Disregarding the restrictive vial-opening policy for BCG vaccine in Guinea-Bissau: impact and cost-effectiveness for tuberculosis mortality and all-cause mortality in children aged 0-4 years.

OBJECTIVE: BCG vaccination is frequently delayed in low-income countries. Restrictive vial-opening policies, where a vial of BCG vaccine is not opened for few children, are a major reason for delay. During delays, children are unprotected against tuberculosis (TB) and deprived of non-specific effects of BCG. We assessed the potential effect and cost-effectiveness of disregarding the restrictive vial-opening policy, on TB and all-cause mortality, in children aged 0-4 years in Guinea-Bissau. METHODS: Using static mathematical models, we estimated the absolute and percentage change in TB and all-cause deaths, in children aged 0-4 years, between the current BCG vaccine restrictive-opening policy scenario, and a non-restrictive policy scenario where all children were vaccinated in the first health-facility contact. Incremental cost-effectiveness was estimated by integration of vaccine and treatment costs. FINDINGS: Disregarding the restrictive BCG vial-opening policy was estimated to reduce TB deaths by 11.0% (95% uncertainty range (UR):0.5%-28.8%), corresponding to 4 (UR:0-15) TB deaths averted per birth cohort in Guinea-Bissau, resulting in incremental cost-effectiveness of US$911 per discounted life-year gained (LYG) (UR:145-9142). For all-cause deaths, the estimated reduction was 8.1$ 9 (UR:5-23) per discounted LYG. CONCLUSIONS: Disregarding the restrictive BCG vial-opening policy was associated with reductions in TB deaths and all-cause deaths and low cost-effectiveness ratios. Our results suggest that it would be cost-effective to disregard the restrictive vial-opening policy. Other settings with similar practice are also likely to gain from disregarding this policy

Association of vitamin D status with arterial blood pressure and hypertension risk : a mendelian randomisation study

Peer reviewe

Contact Angles of Polymer Solutions on Anodized Aluminum Oxide Templates and their Effect on Nanostructure Morphology

The synthesis of a variety of nanostructures is currently the focus of society due to their many possible applications. Of the various techniques to produce nanostructures, template assisted fabrication is of interest as a cost effective method to produce nanotubes and nanorods. This research focused on the fabrication of polystyrene (PS) and poly(methyl methacrylate) (PMMA) nanostructures by polymer solution infiltration of anodized aluminum oxide (AAO) templates. The correlation between contact-angles of polymer solutions on AAO templates and Berry's number was investigated. The findings of this work shed light on the nanostructure morphology control, which will allow specific applications of interest to society to be addressed

Photocatalytic Degradation of a Series of Direct Azo Dyes Using Immobilized TiO2

Azo dyes present in wastewater require removal due to negative environmental and health effects. This study focused on photocatalytic degradation of these dyes on a titanium dioxide substrate. Solutions of each dye in water were run through a photocatalytic reactor and analyzed using UV spectroscopy, non-purgeable organic carbon method, Nessler method, ion chromatography, and lettuce test. The degradation rate increased with the presence of sulfate groups and decreased with molecules containing additional azo groups and aromatic rings. As the degradation rate increased, the concentration of ammonia in the final solution typically decreased. All solutions had a reduced total organic content. The majority of dye solutions increased in toxicity after exposure to the reactor