Prevalence of Infectious Diseases Among Immigrants Detected in Kuwait

Abstract

Methods: A Markov cohort model, populated using Netherlands epidemiological, cervical cancer screening, treatment pattern, and cost data was used to perform the analysis. Societal lifetime costs were included at 2006 prices. Initial vaccine efficacy of 95% against HPV-persistent infection with HPV-16/18 plus 30% efficacy against other oncogenic HPV types (''cross-protection'') was assumed in the base case.Reduction in cancer cases, associated quality-adjusted life years (QALYs) and costs for a vaccine against HPV-16/18, and other oncogenic HPV types with lifetime cervical cancer protection were compared with vaccine scenarios having less than lifetime protection. These scenarios included: 1) alternative combinations of HPV types that wane (HPV-18 alone, oncogenic non-vaccine HPV alone, HPV-18 + oncogenic non-vaccine HPV); 2) alternative durations of protection (range: 5-30 years); 3) alternative patterns representing the time of decline to 0% protection (linear 5-year, linear 10-year, other); 4) alternative rates of booster vaccine coverage (range 0% -100%) and protection (i.e. double original vaccine protection vs. lifetime protection)Results: In the hypothetical vaccine scenarios, overall duration of vaccine protection had the largest impact, followed by HPV-type-specific waning, then the pattern of waning decline. Waning impact depended on the relationship between age and HPV infection rate, as well as on HPV-type distribution in cervical cancer. Adding a booster increased the overall costs, but improved clinical outcomes and QALYs.Conclusion: Vaccine waning is an important characteristic to consider when assessing a vaccine's effectiveness against cervical disease related morbidity and mortality; a vaccine with more sustained protection is predicted to have better clinical outcomes at lower total costs.

The Malaria Transition on the Arabian Peninsula: Progress toward a Malaria-Free Region between 1960–2010

“…More than 200,000 immigrants come to Kuwait every year for residence or work and all checked for infectious diseases including malaria. Of 921,012 slides taken during screening between 1991 and 1999, 1366 were positive (0.15%), the majority from the Indian sub-continent (Sher et al, 2004) a situation very similar to a decade previously but in much lower frequencies (Hira et al, 1985). Of 1446 patients screened as acute febrile admissions to Al-Jahra hospital between 1996 and 1999, 183 P. vivax cases were identified, 15 P. falciparum and 4 mixed infections all imported and mostly from India, Bangladesh and Sri Lanka (Shweiki et al, 2002).…”

Seasonality in pulmonary tuberculosis among migrant workers entering Kuwait

“…In the presence of any suspicious lesion in the lungs, confirmatory TB diagnosis was made by sputum smear examination for acid fast bacilli (AFB) using Ziehl Neelsen technique and bacterial culture. Subsequently, migrant worker was classified as a TB case if sputum smear and/or bacterial culture was positive for AFB [ 21 ].…”

Nonlinear pattern of pulmonary tuberculosis among migrants at entry in Kuwait: 1997–2006

“…In the presence of any suspicious lesion in the lungs, confirmatory tuberculosis diagnosis was made by sputum smear examination for acid fast bacilli (AFB) using Ziehl Neelsen technique and bacterial culture. Subsequently, migrant worker was classified as a case of tuberculosis if sputum smear and/or bacterial culture were positive for AFB [ 27 ].…”