Algorithm of contacts identified, included, treatments assigned and outcomes.

<p>1. Cases notified with clinical signs or symptoms of infection and elevated amino-transferase levels, with detectable hepatitis A-specific immunoglobulin M (IgM) antibodies in the serum (in the absence of hepatitis A vaccination in the last 12 months) or an epidemiological link to a confirmed case. 2. Baseline serological status was unknown for 128: 63 were not tested, 65 were tested ≥15 days post exposure. 3. Vaccinated twice (or once if within one year of exposure) with inactivated hepatitis A vaccine. 4. Asymptomatic and total anti-HAV positive within 14 days of exposure. If ≤10 years, also IgM negative. 5. All IgM positive ≤14 days post-exposure. 6. Total anti-HAV negative and without symptoms. 7 Immunoglobulin given as PEP according to guidelines. See Table 1. 8. Hepatitis A vaccine given as PEP according to guidelines. See Table 1. Total anti-HAV negative at baseline and anti-IgM positive with jaundice (+/- HAV RNA on PCR) at follow-up, <u>or</u> in the absence of jaundice, anti-IgM positive and HAV RNA detected by PCR in the same follow-up sample. </p

Timeline of exposure, vaccination, symptom onset and confirmation in secondary hepatitis A cases

<p>◊ One dose hepatitis A vaccine administered. Total anti-HAV negative and asymptomatic. ● Jaundice (conjunctival icterus +/- dark urine, pale stools) ○ Non-specific symptoms: nausea, fatigue, loss of appetite, malaise ■ Date of confirmed infection: IgM positive & PCR positive. i Case was aged 57 and was not immunised according to protocol. ii This case was PCR negative, but IgM positive and symptoms and signs confirmed by general practitioner. iii Child aged 1 year who was asymptomatic throughout, but HAV RNA confirmed on PCR</p

Characteristics of a prospective cohort of short-term travelers from the Netherlands who visited a malaria-endemic area, October 2006–October 2007.

<p>Characteristics of a prospective cohort of short-term travelers from the Netherlands who visited a malaria-endemic area, October 2006–October 2007.</p

Adherence to the most-prescribed antimalarial chemoprophylaxis among travelers who started with recommended chemoprophylaxis.

<p>NA, not applicable.</p

Determinants for 75% adherence to malaria chemoprophylaxis during travel among a prospective cohort of 620 travelers from the Netherlands to high-endemic areas, October 2006–October 2007.

b<p>In the multivariable analysis the variable ‘type of chemoprophylaxis’ was included without the category ‘other’ because of 100% compliance, so multivariable analysis was done with 610 travelers.</p

Characteristics and symptoms of subjects with anti-circumsporozoite antibody seroconversion for <i>P. falciparum</i>, from a cohort of 945 travelers from the Netherlands who visited malaria-endemic areas, October 2006–October 2007.

b<p>DEET (N,N-diethyl-meta-toluamide) use in more than the mean use in the study population.</p

Schematic description of the Markov model.

<p>Annually, women move between health stages according to defined transition rates given in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070319#pone-0070319-t001" target="_blank">Table 1</a>. The natural history of HCV infection (hepatitis C virus) is modelled through the stages of chronic infection, cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC), liver transplantation, and the years after transplantation. The dotted arrows indicate competing mortality. In <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070319#pone-0070319-g001" target="_blank">Figure 1A</a> the model is presented for the women who are not routinely screened for HCV during their pregnancy and are diagnosed in a later stage of infection, in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070319#pone-0070319-g001" target="_blank">Figure 1b</a> the model is presented for women who are routinely screened during their pregnancy.</p

Tornado diagrams of the sensitivity analyses.

<p>Diagram A) describes scenario 1a and diagram B) scenario describes scenario 1b. Both diagrams show the change in ICER when reducing or increasing each parameter with 25%.</p

Overview of annual transition probabilities and cost variables used in the Markov model.

<p>HCV: hepatitis C virus.</p><p>HCC: hepatocellular carcinoma.</p>#<p>In the prevalence a clearance rate of 42% <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070319#pone.0070319-Rozenbaum1" target="_blank">[14]</a> was included. The prevalence used in the model for all pregnant women is 0.2% (9/4563; 95% CI: 0.10–0.37) and for first generation non-Western women 0.43% (7/1612; 95% CI 0.21–0.89).</p>$<p>Transition rate is age-dependent.</p>*<p>same distribution was used for first-generation non-Western women.</p>**<p>new protease inhibitors are added to the standard of care regimen (peginterferon alfa and ribavirine).</p

Best-case scenarios for screening all pregnant women (scenario 1a) and first-generation non-Western women (scenario 1b).

<p>With parameter optimization ±25% and incremental cost-effectiveness ratio calculated with reference to the “no routine screening” strategy.</p><p>LYG:life years gained.</p><p>ICER: incremental cost-effectiveness ratio.</p