ArticlePloS one2017
Cost-effectiveness of expanding childhood routine immunization against Neisseria meningitidis serogroups C, W and Y with a quadrivalent conjugate vaccine in the African meningitis belt.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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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.
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Who cites it
9 citing papers in PubMed, 12 citations in OpenAlex.
- An Assessment of Barriers to Care and Health Literacy: A Cross-Sectional Telephone Survey at a Federally Qualified Health Center Women's Clinic.Journal of racial and ethnic health disparities · 2026Article
- Supply, demand and use of economic evidence in vaccine policymaking in Africa: A scoping review.PLOS global public health · 2026Article
- ModelingInfectious Disease Modelling · 2025Article
- Public health impact and cost-effectiveness of introducing MenACWY vaccination strategies in Germany.BMC public health · 2025Article
- Cost-effectiveness analysis of vaccination strategies against meningococcal disease for children under nine years of age in China.Human vaccines & immunotherapeutics · 2024Article
- Economic evaluation on meningococcal vaccination strategies among children under nine years of age in Zhejiang province, China.PloS one · 2024Article
- Evidence gaps in economic analyses of hearing healthcare: A systematic review.EClinicalMedicine · 2021Article
- Epidemiological impact and cost-effectiveness of universal meningitis b vaccination among college students prior to college entry.PloS one · 2020Article
- Declining Incidence of Invasive Meningococcal Disease in South Africa: 2003-2016.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeisseria meningitidis constitutes a major public health problem among countries in the African meningitis belt. Following regional vaccination campaigns for serogroup A and subsequent increases in protection against this serogroup, non-A serogroups such as C and W now pose significant epidemic threats, particularly in young children.
objectiveTo evaluate the cost-effectiveness of broadening coverage from conjugate serogroup A to quadrivalent ACWY vaccination.
methodsWe developed a 40-year Markov state transition model with annual cycles to simulate costs and clinical outcomes in children aged 1 to 10 in the 26 countries of the African meningitis belt. The incidence of CWY meningitis cases among an unvaccinated population was held constant at inter-epidemic rates of 50 per 100,000/year and 150 per 100,000/year. The country-specific cost and probability of access to meningitis care, vaccine efficacy, the mortality risk among treated and untreated meningitis cases, the risk of clinical sequelae and their respective disability weights were based on published sources. Vaccination cost was based on international prices lists, presented in 2014 US$.
resultsAt an incidence rate of 50 per 100,000/year, routine conjugate vaccination is highly cost-effective in 14 out of 26 countries with a cost/DALY averted ranging from US$555-US$787. At the higher incidence rate of 150 per 100,000/year, quadrivalent vaccination is cost-effective in all 26 countries with a cost/DALY averted ranging from US$105-US$250. The annual incidence rate at which routine conjugate quadrivalent vaccination is expected to be economically justifiable ranges from 13 per 100,000/year in Nigeria to 142 per 100,000/year in Burundi.
conclusionRoutine quadrivalent conjugate vaccination against Neisseria meningitidis is cost-effective at incidence rates well below the epidemic threshold among children living in the African meningitis belt.
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