاعدة البيانات: MEDLINE
الوصف
تدمد:2214-109X
DOI:10.1016/S2214-109X(20)30231-X