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61.
《Vaccine》2018,36(43):6416-6423
PurposeMeasure the preferences of decision makers and researchers associated with the Advisory Committee on Immunization Practices (ACIP) regarding the recommended format for presenting health economics studies to the ACIP.MethodsWe conducted key informant interviews and an online survey of current ACIP work group members, and current and previous ACIP voting members, liaison representatives, and ex-officio members to understand preferences for health economics presentations. These preferences included the presentation of results and sensitivity analyses, the role of health economics studies in decision making, and strategies to improve guidelines for presenting health economics studies. Best-worst scaling was used to measure the relative value of seven attributes of health economics presentations in vaccine decision making.ResultsThe best-worst scaling survey had a response rate of 51% (n = 93). Results showed that summary results were the most important attribute for decision making (mean importance score: 0.69) and intermediate outcomes and disaggregated results were least important (mean importance score: −0.71). Respondents without previous health economics experience assigned sensitivity analysis lower importance and relationship of the results to other studies higher importance than the experienced group (sensitivity analysis scores: −0.15 vs. 0.15 respectively; relationship of the results: 0.13 vs. −0.12 respectively). Key informant interviews identified areas for improvement to include additional information on the quality of the analysis and increased role for liaisons familiar with health economics.ConclusionAdditional specificity in health economics presentations could allow for more effective presentations of evidence for vaccine decision making. 相似文献
62.
《Vaccine》2018,36(50):7659-7665
BackgroundThe number of notified cases of Tick-Borne Encephalitis (TBE) in Sweden has been increasing the past years despite the increased use of TBE-vaccine not subsidized by the healthcare system. Stockholm County is a high endemic area and an earlier study has shown that low-income households have lower vaccination coverage even when they are at high risk. This paper aims to determine the cost-effectiveness of a publicly funded TBE vaccination program in Stockholm.MethodsIn three different cohorts with individuals aged 3, 40 or 50 years, long-term costs and health outcomes of an out-of-pocket strategy (53% of the cohort is vaccinated on their own expenses) and a structured vaccination program (full cohort is vaccinated covered by the publicly funded health care system), were estimated using a Markov model. The Markov model predicts the costs and effects in term of Quality-adjusted Life Years (QALYs) over a lifetime horizon using a third-party healthcare payer perspective. The primary results are presented as an incremental cost effectiveness ratio (ICER) indicating the additional cost required to achieve one additional QALY with the structured vaccination program.ResultsThe results show that the structured vaccination program is associated with a gain in QALYs and increased costs compared with an out-of-pocket strategy. The calculated ICERs were 27 761, 99 527 and 160 827 SEK/QALY in cohorts of age 3, 40 and 50, respectively. The sensitivity analyses showed that the results are robust when varying different parameters.ConclusionGiven the setting of Stockholm county, this analysis shows a cost per QALY of a free vaccinations program, especially for children of 3 years old, below generally acceptable cost-effectiveness thresholds in Sweden. 相似文献
63.
《Vaccine》2018,36(6):859-865
IntroductionInfluenza vaccination has been shown to be safe and effective against influenza and in the prevention of complicating secondary respiratory illnesses. However, its uptake in young children remains low. This study explored the views, attitudes and practices of parents and primary care providers (PCPs) on their knowledge and acceptance of influenza vaccination in children under 5.MethodsUsing a cross-sectional qualitative research design, we conducted 30 in-depth interviews with PCPs (i.e., general practitioners, practice nurses, maternal and child health nurses, and pharmacists) and five focus groups with parents (n = 50) between June 2014 and July 2015 in Melbourne, Australia. Data were thematically analysed.ResultsParents thought the vaccine could cause influenza, and influenza vaccination was not necessary for their children as they needed to build their own ‘immunity’. Parents said that they would consider vaccinating their children if recommended by their GP and if the influenza vaccine was part of the immunisation schedule. PCPs also expressed concerns regarding the efficacy of the vaccine as well as out-of-pocket costs incurred by families, and uncertainty regarding the mortality and morbidity of influenza in otherwise healthy children. However, they said they would recommend the vaccine to high-risk groups (e.g. children with chronic disease(s), and asthma).ConclusionDespite the established safety of influenza vaccines, barriers to uptake include concerns regarding the iatrogenic effects of vaccination, its administration schedule, and knowledge of influenza severity. Updated information on influenza and the efficacy of the vaccine, and incorporating influenza vaccination into the immunisation schedule may overcome some of these barriers to increase influenza vaccination in this vulnerable cohort. 相似文献
64.
