目的探索轮状病毒疫苗规模化生产中实际感染复数(multiplicity of infection,MOI)对病毒增殖的影响。方法用荧光灶试验方法检测接种Vero细胞的轮状病毒接种液的病毒滴度,实际MOI即为接种液病毒数量除以细胞数量。通过致细胞病变的天数...目的探索轮状病毒疫苗规模化生产中实际感染复数(multiplicity of infection,MOI)对病毒增殖的影响。方法用荧光灶试验方法检测接种Vero细胞的轮状病毒接种液的病毒滴度,实际MOI即为接种液病毒数量除以细胞数量。通过致细胞病变的天数及单次病毒收获液的滴度反映规模化生产中实际MOI对轮状病毒增殖的影响。结果规模化生产中,MOI在0.002~0.074范围内影响轮状病毒致细胞病变的进程,与轮状病毒增殖量呈弱相关性,单次病毒收获液滴度均在7.0 lg荧光灶形成单位(fluorescent focus unit,FFU)/ml以上,符合质量标准(不低于6.5 lgFFU/ml)。结论轮状病毒疫苗规模化生产中,实际MOI与轮状病毒增殖量呈弱相关性。展开更多
目的从全社会角度评价5岁以下婴幼儿人群接种5价轮状病毒疫苗相比不接种疫苗的成本收益。方法构建决策树-马尔可夫模型,以接种5价轮状病毒疫苗为研究策略,不接种为对照策略,模拟1000000名5岁以下婴幼儿人群队列,评估接种5价轮状病毒疫...目的从全社会角度评价5岁以下婴幼儿人群接种5价轮状病毒疫苗相比不接种疫苗的成本收益。方法构建决策树-马尔可夫模型,以接种5价轮状病毒疫苗为研究策略,不接种为对照策略,模拟1000000名5岁以下婴幼儿人群队列,评估接种5价轮状病毒疫苗相较于不接种的成本-效果、成本-效益、成本-效用,使用伤残调整寿命年(disability adjusted life year,DALY)作为效用指标,并通过敏感性分析评价模型拟合结果的稳定性。结果模型拟合结果显示,与不接种5价轮状病毒疫苗相比,接种疫苗5年减少22826例轮状病毒感染病例、14618例门诊病例、5243例住院以及1066例死亡病例,成本-效果比为17329.36;成本-效益比为1∶3.59;接种疫苗的成本-效用比为799.54元/DALY,不接种疫苗的成本-效用比为1018.73元/DALY,增量成本-效用比为23201.05元/DALY。单因素敏感性分析显示,5岁以下婴幼儿轮状病毒感染率、5价疫苗保护率和疫苗价格对模型拟合结果影响较大。概率敏感性分析结果显示,接种疫苗是绝对优势策略。结论在5岁以下婴幼儿人群中开展5价轮状病毒疫苗接种具有较好的成本收益,值得推广。展开更多
Introduction: Under five mortality in Zambia is unacceptably high and diarrhoea is the third leading contributor. The Programme for Awareness and Elimination of Diarrhoea (PAED) sought to support the government to acc...Introduction: Under five mortality in Zambia is unacceptably high and diarrhoea is the third leading contributor. The Programme for Awareness and Elimination of Diarrhoea (PAED) sought to support the government to accelerate the introduction of new vaccines, including the pneumococcal, second dose measles and rotavirus vaccines in Zambia. Here we present our approach, progress and lessons learned in two years of the programme. Stakeholder Engagement: Definite commitment and buy-in and sign off by the MOH were fundamental prerequisites. National and international stakeholders including the Inter Agency Coordinating Committee (ICC), GAVI Alliance, WHO, University Teaching Hospital, Paediatrics Association of Zambia, and UNICEF were engaged for stakeholder buy-in and integration. Progress made: Following successful integration, PAED was officially launched in January 2012. Preparatory work done included: Introduction and acceptance of the PAED agenda in ICC, new vaccines proposal to GAVI, resource mobilisation, Effective Vaccine Management implementation, national cold chain scale-up strategy, vaccine orientation and adapted data collection tools, health worker training, step-wise vaccine introduction to Lusaka province districts and finally national roll-out of the rotavirus vaccine immunisation. Between January 2011 and November 2013, over 270,000 vaccine doses were distributed in Lusaka province. When 94,500 infants were fully immunised, adequate preparations had been made to facilitate national launch of rotavirus immunisations countrywide on 27th November 2013. Discussion: The PAED model was successful at resource mobilization;it has demonstrated how private sector can contribute to new vaccine introduction. Lessons learned from this model can be replicated in other countries with similar need and constraints.展开更多
文摘目的从全社会角度评价5岁以下婴幼儿人群接种5价轮状病毒疫苗相比不接种疫苗的成本收益。方法构建决策树-马尔可夫模型,以接种5价轮状病毒疫苗为研究策略,不接种为对照策略,模拟1000000名5岁以下婴幼儿人群队列,评估接种5价轮状病毒疫苗相较于不接种的成本-效果、成本-效益、成本-效用,使用伤残调整寿命年(disability adjusted life year,DALY)作为效用指标,并通过敏感性分析评价模型拟合结果的稳定性。结果模型拟合结果显示,与不接种5价轮状病毒疫苗相比,接种疫苗5年减少22826例轮状病毒感染病例、14618例门诊病例、5243例住院以及1066例死亡病例,成本-效果比为17329.36;成本-效益比为1∶3.59;接种疫苗的成本-效用比为799.54元/DALY,不接种疫苗的成本-效用比为1018.73元/DALY,增量成本-效用比为23201.05元/DALY。单因素敏感性分析显示,5岁以下婴幼儿轮状病毒感染率、5价疫苗保护率和疫苗价格对模型拟合结果影响较大。概率敏感性分析结果显示,接种疫苗是绝对优势策略。结论在5岁以下婴幼儿人群中开展5价轮状病毒疫苗接种具有较好的成本收益,值得推广。
文摘Introduction: Under five mortality in Zambia is unacceptably high and diarrhoea is the third leading contributor. The Programme for Awareness and Elimination of Diarrhoea (PAED) sought to support the government to accelerate the introduction of new vaccines, including the pneumococcal, second dose measles and rotavirus vaccines in Zambia. Here we present our approach, progress and lessons learned in two years of the programme. Stakeholder Engagement: Definite commitment and buy-in and sign off by the MOH were fundamental prerequisites. National and international stakeholders including the Inter Agency Coordinating Committee (ICC), GAVI Alliance, WHO, University Teaching Hospital, Paediatrics Association of Zambia, and UNICEF were engaged for stakeholder buy-in and integration. Progress made: Following successful integration, PAED was officially launched in January 2012. Preparatory work done included: Introduction and acceptance of the PAED agenda in ICC, new vaccines proposal to GAVI, resource mobilisation, Effective Vaccine Management implementation, national cold chain scale-up strategy, vaccine orientation and adapted data collection tools, health worker training, step-wise vaccine introduction to Lusaka province districts and finally national roll-out of the rotavirus vaccine immunisation. Between January 2011 and November 2013, over 270,000 vaccine doses were distributed in Lusaka province. When 94,500 infants were fully immunised, adequate preparations had been made to facilitate national launch of rotavirus immunisations countrywide on 27th November 2013. Discussion: The PAED model was successful at resource mobilization;it has demonstrated how private sector can contribute to new vaccine introduction. Lessons learned from this model can be replicated in other countries with similar need and constraints.
