Decision Making and Implementation of the First Public Sector Introduction of Typhoid Conjugate Vaccine-Navi Mumbai, India, 2018
Decision Making and Implementation of the First Public Sector Introduction of Typhoid Conjugate Vaccine-Navi Mumbai, India, 2018
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DOI：
10.1093/cid/ciaa597
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发表时间：
2020-08-15
影响因子：
11.8
通讯作者：
Bhatnagar, Pankaj
中科院分区：
文献类型：
--
作者：
Date, Kashmira;Shimpi, Rahul;Bhatnagar, Pankaj
背景。在伤寒病原体抗菌药物耐药性不断上升的时代，伤寒预防和控制工作至关重要。印度仍然是伤寒疾病负担最重的国家之一，尽管自 2013 年起就已提供高效伤寒结合疫苗 (TCV)，并于 2017 年通过了世界卫生组织的资格预审。2018 年，新孟买市政公司 (NMMC) 将 TCV 纳入其免疫计划，针对 22 个地区中的 11 个地区的 9 个月至 14 岁儿童（第一阶段运动）。我们描述了决策、实施和交付成本，以告知 TCV 在其他环境中的使用。方法。除了 NMMC 和合作伙伴的行政覆盖范围外，我们还收集了有关决策和活动实施的信息。然后，我们从地方政府 (NMMC) 的角度使用微观成本计算方法，使用基于 Microsoft Excel 的新工具来估算疫苗接种活动的财务和经济成本。结果。该活动的规划和实施由 NMMC 牵头，并得到了多个合作伙伴的支持。 2018年7月至8月，在周末和公共假期开展定点接种活动，行政疫苗接种覆盖率达到71%（高收入地区为46%，低收入地区为92%）。不包括疫苗和疫苗接种用品，每剂 TCV 输送的平均财务成本和经济成本分别为 0.45 美元和 1.42 美元。结论。首个公共部门 TCV 运动由 NMMC 成功实施，在贫民窟和低收入地区的行政覆盖率较高。交付成本估算为评估通过公共部门预防活动进行 TCV 疫苗接种的成本效益和负担能力提供了重要的投入。
Background. Typhoid fever prevention and control efforts are critical in an era of rising antimicrobial resistance among typhoid pathogens. India remains one of the highest typhoid disease burden countries, although a highly efficacious typhoid conjugate vaccine (TCV), prequalified by the World Health Organization in 2017, has been available since 2013. In 2018, the Navi Mumbai Municipal Corporation (NMMC) introduced TCV into its immunization program, targeting children aged 9 months to 14 years in 11 of 22 areas (Phase 1 campaign). We describe the decision making, implementation, and delivery costing to inform TCV use in other settings.Methods. We collected information on the decision making and campaign implementation in addition to administrative coverage from NMMC and partners. We then used a microcosting approach from the local government (NMMC) perspective, using a new Microsoft Excel-based tool to estimate the financial and economic vaccination campaign costs.Results. The planning and implementation of the campaign were led by NMMC with support from multiple partners. A fixed-post campaign was conducted during weekends and public holidays in July-August 2018 which achieved an administrative vaccination coverage of 71% (ranging from46% in high-income to 92% in low-income areas). Not including vaccine and vaccination supplies, the average financial cost and economic cost per dose of TCV delivery were $0.45 and $1.42, respectively.Conclusion. The first public sector TCV campaign was successfully implemented by NMMC, with high administrative coverage in slums and low-income areas. Delivery cost estimates provide important inputs to evaluate the cost-effectiveness and affordability of TCV vaccination through public sector preventive campaigns.