Abstract:
BACKGROUND:Measles was responsible for an estimated 100,000 deaths worldwide in 2008. Despite being a vaccine-preventable disease, measles remains a major cause of morbidity and mortality in young children. Although a safe and effective injectable measles vaccine has been available for over 50 years it has not been possible to achieve the uniformly high levels of coverage (required to achieve measles eradication) in most parts of the developing world. Aerosolised measles vaccines are now under development with the hope of challenging the delivery factors currently limiting the coverage of the existing vaccine. METHODS:We used a modified CHNRI methodology for setting priorities in health research investments to assess the strengths and weaknesses of this emerging intervention to decrease the burden of childhood pneumonia. This was done in two stages. In Stage I, we systematically reviewed the literature related to emerging aerosol vaccines against measles relevant to several criteria of interest. Although there are a number of different aerosol vaccine approaches under development, for the purpose of this exercise, all were considered as one intervention. The criteria of interest were: answerability; cost of development, production and implementation; efficacy and effectiveness; deliverability, affordability and sustainability; maximum potential impact on disease burden reduction; acceptability to the end users and health workers; and effect on equity. In Stage II, we conducted an expert opinion exercise by inviting 20 experts (leading basic scientists, international public health researchers, international policy makers and representatives of pharmaceutical companies). The policy makers and industry representatives accepted our invitation on the condition of anonymity, due to the sensitive nature of their involvement in such exercises. They answered questions from the CHNRI framework and their "collective optimism" towards each criterion was documented on a scale from 0 to 100%. RESULTS:The panel of experts expressed mixed feelings about an aerosol measles vaccine. The group expressed low levels of optimism regarding the criteria of likelihood of efficacy and low cost of development (scores around 50%); moderate levels of optimism regarding answerability, low cost of production, low cost of implementation and affordability (score around 60%); and high levels of optimism regarding deliverability, impact on equity and acceptability to health workers and end-users (scores over 80%). Finally, the experts felt that this intervention will have a modest but nevertheless important impact on reduction of burden of disease due to childhood pneumonia (median: 5%, interquartile range 1-15%, minimum 0%, maximum 45%). CONCLUSION:Aerosol measles vaccine is at an advanced stage of development, with evidence of good immunogenicity. This new intervention will be presented as a feasible candidate strategy in the campaign for global elimination of measles. It also presents an unique opportunity to decrease the overall burden of disease due to severe pneumonia in young children.
journal_name
BMC Public Healthjournal_title
BMC public healthauthors
Higginson D,Theodoratou E,Nair H,Huda T,Zgaga L,Jadhav SS,Omer SB,Rudan I,Campbell Hdoi
10.1186/1471-2458-11-S3-S31subject
Has Abstractpub_date
2011-04-13 00:00:00pages
S31issn
1471-2458pii
1471-2458-11-S3-S31journal_volume
11 Suppl 3pub_type
杂志文章,评审abstract:BACKGROUND:Technological advances have caused poor mobility and lower physical activity among humankind. This study was conducted to assess the impact of a digital media-based (multi-media, internet, and mobile phone) health intervention on promotion of women's physical activity. METHODS:In this quasi-experimental stu...
journal_title:BMC public health
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12889-018-5025-5
更新日期:2018-01-15 00:00:00
abstract:BACKGROUND:Education is closely associated with health. Non-completion of upper secondary school influences academic achievement, employment, income and personal well-being. The purpose of the study is to explore predictors of non-completion of upper secondary school among female and male young adults in relation to me...
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pub_type: 杂志文章
doi:10.1186/s12889-016-3644-2
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abstract:BACKGROUND:Atherosclerotic cardiovascular diseases (ASCVD) are on the rise in low and middle-income countries attributed to modern sedentary lifestyle and dietary habits. This has led to the need of assessment of the burden of at-risk population so that prevention measures can be developed. The objective of this study ...
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2020-11-16 00:00:00
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journal_title:BMC public health
pub_type: 杂志文章,评审
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章,meta分析,评审
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更新日期:2011-04-13 00:00:00
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更新日期:2017-05-30 00:00:00
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pub_type: 杂志文章,随机对照试验
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