@article{da33e7a134e04dfa80a11b484e39079e,
title = "Application of a cost-effectiveness analysis of pathogen-specific vaccines against gastroenteritis to a military population in a developing country setting",
abstract = "Vaccine implementation planning in low- and middle-income countries (LMIC) often focuses on children without considering special adult populations. We adapted an economic model developed by the United States Department of Defense (DoD) to evaluate the cost-effectiveness of vaccine acquisition strategies for Campylobacter-, ETEC-, Shigella-, and norovirus-associated gastroenteritis. We compared implementation costs with current medical management in the Peruvian armed forces, a special population of low- and middle-income (LMIC) adults with a high incidence of infectious gastroenteritis. Pathogen-specific vaccine implementation resulted in calculated cost-effectiveness ratio (CER) per duty day lost averted (CERDDL) of $13,741; $1,272; $301; and $803, and a CER per diarrhea day averted of $2,130; $215; $51; and $199 for Campylobacter, ETEC, Shigella, and norovirus, respectively. These estimates compare favorably to CERDDL estimates from high-income military population and suggest that implementing vaccines gastroenteritis may be cost-effective in the Peruvian military population.",
keywords = "Cost-effectiveness analysis, Gastroenteritis, Low- and middle-income countries, Military, Peru, Vaccine",
author = "Ballard, {Sarah Blythe} and Aaron Tallant and Guerra, {Rosio G.} and Dawn Quigley and Regan Stiegmann and Mirelman, {Andrew J.} and Riddle, {Mark S.} and Gilman, {Robert H.}",
note = "Funding Information: This work was supported by the National Institutes of Health Fogarty International Center through the Fogarty Global Health Fellows UJMT Consortium [grant number 1R25 TW009340-01 ]; the US Fulbright Program; the Pat Tillman Foundation; the Thrasher Research Fund Early Career Award; the Johns Hopkins Bloomberg School of Public Health Procter & Gamble Fellowship; the R. Bradley Sack Family Award; the National Institute of Allergy and Infections Diseases [grant number R21 AI099737 ]; and the US Department of Defense Global Emerging Infections Surveillance and Response System [work number 847705 82000 25 GB B0016 ]. Funding Information: The authors thank the Peruvian military, particularly personnel at the Vargas Guerra Army base in Iquitos, Peru, for their continued support and collaboration. This work was supported by the National Institutes of Health Fogarty International Center through the Fogarty Global Health Fellows UJMT Consortium [grant number 1R25 TW009340-01]; the US Fulbright Program; the Pat Tillman Foundation; the Thrasher Research Fund Early Career Award; the Johns Hopkins Bloomberg School of Public Health Procter & Gamble Fellowship; the R. Bradley Sack Family Award; the National Institute of Allergy and Infections Diseases [grant number R21 AI099737]; and the US Department of Defense Global Emerging Infections Surveillance and Response System [work number 847705 82000 25GB B0016]. Publisher Copyright: {\textcopyright} 2020 Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",
year = "2020",
month = feb,
day = "28",
doi = "10.1016/j.vaccine.2020.01.075",
language = "English (US)",
volume = "38",
pages = "2292--2297",
journal = "Vaccine",
issn = "0264-410X",
publisher = "Elsevier BV",
number = "10",
}