1
|
Patterson J, Cleary S, Norman JM, Van Zyl H, Awine T, Mayet S, Kagina B, Muloiwa R, Hussey G, Silal SP. Modelling the Cost-Effectiveness of Hepatitis A in South Africa. Vaccines (Basel) 2024; 12:116. [PMID: 38400100 PMCID: PMC10893480 DOI: 10.3390/vaccines12020116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/14/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
The World Health Organization (WHO) recommends the consideration of introducing routine hepatitis A vaccination into national immunization schedules for children ≥ 1 years old in countries with intermediate HAV endemicity. Recent data suggest that South Africa is transitioning from high to intermediate HAV endemicity, thus it is important to consider the impact and cost of potential routine hepatitis A vaccination strategies in the country. An age-structured compartmental model of hepatitis A transmission was calibrated with available data from South Africa, incorporating direct costs of hepatitis A treatment and vaccination. We used the calibrated model to evaluate the impact and costs of several childhood hepatitis A vaccination scenarios from 2023 to 2030. We assessed how each scenario impacted the burden of hepatitis A (symptomatic hepatitis A cases and mortality) as well as calculated the incremental cost per DALY averted as compared to the South African cost-effectiveness threshold. All costs and outcomes were discounted at 5%. For the modelled scenarios, the median estimated cost of the different vaccination strategies ranged from USD 1.71 billion to USD 2.85 billion over the period of 2023 to 2030, with the cost increasing for each successive scenario and approximately 39-52% of costs being due to vaccination. Scenario 1, which represented the administration of one dose of the hepatitis A vaccine in children < 2 years old, requires approximately 5.3 million vaccine doses over 2023-2030 and is projected to avert a total of 136,042 symptomatic cases [IQR: 88,842-221,483] and 31,106 [IQR: 22,975-36,742] deaths due to hepatitis A over the period of 2023 to 2030. The model projects that Scenario 1 would avert 8741 DALYs over the period of 2023 to 2030; however, it is not cost-effective against the South African cost-effectiveness threshold with an ICER per DALY averted of USD 21,006. While Scenario 3 and 4 included the administration of more vaccine doses and averted more symptomatic cases of hepatitis A, these scenarios were absolutely dominated owing to the population being infected before vaccination through the mass campaigns at older ages. The model was highly sensitive to variation of access to liver transplant in South Africa. When increasing the access to liver transplant to 100% for the baseline and Scenario 1, the ICER for Scenario 1 becomes cost-effective against the CET (ICER = USD 2425). Given these findings, we recommend further research is conducted to understand the access to liver transplants in South Africa and better estimate the cost of liver transplant care for hepatitis A patients. The modelling presented in this paper has been used to develop a user-friendly application for vaccine policy makers to further interrogate the model outcomes and consider the costs and benefits of introducing routine hepatitis A vaccination in South Africa.
Collapse
Affiliation(s)
- Jenna Patterson
- Vaccines for Africa Initiative, School of Public Health, University of Cape Town, Cape Town 7925, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Susan Cleary
- School of Public Health, University of Cape Town, Cape Town 7925, South Africa
| | - Jared Michael Norman
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Heiletjé Van Zyl
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Timothy Awine
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Saadiyah Mayet
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Benjamin Kagina
- Vaccines for Africa Initiative, School of Public Health, University of Cape Town, Cape Town 7925, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Rudzani Muloiwa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town 7700, South Africa
| | - Gregory Hussey
- Vaccines for Africa Initiative, School of Public Health, University of Cape Town, Cape Town 7925, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Sheetal Prakash Silal
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Cape Town 7700, South Africa
- Centre for Global Health, Nuffield Department of Medicine, Oxford University, Oxford OX3 7LG, UK
| |
Collapse
|
2
|
Okpokoro E, Lesosky M, Osa-Afiana C, Bada F, Okwor U, Odonye G, Igbinomwanhia V, Abdurrahman S, Medugu N, Kagina B, Abimiku A, Adams S. Prevalence and Risk Factors for Mycobacterium tuberculosis Infection among Health Workers in HIV Treatment Centers in North Central, Nigeria. Am J Trop Med Hyg 2023:tpmd220531. [PMID: 37253444 DOI: 10.4269/ajtmh.22-0531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 03/22/2023] [Indexed: 06/01/2023] Open
Abstract
