a b s t r a c tBeginning in the 1930s and continuing through the 1970s, rhesus macaques and patas monkeys were introduced to presumed secure locations, primarily coastal islets, in Puerto Rico. Escapes into the wild began almost immediately after introduction. Today the combined range of the two species covers approximately 600 km 2 of southwestern Puerto Rico, where serious conflicts with agricultural interests have resulted. The Puerto Rico Department of Agriculture surveyed about 90% of commercial farmers in the range of the monkeys to begin quantifying damage by monkeys and the associated economic losses during the years 2002-2006. During that time, total economic losses by commercial farmers to monkeys increased from $1.13 million USD to over $1.46 million per year. Of these amounts, the economic losses due to farmers avoiding monkey damage by switching from fruit and vegetable crops to less rewarding land use (primarily hay or pastureland) increased from $490,000 to $1.33 million per year. The losses reported from the survey represent only a portion of economic losses to the invasive monkeys. Subsistence and other smaller farms and agriculture were not included in the survey. We also discuss many other economic issues surrounding the impacts of the invasive monkeys, but for which sufficient data are not available for economic analyses. These include concerns such as destruction of native (especially endangered) wildlife, threat of disease spread, and property damage, all of which would also have to be considered to fully evaluate invasive monkey economic impacts in Puerto Rico.Published by Elsevier Ltd.
BackgroundNo study has estimated the potential impact of Human Papillomavirus (HPV) vaccination in Puerto Rico, a population with considerable burden of HPV-related morbidities. We evaluated the health and economic impacts of implementing a vaccination strategy for females and males in Puerto Rico, with the quadrivalent HPV (HPV4) vaccine, under different vaccination scenarios.MethodsWe adapted a mathematical model which estimates the direct and indirect health benefits and costs of HPV4 vaccination in a dynamic population. The model compared three vaccination scenarios against screening only (no-vaccination) for three doses of HPV4 vaccine among individuals aged 11–15 years in Puerto Rico: 1) 34% for females and 13% for males (34%F/13%M), 2) 50% for females and 40% for males (50%F/40%M), and 3) 80% for female and 64% for male (80%F/64%M). Data specific to Puerto Rico was used. When not available, values from the United States were used. Input data consisted of demographic, behavioral, epidemiological, screening, and economic parameters.ResultsThe model predicted decreases in: 1) HPV infection prevalence for females and males, 2) cervical intraepithelial neoplasia and cervical cancer incidence for females, 3) genital warts incidence for females and males, and 4) cervical cancer deaths among females, when various vaccination program scenarios were considered. In addition, when the vaccination percentage was increased in every scenario, the reduction was greater and began earlier. The analysis also evidenced an incremental cost effectiveness ratio (ICER) of $1,964 per quality–adjusted life year gained for the 80%F/64%M uptake scenario.ConclusionsHPV vaccine can prove its cost effectiveness and substantially reduce the burden and costs associated to various HPV-related conditions when targeted to the adequate population together with an organized HPV vaccination program.
There is an error in the third sentence of the second paragraph of the Introduction. The correct sentence is: "In Puerto Rico, cancer was the second leading cause of death by 2010 [8], and cervical cancer accounts for 3.9% of all cancer cases [9]." There are errors in Table 1. The numbers from the 34%/13% scenario are repeated for the 50%/40% and 80%/64% scenarios. In addition, I the 80%/64% scenario, the years have an inverted order. Please see the corrected Table 1 here.
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