The potential economic value of a therapeutic Chagas disease vaccine for pregnant women to prevent congenital transmission
| Autor: | Jorge Abelardo Falcón-Lezama, Elizabeth A. Mitgang, Pierre Buekens, Ulrich Strych, Sheba Meymandi, Lindsey Asti, Maria Elena Bottazzi, Owen J. Stokes-Cawley, Patrick T. Wedlock, Sarah M. Bartsch, Peter J. Hotez, Bruce Y. Lee |
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| Rok vydání: | 2020 |
| Předmět: |
Chagas disease
Pediatrics medicine.medical_specialty Cost-Benefit Analysis Uncertainty interval Article 03 medical and health sciences 0302 clinical medicine Pregnancy 030225 pediatrics medicine Humans Chagas Disease 030212 general & internal medicine Mexico health care economics and organizations Vaccines General Veterinary General Immunology and Microbiology business.industry Transmission (medicine) Vaccination Public Health Environmental and Occupational Health Infant Diagnostic test medicine.disease Infant mortality Latin America Infectious Diseases Molecular Medicine Female Pregnant Women Congenital transmission business |
| Zdroj: | Vaccine |
| ISSN: | 0264-410X |
| Popis: | BACKGROUND: Currently, there are no solutions to prevent congenital transmission of Chagas disease during pregnancy, which affects 1–40% of pregnant women in Latin America and is associated with a 5% transmission risk. With therapeutic vaccines under development, now is the right time to determine the economic value of such a vaccine to prevent congenital transmission. METHODS: We developed a computational decision model that represented the clinical outcomes and diagnostic testing strategies for an infant born to a Chagas-positive woman in Mexico and evaluated the impact of vaccination. RESULTS: Compared to no vaccination, a 25% efficacious vaccine averted 125 [95% uncertainty interval (UI): 122–128] congenital cases, 1.9 (95% UI: 1.6–2.2) infant deaths, and 78 (95% UI: 66–91) DALYs per 10,000 infected pregnant women; a 50% efficacious vaccine averted 251 (95% UI: 248–254) cases, 3.8 (95% UI: 3.6–4.2) deaths, and 160 (95% UI: 148–171) DALYs; and a 75% efficacious vaccine averted 376 (95% UI: 374–378) cases, 5.8 (95% UI: 5.5–6.1) deaths, and 238 (95% UI: 227–249) DALYs. A 25% efficacious vaccine was cost-effective (incremental cost-effectiveness ratio |
| Databáze: | OpenAIRE |
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