Mycobacterium tuberculosis and HIV constitute a public health challenge. Health workers (HWs) in HIV clinics maybe at greater risk of M. tuberculosis infection, considering the high rates of HIV/tuberculosis (TB) coinfection among patients. Hence, we measured the prevalence of M. tuberculosis infection and the effect of working in an HIV clinic. We conducted a cross-sectional study in high-HIV burden health-care facilities in Abuja and Nasarawa states and recruited HWs over 4 months. We administered questionnaires and screened for M. tuberculosis infection using QuantiFERON-TB Gold-Plus. A total of 1,043 HWs were enrolled, with the majority being clinical staff (77.4%). Prevalence of interferon gamma release assay (IGRA) positivity was 44.8% (43.8% among HWs from HIV clinic and 45.3% from non-HIV clinics, P = 0.24). Nonoccupational factors such as living in a moderately (odds ratio [OR] = 0.71] or sparsely populated neighborhood (OR = 0.56), remained associated with a reduced risk of IGRA positivity, whereas male gender (OR = 1.37) and having high blood pressure (HBP) (OR = 1.52) remained associated with an increased risk after adjusting. Occupational factors such as length of career as a HW of 10 to 20 years (OR = 1.45) or 20 to 30 years (OR = 1.74) remained associated with an increased risk of IGRA positivity after adjusting. In a final multivariate model, the factors of age between 20 to < 30 years (OR = 0.61), having HBP (OR = 1.56), having a length of career as a HW of 10 to 20 years (OR = 1.66) or 20 to 30 years (OR = 2.09) and being a clinical HW (OR = 0.62) remained associated with IGRA positivity. There is a high prevalence of IGRA positivity among HWs in Nigeria. Working in HIV clinics, however, is not associated with increased risk.
Collapse
Affiliation(s)
- Evaezi Okpokoro
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Division of Epidemiology and Biostatistics, University of Cape Town, School of Public Health, Cape Town, South Africa
| | - Maia Lesosky
- Division of Epidemiology and Biostatistics, University of Cape Town, School of Public Health, Cape Town, South Africa
| | - Chinye Osa-Afiana
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Florence Bada
- Vaccine for Africa, University of Cape Town, Institute of Infectious Disease and Molecular Medicine, School of Public Health, Cape Town, South Africa
| | - Uzoamaka Okwor
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - George Odonye
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Victoria Igbinomwanhia
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Saddiq Abdurrahman
- Department of Public Health, Federal Capital Territory Administration, Abuja, Nigeria
| | - Nubwa Medugu
- Microbiology, National Hospital Abuja, Abuja, Nigeria
| | - Benjamin Kagina
- Vaccine for Africa, University of Cape Town, Institute of Infectious Disease and Molecular Medicine, School of Public Health, Cape Town, South Africa
| | - Alash'le Abimiku
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- University of Maryland, School of Medicine, Baltimore, Maryland
| | - Shahieda Adams
- Division of Occupational Medicine, University of Cape Town, School of Public Health, Cape Town, South Africa
| |
Collapse
|
3
|
Pilic A, Reda S, Jo CL, Burchett H, Bastías M, Campbell P, Gamage D, Henaff L, Kagina B, Külper-Schiek W, Lunny C, Marti M, Muloiwa R, Pieper D, Thomas J, Tunis MC, Younger Z, Wichmann O, Harder T. Use of existing systematic reviews for the development of evidence-based vaccination recommendations: Guidance from the SYSVAC expert panel. Vaccine 2023; 41:1968-1978. [PMID: 36804216 PMCID: PMC10015272 DOI: 10.1016/j.vaccine.2023.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/18/2023]
Abstract
National immunization technical advisory groups (NITAGs) develop immunization-related recommendations and assist policy-makers in making evidence informed decisions. Systematic reviews (SRs) that summarize the available evidence on a specific topic are a valuable source of evidence in the development of such recommendations. However, conducting SRs requires significant human, time, and financial resources, which many NITAGs lack. Given that SRs already exist for many immunization-related topics, and to prevent duplication and overlap of reviews, a more practical approach may be for NITAGs to use existing SRs. Nevertheless, it can be challenging to identify relevant SRs, to select one SR from among multiple SRs, or to critically assess and effectively use them. To support NITAGs, the London School of Hygiene and Tropical Medicine, Robert Koch Institute and collaborators developed the SYSVAC project, which consists of an online registry of systematic reviews on immunization-related topics and an e-learning course, that supports the use of them (both freely accessible at https://www.nitag-resource.org/sysvac-systematic-reviews). Drawing from the e-learning course and recommendations from an expert panel, this paper outlines methods for using existing systematic reviews when making immunization-related recommendations. With specific examples and reference to the SYSVAC registry and other resources, it offers guidance on locating existing systematic reviews; assessing their relevance to a research question, up-to-dateness, and methodological quality and/or risk of bias; and considering the transferability and applicability of their findings to other populations or settings.