目的检测食物中毒优势型ST6型菌株的毒力基因特征,为食品安全风险评估、食源性病原菌的监测和致病性研究提供依据。方法选取深圳地区7次食物中毒收集的32株ST6型菌株进行全基因组测序,利用VFDB数据库进行毒力因子分析,并通过序列比对进行SEA亚型分析。结果第1-4起食物中毒ST6菌株携带的毒力因子谱完全相同;第5-7起食物中毒中,同一起食物中毒的暴发菌株携带的毒力因子一致,而非暴发菌株与暴发菌株携带的毒力因子不完全一致。在32株ST6型菌中,与粘附、酶和Ⅶ型分泌系统相关的毒力基因具有较高的携带率,α-溶血素(hly/hla)、β-溶血素(hlb)、δ-溶血素(hld)、γ-溶血素基因(hlgA、hlgB、hlgC)、肠毒素A基因(sea)和表皮剥脱毒素A基因(eta)的携带率均为100%,双组分白细胞毒素LukDE基因(lukD和lukE)的携带率为96.8%。所有菌株携带的肠毒素A均为SEA1亚型。结论32株ST6型食物中毒相关菌株携带多个毒力因子基因,以cna、sea、eta、lukD、lukE毒力基因携带率较高,编码的毒力因子可能对ST6型菌株的致病性产生影响。 相似文献
65.
66.
67.
弹状病毒科病毒给人类健康、农业、畜牧业和渔业带来重大影响。不同属病毒之间在基因组结构、宿主范围、传播方式等方面性状各异。目前弹状病毒划分为9个属,但仍有不少新发现病毒有待分类。病毒的进化与媒介(宿主)、传播方式、生态环境等多种因素密切相关。 相似文献
68.
目的 调查2013年天津市家蝇对溴氰菊酯、敌敌畏和残杀威3种常用杀虫剂抗药性水平,与历史数据进行比对,了解天津市家蝇对杀虫剂抗药性的发展趋势。方法 采用生物测定方法研究2013年天津市家蝇对溴氰菊酯、敌敌畏和残杀威3种常用杀虫剂的抗药性水平,比对历史数据得到天津市家蝇抗药性趋势。结果 天津市家蝇对敌敌畏、溴氰菊酯和残杀威均产生不同程度的抗药性,其中对敌敌畏的抗药性水平最高,达19.33倍,对残杀威抗药性水平最低,为2.34倍。其中对残杀威的抗药性与其他2种药物相比差异有统计学意义。通过与历史数据进行比对分析发现,在过去的10余年中天津市家蝇的抗药性水平均有不同程度的下降。结论 开展家蝇抗药性常规监测,筛选及合理使用化学杀虫剂,可以有效抑制和延缓家蝇对杀虫剂高抗性的产生。 相似文献
69.
多杀菌素Natular G30对海南省不同生境致倦库蚊的控制效果比较研究 总被引:1,自引:0,他引:1
目的 比较不同剂量多杀菌素Natular G30在生活污水与小型净水中对致倦库蚊海口种群的控制效果,为其在蚊虫控制中的应用提供依据.方法 用海南省海口市生活污水与小型净水中的致倦库蚊幼虫和水,在外环境以减退率为指标,分别测定Natular G30 10、20、40和80 mg/m2对蚊虫的控制效果.试验中,两次测量试验水体的水质pH值、温度、总固体含量、盐度、溶解氧含量.结果 生活污水的pH值、溶解氧含量分别为(9.62±0.43)、(12.79±3.01)mg/L,小型净水分别为(8.91±0.39)、(7.77±3.46)mg/L,二者差异有统计学意义(P<0.05).在生活污水中,多杀菌素有效浓度为10和20 mg/m2时,蚊虫控制持效时间为12d,40和80 mg/m2处理的则>30 d;而在小型净水中,所有4个浓度均有超过30 d的持效期.两种水体所有剂量在第1天对1、2龄期幼虫的减退率即接近100%,3、4龄期幼虫在第3~7天出现100%减退,而蛹在第1天的减退率基本为负值.结论 多杀菌素Natular G30对致倦库蚊幼虫的控制效果具有高效、持久的特点;且对1、2龄幼虫的毒性高于对3、4龄幼虫的毒性,对蛹无明显的毒杀作用.因其在小型净水中的效果优于生活污水,使用时应根据水质调整剂量. 相似文献
70.
《The Journal of infection》2020,80(1):121-142
The FilmArrayⓇ Meningitis/Encephalitis Panel detects the 14 most frequent pathogens causing meningitis and/or encephalitis. The use of FilmArray ME with non-validated samples is seldom published in the literature. We describe the case of a 3-year-old child, diagnosed with acute meningoencephalitis, in whom the FilmArrayⓇ ME technique successfully identified Neisseria meningitidis in both skin biopsy and whole blood samples. 相似文献