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Reviews of "The Potential Health and Economic Impacts of New Tuberculosis Vaccines under Varying Delivery Strategies in Delhi and Gujarat, India: A Modelling Study"

Reviewers: M Weaver (University of Washington) | 📗📗📗📗◻️ • C Levin (University of Washington) | 📒📒📒◻️◻️ • E Sinanovic (University of Cape Town) | 📘📘📘📘📘

Published onNov 06, 2023
Reviews of "The Potential Health and Economic Impacts of New Tuberculosis Vaccines under Varying Delivery Strategies in Delhi and Gujarat, India: A Modelling Study"
key-enterThis Pub is a Review of
The potential health and economic impacts of new tuberculosis vaccines under varying delivery strategies in Delhi and Gujarat, India: a modelling study
The potential health and economic impacts of new tuberculosis vaccines under varying delivery strategies in Delhi and Gujarat, India: a modelling study
Description

Abstract Background India has the largest tuberculosis burden globally, but this burden varies nationwide. All-age tuberculosis prevalence in 2021 ranged from 747/100,000 in Delhi to 137/100,000 in Gujarat. Previous modelling has demonstrated the benefits and costs of introducing novel tuberculosis vaccines in India overall. However, no studies have compared the potential impact of tuberculosis vaccines in regions within India with differing tuberculosis disease and infection prevalence. We used mathematical modelling to investigate how the health and economic impact of two potential tuberculosis vaccines, M72/AS01E and BCG-revaccination, could differ in Delhi and Gujarat under varying delivery strategies.Methods We applied a compartmental tuberculosis model separately for Delhi (higher disease and infection prevalence) and Gujarat (lower disease and infection prevalence), and projected epidemiological trends to 2050 assuming no new vaccine introduction. We simulated M72/AS01E and BCG-revaccination scenarios varying target ages and vaccine characteristics. We estimated cumulative cases, deaths, and disability-adjusted life years averted between 2025–2050 compared to the no-new-vaccine scenario and compared incremental cost-effectiveness ratios to three cost-effectiveness thresholds.Results M72/AS01E averted a higher proportion of tuberculosis cases than BCG-revaccination in both regions (Delhi: 16.0% vs 8.3%, Gujarat: 8.5% vs 5.1%) and had higher vaccination costs (Delhi: USD$118 million vs USD$27 million, Gujarat: US$366 million vs US$97 million). M72/AS01E in Delhi could be cost-effective, or even cost-saving, for all modelled vaccine characteristics. M72/AS01E could be cost-effective in Gujarat, unless efficacy was assumed only for those with current infection at vaccination. BCG-revaccination could be cost-effective, or cost-saving, in both regions for all modelled vaccine scenarios.Discussion M72/AS01E and BCG-revaccination could be impactful and cost-effective in Delhi and Gujarat. Differences in impact, costs, and cost-effectiveness between vaccines and regions, were determined partly by differences in disease and infection prevalence, and demography. Age-specific regional estimates of infection prevalence could help to inform delivery strategies for vaccines that may only be effective in people with a particular infection status. Evidence on the mechanism of effect of M72/AS01E and its effectiveness in uninfected individuals, which were important drivers of impact and cost-effectiveness, particularly in Gujarat, are also key to improve estimates of population-level impact.

To read the original manuscript, click the link above.

Summary of Reviews: This preprint aims to model the potential health impact of two novel TB vaccines in both higher and lower incidence settings. It concludes that BCG-revaccination could be cost-effective for all scenarios in both settings and that M72/AS01E would be cost-effective for higher incidence settings, but not necessarily lower incidence settings. Overall, reviewers had divided opinions on the strength of this preprint with some concerns about adherence to the CHEER standards. 

Reviewer 1 (Marcia W…) | 📗📗📗📗◻️

Reviewer 2 (Carol L…) | 📒📒📒 ◻️◻️

Reviewer 3 (Edina S…) | 📘📘📘📘📘

RR:C19 Strength of Evidence Scale Key

📕 ◻️◻️◻️◻️ = Misleading

📙📙 ◻️◻️◻️ = Not Informative

📒📒📒 ◻️◻️ = Potentially Informative

📗📗📗📗◻️ = Reliable

📘📘📘📘📘 = Strong

To read the reviews, click the links below. 

Comments
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alnoor alnoor:

شركة النور لخدمات التنظيف في الدمام هي شركة متخصصة ومعترف بها في مجال تقديم خدمات التنظيف عالية الجودة في المنطقة. تتميز هذه الشركة بفريق عمل مدرب ومحترف يسعى دائمًا لتحقيق أعلى معايير النظافة في المنازل والمكاتب والمنشآت التجارية.تقدم شركة النور مجموعة متنوعة من خدمات التنظيف، بما في ذلك تنظيف الأرضيات والسجاد والستائر والأثاث، بالإضافة إلى خدمات تنظيف المطابخ والحمامات. يتم استخدام منتجات ومعدات تنظيف متقدمة لضمان تحقيق أفضل النتائج بدقة وفعالية.بفضل شركة النور، يمكن للعملاء الاستمتاع بمنازل نظيفة وصحية دون الحاجة إلى التعب والمجهود في التنظيف. تعتبر هذه الشركة خيارًا موثوقًا لأولئك الذين يبحثون عن خدمات تنظيف محترفة وموثوقة في الدمام. 

افضل شركة تنظيف بالدمام