Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Cost-effectiveness of novel vaccines for tuberculosis control: a decision analysis study

Authors: Chia-Lin Tseng, Olivia Oxlade, Dick Menzies, Anne Aspler, Kevin Schwartzman

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

The development of a successful new tuberculosis (TB) vaccine would circumvent many limitations of current diagnostic and treatment practices. However, vaccine development is complex and costly. We aimed to assess the potential cost effectiveness of novel vaccines for TB control in a sub-Saharan African country - Zambia - relative to the existing strategy of directly observed treatment, short course (DOTS) and current level of bacille Calmette-Guérin (BCG) vaccination coverage.

Methods

We conducted a decision analysis model-based simulation from the societal perspective, with a 3% discount rate and all costs expressed in 2007 US dollars. Health outcomes and costs were projected over a 30-year period, for persons born in Zambia (population 11,478,000 in 2005) in year 1. Initial development costs for single vaccination and prime-boost strategies were prorated to the Zambian share (0.398%) of global BCG vaccine coverage for newborns. Main outcome measures were TB-related morbidity, mortality, and costs over a range of potential scenarios for vaccine efficacy.

Results

Relative to the status quo strategy, a BCG replacement vaccine administered at birth, with 70% efficacy in preventing rapid progression to TB disease after initial infection, is estimated to avert 932 TB cases and 422 TB-related deaths (prevention of 199 cases/100,000 vaccinated, and 90 deaths/100,000 vaccinated). This would result in estimated net savings of $3.6 million over 30 years for 468,073 Zambians born in year 1 of the simulation. The addition of a booster at age 10 results in estimated savings of $5.6 million compared to the status quo, averting 1,863 TB cases and 1,011 TB-related deaths (prevention of 398 cases/100,000 vaccinated, and of 216 deaths/100,000 vaccinated). With vaccination at birth alone, net savings would be realized within 1 year, whereas the prime-boost strategy would require an additional 5 years to realize savings, reflecting a greater initial development cost.

