Pneumococcal Pneumonia in Hospitalized Uruguayan Children and Potential Prevention with Different Vaccine Formulations

Hortal, María; Sehabiague, Graciela; Camou, Teresa; Iraola, Inés; Estevan, Miguel; Pujadas, Mónica

doi:10.1016/j.jpeds.2007.11.008

Cited by 24 publications

(17 citation statements)

References 19 publications

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“…Se evidenció una efectividad vacunal de 95% frente a la enfermedad invasora causada por S. pneumoniae en niños con dos dosis 13 . Otros estudios muestran una reducción significativa sobre la carga de neumonía adquirida en la comunidad y las hospitalizaciones por neumonía y meningitis en el HP-CHPR [14][15][16] . No se dispone de datos nacionales acerca del impacto de la vacunación sobre las IOA.…”

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Etiología y evolución de las infecciones osteo-articulares 2009-2015: Hospital Pediátrico del Centro Hospitalario Pereira Rossell, Uruguay

Zunino

Vomero

Pandolfo

et al. 2017

Rev. chil. infectol.

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Etiología y evolución de las infecciones osteo-articulares 2009-2015: Hospital Pediátrico del Centro Hospitalario Pereira Rossell, Uruguay

Zunino

Vomero

Pandolfo

et al. 2017

Rev. chil. infectol.

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“…Serotype distribution was 52% for PCV7 vaccine-included serotypes (4, 6B, 9V, 14, 18C, 19F, 23F), 34% for additional serotypes included in the PCV10 (1, 5, 7F), 12% for additional serotypes included in the PCV13 (3, 6A, 19A); and 2% for other serotypes not included in these PCVs in Uruguay [43].…”

Section: Discussionmentioning

confidence: 99%

“…Two observational studies by Hortal et al [43] and Cedrés et al [44], considered to be relevant sources for the analysis, were selected. These studies were based on epidemiological surveillance information from Uruguay, a middleincome Latin American country with a population of approximately three million.…”

Section: Study Parameters and Findings Of The Systematic Searchmentioning

confidence: 99%

Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian children

Mezones‐Holguín

Bolaños-Díaz

Fiestas

et al. 2014

J Infect Dev Ctries

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Introduction: Pneumococcal pneumonia (PP) has a high burden of morbimortality in children. Use of pneumococcal conjugate vaccines (PCVs) is an effective preventive measure. After PCV 7-valent (PCV7) withdrawal, PCV 10-valent (PCV10) and PCV 13-valent (PCV13) are the alternatives in Peru. This study aimed to evaluate cost effectiveness of these vaccines in preventing PP in Peruvian children <5 yearsold. Methodology: A cost-effectiveness analysis was developed in three phases: a systematic evidence search for calculating effectiveness; a cost analysis for vaccine strategies and outcome management; and an economic model based on decision tree analysis, including deterministic and probabilistic sensitivity analysis using acceptability curves, tornado diagram, and Monte Carlo simulation. A hypothetic 100 vaccinated children/vaccine cohort was built. An incremental cost-effectiveness ratio (ICER) was calculated. Results: The isolation probability for all serotypes in each vaccine was estimated: 38% for PCV7, 41% PCV10, and 17% PCV13. Avoided hospitalization was found to be the best effectiveness model measure. Estimated costs for PCV7, PCV10, and PCV13 cohorts were USD13,761, 11,895, and 12,499, respectively. Costs per avoided hospitalization were USD718 for PCV7, USD333 for PCV10, andUSD 162 for PCV13. At ICER, PCV7 was dominated by the other PCVs. Eliminating PCV7, PCV13 was more cost effective than PCV10 (confirmed in sensitivity analysis). Conclusions: PCV10 and PCV13 are more cost effective than PCV7 in prevention of pneumonia in children <5 years-old in Peru. PCV13 prevents more hospitalizations and is more cost-effective than PCV10. These results should be considered when making decisions about the Peruvian National Inmunizations Schedule.

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“…The distribution of cases and deaths by age were taken from Hortal and colleagues [29] who evaluated the incidence of pneumococcal serotypes in pediatric inpatients <5 years of age in Uruguay. This report was used because the baseline distribution of pneumococcal serotypes (pre-vaccination period) in Uruguay was similar to the distribution reported in Peru [30].…”

Section: Disability Weights Distribution Of Disease Cases and Deathsmentioning

confidence: 99%

“…Moreover, coverage and timing estimates were based on Diphtheria, Pertussis and Tetanus (DPT) vaccine coverage as showed in Table 2 [33]. On the other hand, the coverage reported by the Peruvian Demographic and Family Health Survey (ENDES) [34] was considered for the "what-if" scenario analysis as low coverage, [29] a All pneumococcal sepsis refer to non-pneumonia non-meningitis invasive disease (NPNM). b In the absence of vaccination, Case Fatality Ratios are assumed to decline in each successive birth cohort in line with the general trend in under-five mortality.…”

Section: Vaccination Schedule and Coveragementioning

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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Pneumococcal Pneumonia in Hospitalized Uruguayan Children and Potential Prevention with Different Vaccine Formulations

Cited by 24 publications

References 19 publications

Etiología y evolución de las infecciones osteo-articulares 2009-2015: Hospital Pediátrico del Centro Hospitalario Pereira Rossell, Uruguay

Etiología y evolución de las infecciones osteo-articulares 2009-2015: Hospital Pediátrico del Centro Hospitalario Pereira Rossell, Uruguay

Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian children

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

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