Collapse
Affiliation(s)
- Antonia Pilic
- Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany.
| | - Sarah Reda
- Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany
| | - Catherine L Jo
- Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany
| | - Helen Burchett
- Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine (LSHTM), 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
| | | | - Pauline Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Govan Mbeki Building, Glasgow G4 0BA, United Kingdom
| | - Deepa Gamage
- Epidemiology Unit and Advisory Committee on Communicable Diseases, Ministry of Health, #231, De Saram Place, Colombo 10, Sri Lanka
| | - Louise Henaff
- World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Benjamin Kagina
- University of Cape Town, Faculty of Health Sciences, Observatory, 7925 Cape Town, South Africa
| | | | - Carole Lunny
- Knowledge Translation Program, St Michael's Hospital, Unity Health Toronto, and Cochrane Hypertension Review Group, University of British Columbia, 2176 Health Sciences Mall, Vancouver, BC V6T1Z2, Canada
| | - Melanie Marti
- World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Rudzani Muloiwa
- University of Cape Town, Faculty of Health Sciences, Observatory, 7925 Cape Town, South Africa
| | - Dawid Pieper
- Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg, Institute for Health Services and Health System Research, 15562 Rüdersdorf bei Berlin, Germany; Brandenburg Medical School Theodor Fontane, Center for Health Services Research, 15562 Rüdersdorf bei Berlin, Germany
| | - James Thomas
- Evidence for Policy and Practice Information and Co-ordinating (EPPI-) Centre, UCL Social Research Institute, University College London, 10 Woburn Square, London WC1H 0NR, United Kingdom
| | - Matthew C Tunis
- Public Health Agency of Canada, Centre for Immunization Readiness, 130 Colonnade Road, A.L. 6501H, Ottawa, Ontario K1A 0K9, Canada
| | - Zane Younger
- Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany
| | - Ole Wichmann
- Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany
| | - Thomas Harder
- Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany
| |
Collapse
|
4
|
Patterson J, Hussey HS, Abdullahi LH, Silal S, Goddard L, Setshedi M, Spearman W, Hussey GD, Kagina B, Muloiwa R. The global epidemiology of viral-induced acute liver failure: a systematic review protocol. BMJ Open 2019; 9:e029819. [PMID: 31473618 PMCID: PMC6720318 DOI: 10.1136/bmjopen-2019-029819] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION The burden of viral-induced acute liver failure (ALF) around the world still remains unclear, with little to no data collected regarding the disease incidence in general and synthesised data on the relative contribution of different viruses to the aetiology of ALF is missing in the field. The aim of this review is to estimate the burden (prevalence, incidence, mortality, hospitalisation) of ALF following infection HAV, HBV, HCV, HDV, HEV, EBV), HSV1, HSV2, VZV, parvo-virus B19, HPIVs, YFV, HVV-6, CMV, CA16 and/or HAdVs. Establishing the common aetiologies of viral-induced ALF, which vary geographically, is important so that: (1) treatment can be initiated quickly, (2) contraindications to liver transplant can be identified, (3) prognoses can be deterined more accurately, and most importantly, (4) vaccination against viral ALF aetiologies can be prioritised especially in under-resourced regions with public health risks associated with the relevant attributable diseases. METHODS AND ANALYSIS EBSCOhost, PubMed, ScienceDirect, Scopus and Web of Science databases will be searched for relevant literature published and grey literature from 2009 up to 2019. Published cross-sectional and cohort studies will be eligible for inclusion in this review. Qualifying studies will be formally assessed for quality and risk of bias using a standardised scoring tool. Following standardised data extraction, meta-analyses will be carried out using STATA. Depending on characteristics of included studies, subgroup analyses and meta-regression analyses will be performed. This review will be reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. ETHICS AND DISSEMINATION No ethics approval is required as the systematic review will use only published data already in the public domain. Findings will be disseminated through publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42018110309.
