Comparative Economic Evaluation of Haemophilus influenzae Type b Vaccination in Belarus and Uzbekistan

BACKGROUND: Hib vaccine has gradually been introduced into more and more countries during the past two decades, partly due to GAVI Alliance support to low-income countries. However, since Hib disease burden is difficult to establish in settings with limited diagnostic capacities and since the vaccine continues to be relatively expensive, some Governments remain doubtful about its value leading to concerns about financial sustainability. Similarly, several middle-income countries have not introduced the vaccine. The aim of this study is to estimate and compare the cost-effectiveness of Hib vaccination in a country relying on self-financing (Belarus) and a country eligible for GAVI Alliance support (Uzbekistan). METHODS AND FINDINGS: A decision analytic model was used to estimate morbidity and mortality from Hib meningitis, Hib pneumonia and other types of Hib disease with and without the vaccine. Treatment costs were attached to each disease event. Data on disease incidence, case fatality ratios and costs were primarily determined from national sources. For the Belarus 2009 birth cohort, Hib vaccine is estimated to prevent 467 invasive disease cases, 4 cases of meningitis sequelae, and 3 deaths, while in Uzbekistan 3,069 invasive cases, 34 sequelae cases and 341 deaths are prevented. Estimated costs per discounted DALY averted are US$9,323 in Belarus and US$ 267 in Uzbekistan. CONCLUSION: The primary reason why the cost-effectiveness values are more favourable in Uzbekistan than in Belarus is that relatively more deaths are averted in Uzbekistan due to higher baseline mortality burden. Two other explanations are that the vaccine price is lower in Uzbekistan and that Uzbekistan uses a three dose schedule compared to four doses in Belarus. However, when seen in the context of the relative ability to pay for public health, the vaccine can be considered cost-effective in both countries

Абсорбционная функция тонкой кишки при хронических воспалительных заболеваниях кишечника

The absorption function of small intestine has been studied at chronic inflammatory intestine diseases anв assessed depending on the severity of the main process. In groups of patients with ulcerative colitis, Crohn’s disease, and irritable bowel syndrome, as well as in healthy persons, diurnal fat loss with feces was determined by the van de Kamer method, and the D-xylose tolerance test was performed. The disorder of nutrient absorption in patients with chronic inflammatory intestinal diseases is directly proportional to the severity of the main disease.Исследована абсорбционная функция тонкой кишки при хронических воспалительных заболеваниях кишечника, проведена оценка ее в зависимости от тяжести основного процесса. В группах больных язвенным колитом, болезнью Крона, синдромом раздраженного кишечника и здоровых лиц определены суточные потери жира с калом методом Камера и проведена проба с нагрузкой D-ксилозой. Нарушение всасывания питательных веществ у больных с хроническими воспалительными заболеваниями кишечника находится в прямо пропорциональной зависимости от степени тяжести

Absorptive function of the small intestine at chronic inflammatory bowel diseases

The absorption function of small intestine has been studied at chronic inflammatory intestine diseases anв assessed depending on the severity of the main process. In groups of patients with ulcerative colitis, Crohn’s disease, and irritable bowel syndrome, as well as in healthy persons, diurnal fat loss with feces was determined by the van de Kamer method, and the D-xylose tolerance test was performed. The disorder of nutrient absorption in patients with chronic inflammatory intestinal diseases is directly proportional to the severity of the main disease

Virulence Factors and Phylogenetic Characteristics of Uropathogenic <i>Eschericihia coli</i> Strains Isolated in Saratov

Objective of this study was the molecular genetic characteristics of uropathogenic strains of Escherichia coli, isolated from urine of patients with urinary tract infections in Saratov City, in order to determine the phylogenetic groups and subgroups to which the strains belong, and to identify the genetic markers associated with virulence. Materials and methods. Molecular genetic characteristics of 102 strains of uropathogenic E. coli which were isolated from urine of patients with urinary tract infections, was performed. PCR was used to determine the frequency of oc-currence of genes (fimH, pap, sfa, afa, iha, irp2, iuc, iroN, hlyA, vat, usp, set-1, kpsMT, iss, cva, ompT) associated with factors of adhesion, iron intake, toxigenicity, resistance to action of serum (complement) and persistence, as well as belonging of studied strains to the specific phylogenetic groups and subgroups (by amplification of genes chuA,yjaA and TspE4.C2). Results and discussion. It was revealed that E. coli strains isolated from patients with urinary tract infections in Saratov city belonged to different phylogenetic groups and subgroups (A1, B1, B23, D3 и D2) and differed in their set of genes, which encode the basic virulence factors. At the same time, detection of uropathogenic E. coli which belong to the B23 subgroup was the most frequent. Moreover, the strains of this phylogenetic subgroup differed from others in the largest set of genes which encode virulence factors of the etiological agent. In all studied strains of uropathogenic E. coli which belong to different phylogenetic groups and subgroups the presence of genes responsible for the synthesis of siderophores (irp2, iuc, iroN), resistance and persistency (ompT) and adhesion factors (fimH, iha) was revealed. Therefore, strains of uropathogenic E. coli isolated from patients with urinary tract infections in Saratov city belong to different phylogenetic groups and subgroups and have a different set of genetic markers of virulence that can affect the degree of pathogenicity of the etiological agent, and the course of the disease