Epidemiology of acute otitis media in children of Latin America and the Caribbean: A systematic review and meta-analysis

Bardach, Ariel; Ciapponi, Agustín; García-Martí, Sebastián; Glujovsky, Demián; Mazzoni, Agustina; Fayad, Alicia; Colindres, Rómulo E.; Gentile, Ángela

doi:10.1016/j.ijporl.2011.05.014

Cited by 47 publications

(53 citation statements)

References 38 publications

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“…Vaccine efficacies against NTHi AOM were assumed to be 35.3% for PHiD-CV (based on the 11-valent precursor to PHiD-CV study [13]) and −11% for PCV-7 and PCV-13 (based on the PCV-7 study [32], incorporating a replacement effect as was found in this study). The vaccine coverage on the pneumococcal types isolated in AOM was calculated using the pneumococcal type prevalence in AOM described in a meta-analysis of AOM etiology in Latin America by Bardach et al [41]. Overall, the final estimated coverages for PCV-7, PHiD-CV, and PCV-13 were 69.8%, 76.2%, and 89.5%, respectively.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness and cost utility analysis of three pneumococcal conjugate vaccines in children of Peru

Gómez¹,

Tirado²,

Rojas³

et al. 2013

BMC Public Health

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BackgroundThe clinical and economic burden associated with invasive and non-invasive pneumococcal and non-typeable Haemophilus influenzae (NTHi) diseases is substantial in the Latin America and Caribbean region, where pneumococcal vaccines have only been introduced to a few countries. This study analyzed the cost-effectiveness and cost utility of three different pneumococcal conjugate vaccines (PCVs) for Peru.MethodsA Markov model that simulated the disease processes in a birth cohort over a lifetime, within 1,128 month cycles was used to evaluate the cost-effectiveness of 10-valent pneumococcal NTHi protein D conjugate vaccine (PHiD-CV) and 7- and 13-valent PCVs (PCV-7 and PCV-13). Expected quality-adjusted life years (QALYs), cost-savings and incremental cost-effectiveness ratios (ICERs) were calculated.ResultsWithout vaccination, pneumonia was associated with the greatest health economic burden (90% of QALYs lost and 63% of lifetime direct medical costs); while acute otitis media (AOM) was responsible for 1% of QALYs lost and 25% of direct medical costs. All vaccines were predicted to be cost-effective for Peru, with PHiD-CV being most cost-effective. PHiD-CV was predicted to generate 50 more QALYs gained and required a reduced investment (−US$ 3.4 million) versus PCV-13 (discounted data), and was therefore dominant and cost saving. The probabilistic sensitivity analysis showed that PHiD-CV generated more QALYs gained at a reduced cost than PCV-13 in 84% of the simulations and less QALYs gains at a reduced cost in 16%. Additional scenarios using different assumptions on vaccine efficacies based on previous evidence were explored, but no significant change in the overall cost-effective results were observed.ConclusionsThe results of this modeling study predict that PCVs are likely to be a cost-effective strategy to help relieve the epidemiological and economic burden associated with pediatric pneumococcal and NTHi diseases for Peru. PHiD-CV is likely to be a dominant (better health gains at a reduced net cost) intervention compared to PCV-13 or PCV-7. The most significant drivers for these results are the better health and economic profile of PHiD-CV against AOM and its reduced cost per dose available through the PAHO Revolving Fund in the LAC region.

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Section: Methodsmentioning

confidence: 99%

Cost-effectiveness and cost utility analysis of three pneumococcal conjugate vaccines in children of Peru

Gómez¹,

Tirado²,

Rojas³

et al. 2013

BMC Public Health

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“…PCV10 includes Haemophilus Influenzae Type b (Hib) surface protein D as a carrier-possibly providing additional protection against NTHi, an important cause of AOM-and is similar in composition to the PCV11 prototype [24,36]. Efficacy for PCV13 in preventing AOM cases was directly extrapolated from the meta-analysis of PCV7 clinical data [37].…”

Section: Vaccine Effectiveness Estimationsmentioning

confidence: 99%

“…(1), which takes into account the proportional distribution of Hib and S. pneumoniae in Peru, together with the countryspecific pneumococcal serotype coverage. The proportion of cases of AOM caused by S. pneumoniae and NTHi was 32.4% and 18.3%, respectively, based on the meta-analysis published by Bardach and colleagues [36]. The proportional vaccine coverage of pneumococcal AOM (excluding cross-protection serotypes) was 58% for PCV10 and 70% for PCV13 [38].…”