Collapse
Affiliation(s)
- Jenna Patterson
- Vaccines for Africa Initiative, University of Cape Town, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Hannah Sophia Hussey
- Vaccines for Africa Initiative, University of Cape Town, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Leila Hussein Abdullahi
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Somaliland Country Office, Save the Children International, Nairobi, Kenya
| | - Sheetal Silal
- Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa
- Modelling and Simulation Hub Africa, University of Cape Town, Cape Town, South Africa
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Liz Goddard
- Department of Paediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Mashiko Setshedi
- Department of Medicine, Division of Gastroenterology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Wendy Spearman
- Department of Medicine, Division of Hepatology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Gregory D Hussey
- Vaccines for Africa Initiative, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Benjamin Kagina
- Vaccines for Africa Initiative, University of Cape Town, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rudzani Muloiwa
- Vaccines for Africa Initiative, University of Cape Town, Cape Town, South Africa
- Department of Paediatrics, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
5
|
Akinola F, Muloiwa R, Hussey GD, Dirix V, Kagina B, Amponsah-Dacosta E. Assessment of humoral and cell-mediated immune responses to pertussis vaccination: a systematic review protocol. BMJ Open 2019; 9:e028109. [PMID: 31182449 PMCID: PMC6561409 DOI: 10.1136/bmjopen-2018-028109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Globally, some studies show a resurgence of pertussis. The risks and benefits of using whole-cell pertussis (wP) or acellular pertussis (aP) vaccines in the control of the disease have been widely debated. Better control of pertussis will require improved understanding of the immune response to pertussis vaccines. Improved understanding and assessment of the immunity induced by pertussis vaccines is thus imperative. Several studies have documented different immunological outcomes to pertussis vaccination from an array of assays. We propose to conduct a systematic review of the different immunological assays and outcomes used in the assessment of the humoraland cell-mediated immune response following pertussis vaccination. METHODS AND ANALYSIS The primary outcomes for consideration are quality and quantity of immune responses (humoral and cell-mediated) post-pertussis vaccination. Of interest as secondary outcomes are types of immunoassays used in assessing immune responses post-pertussis vaccination, types of biological samples used in assessing immune responses post-pertussis vaccination, as well as the types of antigens used to stimulate these samples during post-pertussis vaccination immune response assessments. Different electronic databases (including PubMed, Cochrane, EBSCO Host, Scopus and Web of Science) will be accessed for peer-reviewed published and grey literature evaluating immune responses to pertussis vaccines between 1990 and 2019. The quality of included articles will be assessed using standardised risk and quality assessment tools specific to the study design used in each article. Data extraction will be done using a data extraction form. The extracted data will be analysed using STATA V.14.0 and RevMan V.5.3 software. A subgroup analysis will be conducted based on the study population, type of vaccine (wP or aP) and type of immune response (cell-mediated or humoral). Guidelines for reporting systematic reviews in the revised 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement will be used in this study. ETHICS AND DISSEMINATION Ethics approval is not required for this study as it is a systematic review. We will only make use of data already available in the public space. Findings will be reported via publication in a peer-reviewed journal and presented at scientific meetings and workshops. TRIAL REGISTRATION NUMBER CRD42018102455.
