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Cost-effectiveness of childhood pneumococcal vaccination program in Ethiopia: Results from a quasi-experimental evaluation

Artikel i vetenskaplig tidskrift
Författare Tayue Tateke Kebede
Mikael Svensson
Adamu Addissie
Birger Trollfors
Rune Andersson
Publicerad i BMC Public Health
Volym 19
Publiceringsår 2019
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Institutionen för biomedicin, avdelningen för infektionssjukdomar
Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
Språk en
Länkar https://doi.org/10.1186/s12889-019-...
Ämnesord Childhood respiratory infection, Cost-effectiveness, Pneumococcal vaccination
Ämneskategorier Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi, Infektionsmedicin

Sammanfattning

© 2019 The Author(s). Background: Ethiopia was among the 15 countries that, together accounted for 64% of the world's severe episodes of pneumonia among children below the age of 5 in 2011. To reduce this burden, the 10-valent pneumococcal conjugate vaccine (PCV 10) was introduced into the general childhood national immunization program in Ethiopia in 2011. However, there is little evidence on its cost-effectiveness, and the aim of this study was to estimate the cost-effectiveness of the introduction of PCV 10 vaccination in the Ethiopian setting. Methods: The cost-effectiveness analysis was carried out based on a quasi-experimental evaluation of implementing PCV 10 at the Butajira rural health program site in Ethiopia. The intervention and the control groups consisted 876 and 1010 children, respectively. Using data from program site's surveillance system database as a framework, health outcome and vaccination data were collected from medical records, immunization registration books and reports. Disability- Adjusted Life Year (DALY) was a main health outcome metric complimented by incidence of acute lower respiratory infection/1000-person years. Vaccination and treatment costs were collected by document review and cross-sectional household survey. Results: In the intervention cohort, 626 of 876 (71.5%) children received PCV 10 vaccination. Until the first year of life, the incidence of acute lower respiratory infection was higher in the intervention group. After the first year of life, the incidence rate was 35.2 per 1000-person years in the intervention group compared to 60.4 per 1000-person years in the control group. The incremental cost-effectiveness ratio (ICER) per averted DALY for the intervention group during the total follow-up period was (2013 US) 394.3 (undiscounted) and 413.8 (discounted). The ICER per averted DALY excluding the first year of life was (2013 US) 225 (undiscounted) and 292.7 (discounted). Conclusion: Compared to the WHO's suggested cost-effectiveness threshold value, the results indicate that the general childhood PCV 10 vaccination was a cost-effective intervention in the Butajira rural health program site.

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