Section: Vaccine Effectiveness Estimationsmentioning

confidence: 99%

Cost-effectiveness analysis of 10- and 13-valent pneumococcal conjugate vaccines in Peru

Mezones‐Holguín

Canelo‐Aybar

Clark

et al. 2015

Vaccine

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a b s t r a c tObjective: To evaluate the cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine (PCV10) versus the 13-valent PCV (PCV13) to the National Immunization Schedule in Peru for prevention of pneumococcal disease (PD) in children <5 years of age. Methods: The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (version 2.0) was applied from the perspective of the Government of Peru. Twenty successive cohorts of children from birth to 5 years were evaluated. Clinical outcomes were pneumococcal pneumonia (PP), pneumococcal meningitis (PM), pneumococcal sepsis (PS) and acute otitis media from any causes (AOM). Measures included prevention of cases, neurological sequelae (NS), auditory sequelae (AS), deaths and disability adjusted life years (DALYs). A sensitivity analyses was also performed. Findings: For the 20 cohorts, net costs with PCV10 and PCV13 were US$ 363.26 million and US$ 408.26 million, respectively. PCV10 prevented 570,273 AOM; 79,937 PP; 2217 PM; 3049 PS; 282 NS; 173 AS; and 7512 deaths. PCV13 prevented 419,815 AOM; 112,331 PN; 3116 PM; 4285 PS; 404 NS; 248 AS;and 10,386 deaths. Avoided DALYs were 226,370 with PCV10 and 313,119 with PCV13. Saved treatment costs were US$ 37.39 million with PCV10 and US$ 47.22 million with PCV13. Costs per DALY averted were US$ 1605 for PCV10, and US$ 1304 for PCV13. Sensitivity analyses showed similar results. PCV13 has an extended dominance over PCV10. Conclusion: Both pneumococcal vaccines are cost effective in the Peruvian context. Although the net cost of vaccination with PCV10 is lower, PCV13 prevented more deaths, pneumococcal complications and sequelae. Costs per each prevented DALY were lower with PCV13. Thus, PCV13 would be the preferred policy; PCV10 would also be reasonable (and cost-saving relative to the status quo) if for some reason 13-valent were not feasible.

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“…Chronic suppurative otitis media (CSOM) was reported to be the major cause of childhood morbidity 2,3,4,5 . Recurrent ear discharge is the commonest clinical presentation of CSOM.…”

Section: Introductionmentioning

confidence: 99%

"Study on Aerobic Bacteria Causing Chronic Suppurative Otitis Media among the Pediatric Age Group"

2017

IJCRR

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Objectives: Chronic suppurative otitis media (CSOM) was reported to be the major cause of childhood morbidity. Recurrent ear discharge is the commonest clinical presentation. With these, a study was conducted to find the aerobic bacterial as well as fungal profile among the school going children Methods: Study was conducted in the department of Microbiology and ENT, GSL Medical College, Rajahmundry from February 2017 to July 2017. Children with ear discharge were selected for the study. An informed written consent was obtained from the parents of all the participants. Study protocol was approved by the Institutional Ethics committee. Aural swabs were collected and send to the Microbiology laboratory for aerobic culture and sensitivity test.Results: Microorganisms were isolated from 98% (219) samples. Gram negative bacilli (46.6%; 129) were isolated maximum, followed by Gram positive cocci (41%; 114) and fungi (12.3%; 34). Pseudomonas aeruginosa (62; 22.4%) was the leading cause of CSOM. Conclusion:Decreased sensitivity was detected to Gentamycin and Cotrimoxazole, commonly used antibiotics in the form of ear drops. Hence antibiotic susceptibility testing is always advisable.

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Epidemiology of acute otitis media in children of Latin America and the Caribbean: A systematic review and meta-analysis

Cited by 47 publications

References 38 publications

Cost-effectiveness and cost utility analysis of three pneumococcal conjugate vaccines in children of Peru

Cost-effectiveness and cost utility analysis of three pneumococcal conjugate vaccines in children of Peru

Cost-effectiveness analysis of 10- and 13-valent pneumococcal conjugate vaccines in Peru

"Study on Aerobic Bacteria Causing Chronic Suppurative Otitis Media among the Pediatric Age Group"

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