Collapse
Affiliation(s)
- Funbi Akinola
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rudzani Muloiwa
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Paediatrics and Child Health, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Gregory D Hussey
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Division of Medical Microbiology and Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Violette Dirix
- Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles, Brussels, Belgium
| | - Benjamin Kagina
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Edina Amponsah-Dacosta
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
6
|
Mulenga H, Bunyasi EW, Mbandi SK, Mendelsohn SC, Kagina B, Penn-Nicholson A, Scriba T, Hatherill M. Performance of host blood transcriptomic signatures for diagnosing and predicting progression to tuberculosis disease in HIV-negative adults and adolescents: a systematic review protocol. BMJ Open 2019; 9:e026612. [PMID: 31122978 PMCID: PMC6538208 DOI: 10.1136/bmjopen-2018-026612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION One-quarter of the global population, including the majority of adults in tuberculosis (TB) endemic countries, are estimated to be Mycobacterium tuberculosis (MTB) infected. An estimated 10 million new TB cases occurred in 2017. One of the biggest challenges confronting TB control is the lack of accurate diagnosis and prediction of prevalent and incident TB disease, respectively. Several host blood transcriptomic messenger RNA (mRNA) signatures that reflect the host immune response following infection with MTB and progression to TB disease in different study populations have recently been published, but these TB biomarkers have not been systematically described. We will conduct a systematic review of the performance of host blood transcriptional signatures for TB diagnosis and prediction of progression to TB disease. METHODS AND ANALYSIS This systematic review will involve conducting a comprehensive literature search of cohort, case-control, cross-sectional and randomised-controlled studies of the performance of host blood transcriptomic signatures for TB diagnosis and prediction of progression to TB disease. We will search Medline via PubMed, Scopus, Web of Science and EBSCO libraries, complemented by a search of bibliographies of selected articles for other relevant articles. The literature search will be restricted to studies published in English from 2005 to 2018 and conducted in HIV-uninfected adults and adolescents (≥12 years old). Forest plots and a narrative synthesis of the findings will be provided. The primary outcomes will be sensitivity, specificity, as well as true/false positives and true/false negatives. Heterogeneity resulting from differences in the design, composition and structure of individual signatures will preclude meta-analysis and pooling of results. ETHICS AND DISSEMINATION Ethics approval is not required for this systematic review protocol. The results of this review will be disseminated through a peer-reviewed journal as well as conference presentations. PROSPERO REGISTRATION NUMBER CRD42017073817.
Collapse
Affiliation(s)
- Humphrey Mulenga
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Department of Pathology, University of Cape Town, Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| | - Erick Wekesa Bunyasi
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Department of Pathology, University of Cape Town, Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| | - Stanley Kimbung Mbandi
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Department of Pathology, University of Cape Town, Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| | - Simon C Mendelsohn
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Department of Pathology, University of Cape Town, Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| | - Benjamin Kagina
- Vaccines For Africa (VACFA), University of Cape Town, Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| | - Adam Penn-Nicholson
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Department of Pathology, University of Cape Town, Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| | - Thomas Scriba
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Department of Pathology, University of Cape Town, Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| | - Mark Hatherill
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Department of Pathology, University of Cape Town, Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| |
Collapse
|
7
|
Hussey H, Abdullahi L, Collins J, Muloiwa R, Hussey G, Kagina B. Varicella zoster virus-associated morbidity and mortality in Africa - a systematic review. BMC Infect Dis 2017; 17:717. [PMID: 29137604 PMCID: PMC5686819 DOI: 10.1186/s12879-017-2815-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 11/02/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Varicella zoster virus (VZV) causes varicella and herpes zoster. These vaccine preventable diseases are common globally. Most available data on VZV epidemiology are from industrialised temperate countries and cannot be used to guide decisions on the immunization policy against VZV in Africa. This systematic review aims to review the published data on VZV morbidity and mortality in Africa. METHODS All published studies conducted in Africa from 1974 to 2015 were eligible. Eligible studies must have reported any VZV epidemiological measure (incidence, prevalence, hospitalization rate and mortality rate). For inclusion in the review, studies must have used a defined VZV case definition, be it clinical or laboratory-based. RESULTS Twenty articles from 13 African countries were included in the review. Most included studies were cross-sectional, conducted on hospitalized patients, and half of the studies used varying serological methods for diagnosis. VZV seroprevalence was very high among adults. Limited data on VZV seroprevalence in children showed very low seropositivity to anti-VZV antibodies. Co-morbidity with VZV was common. CONCLUSION There is lack of quality data that could be used to develop VZV control programmes, including vaccination, in Africa. TRIAL REGISTRATION PROSPERO 2015: CRD42015026144 .
Collapse
Affiliation(s)
- Hannah Hussey
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Leila Abdullahi
- Vaccines for Africa Initiative, Division of Medical Microbiology & Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Jamie Collins
- Department of Biostatistics, School of Public Health, Harvard Medical School, Boston, MA USA
| | - Rudzani Muloiwa
- Department of Paediatrics & Child Health, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Gregory Hussey
- Vaccines for Africa Initiative, Division of Medical Microbiology & Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Benjamin Kagina
- Vaccines for Africa Initiative, Division of Medical Microbiology & Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Vaccines for Africa Initiative, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| |
Collapse
|