Evidence map›Paper›PMID 27002501›Full record

ArticleVaccine2016

Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting.

Sarah M Bartsch, Peter J Hotez, Daniel L Hertenstein, David J Diemert, Kristina M Zapf, Maria Elena Bottazzi, Jeffrey M Bethony, Shawn T Brown, Bruce Y Lee

Abstract read
In one paragraph

Article in Vaccine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  11. Health science reports · 2022
    Article
  12. Article
  13. The yin and yang of human soil-transmitted helminth infections.International journal for parasitology · 2021
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sarah M BartschPublic Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
Peter J HotezNational School of Tropical Medicine, and Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, One Baylor Plaza, BCM113, Houston, TX 77030, USA; Sabin Vaccine Institute, 2000 Pennsylvania Avenue NW, Washington, DC 20006, USA.
Daniel L HertensteinPublic Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
David J DiemertSabin Vaccine Institute, 2000 Pennsylvania Avenue NW, Washington, DC 20006, USA; Department of Microbiology, Immunology and Tropical Medicine, The George Washington University Medical Center, Washington, DC 20037, USA.
Kristina M ZapfPublic Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
Maria Elena BottazziNational School of Tropical Medicine, and Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, One Baylor Plaza, BCM113, Houston, TX 77030, USA; Sabin Vaccine Institute, 2000 Pennsylvania Avenue NW, Washington, DC 20006, USA.
Jeffrey M BethonySabin Vaccine Institute, 2000 Pennsylvania Avenue NW, Washington, DC 20006, USA; Department of Microbiology, Immunology and Tropical Medicine, The George Washington University Medical Center, Washington, DC 20037, USA.
Shawn T BrownPittsburgh Supercomputing Center, Carnegie Mellon University, 300S Craig St, Pittsburgh, PA 15213, USA.
Bruce Y LeePublic Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA. Electronic address: brucelee@jhu.edu.

Funding

MULTILEVEL SYSTEMS-ORIENTED CHILDHOOD OBESITY STUDY IN CHINAU54HD070725 · NICHD · JOHNS HOPKINS UNIVERSITY · PI CURRIERO, FRANK · 2011 to 2016
$15.9M
MIDAS Informatics Services Group (ISG)U24GM110707 · NIGMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ESPINO, JESSI U, WAGNER, MICHAEL MATTHEW · 2014 to 2018
$11.6M
Virtual Population Obesity Prevention (VPOP) Labs: Computational, Multi-Scale Models for Obesity SolutionsU01HD086861 · NICHD · JOHNS HOPKINS UNIVERSITY · PI LEE, BRUCE Y · 2015 to 2019
$2.8M
Regional Healthcare Ecosystem Analyst for Healthcare Associated InfectionsR01HS023317 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI LEE, BRUCE Y · 2014 to 2014
$2.4M
AHRQ HHS R01 HS023317AHRQ HHS R01HS023317NICHD NIH HHS U01 HD086861NICHD NIH HHS U54 HD070725NICHD NIH HHS U54HD070725NIGMS NIH HHS 5U24GM110707
6 · The paper itself

Abstract

backgroundAlthough mass drug administration (MDA) has helped reduce morbidity attributed to soil-transmitted helminth infections in children, its limitations for hookworm infection have motivated the development of a human hookworm vaccine to both improve morbidity control and ultimately help block hookworm transmission leading to elimination. However, the potential economic and epidemiologic impact of a preventive vaccine has not been fully evaluated.

methodsWe developed a dynamic compartment model coupled to a clinical and economics outcomes model representing both the human and hookworm populations in a high transmission region of Brazil. Experiments simulated different implementation scenarios of MDA and vaccination under varying circumstances.

resultsConsidering only intervention costs, both annual MDA and vaccination were highly cost-effective (ICERs ≤ $790/DALY averted) compared to no intervention, with vaccination resulting in lower incremental cost-effectiveness ratios (ICERs ≤ $444/DALY averted). From the societal perspective, vaccination was economically dominant (i.e., less costly and more effective) versus annual MDA in all tested scenarios, except when vaccination was less efficacious (20% efficacy, 5 year duration) and MDA coverage was 75%. Increasing the vaccine's duration of protection and efficacy, and including a booster injection in adulthood all increased the benefits of vaccination (i.e., resulted in lower hookworm prevalence, averted more disability-adjusted life years, and saved more costs). Assuming its target product profile, a pediatric hookworm vaccine drastically decreased hookworm prevalence in children to 14.6% after 20 years, compared to 57.2% with no intervention and 54.1% with MDA. The addition of a booster in adulthood further reduced the overall prevalence from 68.0% to 36.0% and nearly eliminated hookworm infection in children.

conclusionUsing a human hookworm vaccine would be cost-effective and in many cases economically dominant, providing both health benefits and cost-savings. It could become a key technology in effecting control and elimination efforts for hookworm globally.

Indexed as

Models, EconomicAdolescentAnthelminticsBrazilChildChild, PreschoolCost-Benefit AnalysisHookworm InfectionsHumansInfantInfant, NewbornMass VaccinationVaccinesAnthelminticsVaccinesCostDrug treatmentEconomicsHookwormTransmissionVaccine

Identifiers

PMID27002501
PMCPMC5547742

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.