4 research outputs found
Cost-effectiveness analysis of domestic 13-valent pneumococcal conjugate vaccine for children under 5 years of age in mainland China
Background: The first Chinese domestic 13-valent pneumococcal conjugate vaccine (WoAnxinÂź, PCV-13) is available for children aged 2Â months to 5Â years and is more economical than import vaccine with equal safety and immunogenicity. However, the cost-effectiveness of this new PCV-13 for children <5Â years in mainland China is not clear. Methods: In the present study, we developed a Markov model under societal perspective to evaluate the incremental cost-effectiveness ratios (ICERs) of five birth cohorts of 100,000 Chinese infants across four alternative vaccination programs:1) no vaccination; 2) vaccinate 4 doses of new PCV-13 for children aged 2 to 6Â months; 3) vaccinate 3 doses of new PCV-13 for children aged 7 to 11Â months; 4) vaccinate 2 doses of new PCV-13 for children aged 12 to 23Â months; 5) vaccinate 1 dose of new PCV-13 for children aged 2 to 5Â years. We conducted one-way and probability sensitivity analysis to determine the uncertainty of the model findings. Results: We found that with awillingness-to-pay (WTP) threshold of three-times Chinese per-capita gross domestic product (GDP) all vaccination programs were cost-effective compared to no vaccination and children aged 2 to 5Â years received 1 dose of new PCV-13 would incur the lowest additional cost of US15394/QALYs for 4 doses program, 4445/QALYs for 2 doses program). Conclusions: According to our results, China should give priority to incorporating new PCV-13 into its national immunization program
Highâproduction dairy cattle exhibit different rumen and fecal bacterial community and rumen metabolite profile than lowâproduction cattle
Abstract Our aim was to simultaneously investigate the gut bacteria typical characteristic and conduct rumen metabolites profiling of high production dairy cows when compared to lowâproduction dairy cows. The bacterial differences in rumen fluid and feces were identified by 16S rDNA gene sequencing. The metabolite differences were identified by metabolomics profiling with liquid chromatography mass spectrometry (LCâMS). The results indicated that the highâproduction dairy cows presented a lower rumen bacterial richness and species evenness when compared to lowâproduction dairy cows. At the phylum level, the highâproduction cows increased the abundance of Proteobacteria and decreased the abundance of Bacteroidetes, SR1, Verrucomicrobia, Euryarchaeota, Planctomycetes, Synergistetes, and Chloroflexi significantly (p < 0.05). At the genus level, the rumen fluid of the highâproduction group was significantly enriched for Butyrivibrio, Lachnospira, and Dialister (p < 0.05). Meanwhile, rumen fluid of highâproduction group was depleted for Prevotella, Succiniclasticum, Ruminococcu, Coprococcus,YRC22, CF231, 02d06, Anaeroplasma, Selenomonas, and Ruminobacter significantly (p < 0.05). A total of 92 discriminant metabolites were identified between highâproduction cows and lowâproduction cows. Compared to rumen fluid of lowâproduction dairy cows, 10 differential metabolites were found upâregulated in rumen fluid of highâproduction dairy cows, including 6alphaâFluoropregnâ4âeneâ3,20âdione, 3âOctaprenylâ4âhydroxybenzoate, disopyramide, compound III(S), 1,2âDimyristylâsnâglycerol, 7,10,13,16âDocosatetraenoic acid, ferrous lactate, 6âDeoxyerythronolide B, vitamin D2, LâOlivosylâoleandolide. The remaining differential metabolites were found downâregulated obviously in highâproduction cows. Metabolic pathway analyses indicated that most increased abundances of rumen fluid metabolites of highâyield cows were related to metabolic pathways involving biosynthesis of unsaturated fatty acids, steroid biosynthesis, ubiquinone and other terpenoidâquinone biosynthesis. Most downâregulated metabolic pathways were relevant to nucleotide metabolism, energy metabolism, lipid metabolism and biosynthesis of some antibiotics
Long-term neurological sequelae and disease burden of Japanese encephalitis in Gansu Province, China
Background and objects: The study aimed to evaluate the long-term neurological sequelae and the disease burden of JE in Gansu, China. Methods: JE patients were included as study population from 2005â2011 in Gansu, and a follow-up survey was conducted in 2007â2014. Pair-matched healthy individuals were selected as controls. All subjects underwent a neurological examination and intelligence quotient (IQ) and memory quotient (MQ) assessments. Then, the disability-adjusted life years (DALYs), and direct and indirect medical expenses were systematic assessed. Results: Forty-four point seven percent of the JE patients had objective neurological deficits, compared with 2.4% of controls. Subnormal intelligence was found in 21.2% of JE subjects, compared with 1.2% control who exhibited a mildly reduced IQ. Abnormal MQ scores were noted in 56.3% JE subjects, compared with only 12.7% controls. Prevalence of each sequelae caused by JE were significantly higher in adults than in younger subjects. Furthermore, median DALY lost due to JE was 9.2 per subject. Median economic cost of JE was approximately $2776.6 per subject and significantly higher in adults than in younger subjects. Findings and Conclusions: JE patients suffered from severe neurological sequelae and high disease burden, resulting in a significant downstream burden for both the patients (especially adults) and the healthcare system.</p