Resources Repository
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ArticlePublication 2022Modeling the Relative Risk of Incidence and Mortality of Select Vaccine-Preventable Diseases
Immunization is one of the most effective public health interventions, saving millions of lives every …
Immunization is one of the most effective public health interventions, saving millions of lives every year. Ethiopia has seen gradual improvements in immunization coverage and access to child health care services; however, inequalities in child mortality across wealth quintiles and regions remain persistent. This paper models the relative distributional incidence and mortality of four vaccine-preventable diseases (VPDs) (rotavirus diarrhea, human papillomavirus, measles, and pneumonia) by wealth quintile and geographic region in Ethiopia. The authors approach…
Priority Setting/Ethics | Infectious Diseases | Evidence Synthesis | Social Determinants | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2022Comparative Health Systems Analysis of Differences in Catastrophic Health Expenditure
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications …
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…
Cost-Effectiveness Analysis | Infectious Diseases | Costing Methods | Evidence Synthesis | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2021Health Gains and Financial Protection from HPV Vaccination
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical …
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical impoverishment in many low-resource settings. This article uses a static cohort model that captures the main features of HPV vaccines and population demographics to project health and economic outcomes associated with routine HPV vaccination in Ethiopia. The findings show that, assuming 100% vaccine efficacy against HPV-16/18 and 50% vaccination coverage, routine HPV vaccination could avert up to 970 000 cases…
Priority Setting/Ethics | Infectious Diseases | Microsimulation | Sub-Saharan Africa -
ArticlePublication 2020Distributional Impact of Supplementary Immunization Activities: Measles
Although evidence shows that inequalities in under-5 mortality in low- and middle-income countries are decreasing, …
Although evidence shows that inequalities in under-5 mortality in low- and middle-income countries are decreasing, disparities persist and highlight the need to prioritize inequality reduction and equity in decision-making at the global and national levels. This article studied the differential coverage impact of routine delivery versus supplementary immunization activities (e.g., campaigns) for the delivery of measles vaccine in defining and comparing an equity impact number across the two distinct vaccine delivery modes. The analysis can…
Priority Setting/Ethics | Infectious Diseases | Global -
ArticlePublication 2020Integrating Non-Communicable Disease and HIV Treatment in Uganda
Despite growing enthusiasm for integrating treatment of non-communicable diseases into human immunodeficiency virus (HIV) care …
Despite growing enthusiasm for integrating treatment of non-communicable diseases into human immunodeficiency virus (HIV) care and treatment services in sub-Saharan Africa, there is little evidence on the potential health and financial consequences of such integration. This article aims to study the cost-effectiveness of basic non-communicable disease-HIV integration in a Ugandan setting. The article presents an epidemiologic-cost model to analyze, from the provider perspective, the cost-effectiveness of integrating hypertension, diabetes mellitus and high cholesterol screening and…
Cost-Effectiveness Analysis | Infectious Diseases | Sub-Saharan Africa -
ReportPublication 2022Investment Case for New Tuberculosis Vaccines
Investing more financial resources to accelerate scientific progress toward an effective tuberculosis (TB) vaccine will …
Investing more financial resources to accelerate scientific progress toward an effective tuberculosis (TB) vaccine will save lives, fight antimicrobial resistance, advance health equity, improve economic growth, and bring a substantial return on investment. This World Health Organization (WHO) report describes the full value proposition for new TB vaccines. These analyses articulate the broader economic impacts of new TB vaccines to guide global stakeholders when making investment decisions for novel TB vaccines and to plan for…
Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2022Re-Evaluating the Health Impact and Cost-Effectiveness of Tuberculosis Prevention for Modern ART Cohorts
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in …
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in HIV-infected individuals receiving antiretroviral therapy (ART). However, as individuals initiate ART earlier in the course of disease, TB incidence is lower, and it is unclear how ART cost-effectiveness has changed. This study assessed the cost-effectiveness of TPT in contemporary ART cohorts. The authors developed a microsimulation model of TB and HIV and parameterised it using data from a large HIV…
Cost-Effectiveness Analysis | Infectious Diseases | Microsimulation | Health/Medicine | Global | Sub-Saharan Africa -
ArticlePublication 2021New Microsimulation Models to Inform Cervical Cancer Control
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis …
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis of cervical cancer, and estimate the long-term impact of preventive interventions. We propose a new health decision modeling framework that de-emphasizes previously used cytologic-colposcopic-histologic diagnoses, which are subjective and lack reproducibility, relying instead on HPV type and duration of infection as the major determinants of model transition probabilities. We posit that new model health states and corollary transitions are universal,…
Cost-Effectiveness Analysis | Infectious Diseases | Mathematical Models | Microsimulation | Calibration/Validation | Decision Analysis | Global -
ArticlePublication 2022Early HPV Natural History Transitions
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on …
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on accurate transition risks for human papillomavirus (HPV) infection, persistence (or absence of HPV clearance), progression to precancerous lesions, and invasion. To inform the refinement of such models, we compared the early natural history of HPV types using prospective data from immunocompetent women in the Guanacaste Natural History Study, the ASCUS-LSIL Triage Study, and the Costa Rica HPV Vaccine Trial. We…
Cost-Effectiveness Analysis | Infectious Diseases | Mathematical Models | Microsimulation | North America | Latin America & Caribbean