The health care use associated with rotavirus in Kenya, by month of age, observed before (light grey bars) and predicted after (dark grey bars) introduction of a rotavirus vaccine.

<p> The panels represent the number of outpatient clinic visits (panel a), hospital admissions (b) and deaths (c). The figures are representative for both Rotarix and RotaTeq as an identical efficacy was assumed.</p

Scenario sensitivity analysis.

<p>Outcome in the cost per DALY for various scenarios. For each scenario the median Cost per DALY are shown (societal perspective).</p

Overview assumptions cost effectiveness model in the base case.

1<p>DALYs were estimated using the formula developed by Murray et.al assuming a beta of 0.04 and a constant of 0.1685.</p

Number of vaccine storage locations with an estimated shortage of more than 10% as estimated in CCEM for the current vaccination schedule, introduction of Rotarix (2 doses, volume 17.1 cm2 per dose), or introduction of RotaTeq (3 doses, volume 46.3 cm2 per dose).

<p>Assumed was a coverage 85% and wastage 5%.</p

Overview of the number of cases, discounted costs and DALYs, programme costs and Cost/DALY for the situation without vaccination and with vaccination and the prevented number of cases and costs.

<p>Presented number is the median outcome of 1000 latin hypercube samples.</p

Characteristics of Rotarix and RotaTeq vaccines for the prevention of rotavirus associated diarrhoea.

<p>Characteristics of Rotarix and RotaTeq vaccines for the prevention of rotavirus associated diarrhoea.</p

Cost-effectiveness acceptability curve for Rotarix (red) and RotaTeq (black) following vaccine introduction in Kenya modelled over a five year period.

<p>The Societal Perspective (SP) is the solid line, the Health Care Perspective is marked by the dashed line.</p

The cumulative coverage of one, two and three doses of vaccine (lines of decreasing greyness) and the cumulative proportion of mortality (dark grey) by month of age over the first year of life.

<p>The cumulative coverage of one, two and three doses of vaccine (lines of decreasing greyness) and the cumulative proportion of mortality (dark grey) by month of age over the first year of life.</p

Multisectoral prioritization of zoonotic diseases in Uganda, 2017: A One Health perspective

<div><p>Background</p><p>Zoonotic diseases continue to be a public health burden globally. Uganda is especially vulnerable due to its location, biodiversity, and population. Given these concerns, the Ugandan government in collaboration with the Global Health Security Agenda conducted a One Health Zoonotic Disease Prioritization Workshop to identify zoonotic diseases of greatest national concern to the Ugandan government.</p><p>Materials and methods</p><p>The One Health Zoonotic Disease Prioritization tool, a semi-quantitative tool developed by the U.S. Centers for Disease Control and Prevention, was used for the prioritization of zoonoses. Workshop participants included voting members and observers representing multiple government and non-governmental sectors. During the workshop, criteria for prioritization were selected, and questions and weights relevant to each criterion were determined. We used a decision tree to provide a ranked list of zoonoses. Participants then established next steps for multisectoral engagement for the prioritized zoonoses. A sensitivity analysis demonstrated how criteria weights impacted disease prioritization.</p><p>Results</p><p>Forty-eight zoonoses were considered during the workshop. Criteria selected to prioritize zoonotic diseases were (1) severity of disease in humans in Uganda, (2) availability of effective control strategies, (3) potential to cause an epidemic or pandemic in humans or animals, (4) social and economic impacts, and (5) bioterrorism potential. Seven zoonotic diseases were identified as priorities for Uganda: anthrax, zoonotic influenza viruses, viral hemorrhagic fevers, brucellosis, African trypanosomiasis, plague, and rabies. Sensitivity analysis did not indicate significant changes in zoonotic disease prioritization based on criteria weights.</p><p>Discussion</p><p>One Health approaches and multisectoral collaborations are crucial to the surveillance, prevention, and control strategies for zoonotic diseases. Uganda used such an approach to identify zoonoses of national concern. Identifying these priority diseases enables Uganda’s National One Health Platform and Zoonotic Disease Coordination Office to address these zoonoses in the future with a targeted allocation of resources.</p></div

Multisectoral prioritization of zoonotic diseases in Uganda, 2017: A One Health perspective - Fig 1

<p>Comparison of disease prioritization scores obtained from weighted criteria and (a) equal criteria weights or (b) excluding each of the five criteria.</p