Conclusions

Investment in an improved TB vaccine is predicted to result in considerable cost savings, as well as a reduction in TB morbidity and TB-related mortality, when added to existing control strategies. For a vaccine with waning efficacy, a prime-boost strategy is more cost-effective in the long term.
Appendix
Available only for authorised users
Literature
1.
Global tuberculosis control: epidemiology, strategy, financing. WHO report 2009. 2009, Geneva: WHO Press
2.
Meulemans H, Mortelmans D, Liefooghe R, Mertens P, Zaidi SA, Solangi MF, De Muynck A: The limits to patient compliance with directly observed therapy for tuberculosis: a socio-medical study in Pakistan. Int J Health Plann Manage. 2002, 17: 249-267. 10.1002/hpm.675.CrossRefPubMed
3.
Elzinga G, Raviglione MC, Maher D: Scale up: meeting targets in global tuberculosis control. Lancet. 2004, 363: 814-819. 10.1016/S0140-6736(04)15698-5.CrossRefPubMed
4.
Bonnet M, Sizaire V, Kebede Y, Janin A, Doshetov D, Mirzoian B, Arzumanian A, Muminov T, Iona E, Rigouts L, Rüsch-Gerdes S, Varaine F: Does one size fit all? Drug resistance and standard treatments: results of six tuberculosis programmes in former Soviet countries. Int J Tuberc Lung Dis. 2005, 9: 1147-1154.PubMed
5.
Global Plan to Stop TB 2006-2015. 2006, Stop TB Partnership and World Health Organization. Geneva, World Health Organization, (WHO/HTM/STB/2006.35)
6.
Colditz GA, Berkey CS, Mosteller F, Brewer TF, Wilson ME, Burdick E, Fineberg HV: The efficacy of bacillus Calmette-Guérin vaccination of newborns and infants in the prevention of tuberculosis: meta-analysis of the published literature. Pediatrics. 1995, 96: 29-35.PubMed
7.
Rodrigues LC, Diwan VK, Wheeler JG: Protective effect of BCG against tuberculous meningitis and military tuberculosis: a meta-analysis. Int J Epidemiol. 1993, 22: 1154-1158. 10.1093/ije/22.6.1154.CrossRefPubMed
8.
Skeiky YA, Sadoff JC: Advances in tuberculosis vaccine strategies. Nat Rev Microbiol. 2006, 4: 469-476. 10.1038/nrmicro1419.CrossRefPubMed
9.
Menzies D: A survey of vaccine technology. Presentation at 36th Union World Conference on lung health, Paris, France. 2005
10.
11.
Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB: Recommendations of the Panel on cost-effectiveness in health and medicine. JAMA. 1996, 276: 1253-1258. 10.1001/jama.276.15.1253.CrossRefPubMed
12.
Brewer TF: Preventing tuberculosis with bacillus Calmette-Guérin vaccine: a meta-analysis of the literature. Clin Infect Dis. 2000, 31 (Suppl 3): 64-67. 10.1086/314072.CrossRef
13.
Colditz GA, Brewer TF, Berkey CS, Wilson ME, Burdick E, Fineberg HV, Mosteller F: Efficacy of BCG vaccine in the prevention of tuberculosis. Meta-analysis of the published literature. JAMA. 1994, 271: 698-702. 10.1001/jama.271.9.698.CrossRefPubMed
14.
Schwartzman K, Oxlade O, Barr RG, Grimard F, Acosta I, Baez J, Ferreira E, Melgen RE, Morose W, Salgado AC, Jacquet V, Maloney S, Laserson K, Mendez AP, Menzies D: Domestic returns from investment in the control of tuberculosis in other countries. N Engl J Med. 2005, 353: 1008-1020. 10.1056/NEJMsa043194.CrossRefPubMed
15.
Jacquet V, Morose W, Schwartzman K, Oxlade O, Barr G, Grimard F, Menzies D: Impact of DOTS expansion on tuberculosis related outcomes and costs in Haiti. BMC Public Health. 2006, 6: 209-10.1186/1471-2458-6-209.CrossRefPubMedPubMedCentral
16.
Styblo K: The relationship between the risk of tuberculosis infection and the risk of developing infectious tuberculosis. Bull Int Union Tuberc. 1985, 60: 117-119.
17.
Sutherland I: The evolution of clinical tuberculosis in adolescents. Tuberc. 1966, 47: 308-
18.
Nolan CM, Elarth AM: Tuberculosis in a cohort of Southeast Asian refugees. A five-year surveillance study. Am Rev Respir Dis. 1988, 137: 805-809.CrossRefPubMed
19.
Comstock GW, Edwards LB, Livesay VT: Tuberculosis morbidity in the U.S. Navy: its distribution and decline. Am Rev Respir Dis. 1974, 110: 572-580.PubMed
20.
Burgess AL, Fitzgerald DW, Severe P, Joseph P, Noel E, Rastogi N, Johnson WD, Pape JW: Integration of tuberculosis screening at an HIV voluntary counselling and testing centre in Haiti. AIDS. 2001, 15: 1875-79. 10.1097/00002030-200109280-00018.CrossRefPubMed
21.
Dasgupta K, Schwartzman K, Marchand R, Tannenbaum TN, Brassard P, Menzies D: Comparison of cost effectiveness of tuberculosis screening of close contacts and foreign-born populations. Am J Respir Crit Care Med. 2000, 162: 2079-2086.CrossRefPubMed
22.
Morgan D, Mahe C, Mayanja B, Okongo JM, Lubega R, Whitworth JA: HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries?. AIDS. 2002, 16: 597-603. 10.1097/00002030-200203080-00011.CrossRefPubMed
23.
Wood R, Maartens G, Lombard CJ: Risk factors for developing tuberculosis in HIV-1-infected adults from communities with low or very high incidence of tuberculosis. J Acquir Immune Defic Syndr. 2000, 23: 75-80.CrossRefPubMed
24.
Murray J, Sonnenberg P, Shearer SC, Godgrey-Faussett P: Human immunodeficiency virus and outcome of treatment for new and recurrent pulmonary tuberculosis in African patients. Am J Respir Crit Care Med. 1999, 159: 733-740.CrossRefPubMed
25.
Edlin BR, Tokars JI, Grieco MH, Crawford JT, Williams J, Sordillo EM, Ong KR, Kilburn JO, Dooley SW, Castro KG, Jarvis WR, Holmberg SD: An outbreak of multi-drug resistant tuberculosis among hospitalized patients with the acquired immunodeficiency syndrome. New Engl J Med. 1992, 326: 1514-1521. 10.1056/NEJM199206043262302.CrossRefPubMed
26.
Malkin JE, Prazuck T, Simonnet F, Yameogo M, Rochereau A, Ayerour J, Masson D, Lafaix C: Tuberculosis and human immunodeficiency virus infection in West Burkina Faso: clinical presentation and clinical evolution. Int J Tuberc Lung Dis. 1997, 1: 68-74.PubMed
27.
Aspler A, Menzies D, Oxlade O, Banda J, Mwenge L, Godfrey-Faussett P, Ayles H: Cost of tuberculosis diagnosis and treatment from the patient perspective in Lusaka, Zambia. Int J Tuberc Lung Dis. 2008, 12: 928-935.PubMed
28.
Sherman LF, Fujiwara PI, Cook SV, Bazerman LB, Frieden TR: Patient and health care system delays in the diagnosis and treatment of tuberculosis. Int J Tuberc Lung Dis. 1999, 3: 1088-1095.PubMed
29.
Yamasaki-Nakagawa M, Ozasa K, Yamada N, Osuga K, Shimouchi A, Ishikawa N, Bam DS, Mori T: Gender difference in delays to diagnosis and health care seeking behaviour in a rural area of Nepal. Int J Tuberc Lung Dis. 2001, 5: 24-31.PubMed
30.
Wandwalo ER, Morkve O: Delay in tuberculosis case-finding and treatment in Mwanza, Tanzania. Int J Tuberc Lung Dis. 2000, 4: 133-138.PubMed
31.
Vaca J, Peralta H, Gresely L, Cordova R, Kuffo D, Romero E, Tannenbaum TN, Houston S, Graham B, Hernandez L, Menzies D: DOTS implementation in a middle-income country: development and evaluation of a novel approach. Int J Tuberc Lung Dis. 2005, 9: 521-527.PubMed
32.
33.
Stop TB Partnership Global Drug Facility: Stop TB Partnership. First-Line tuberculosis drugs & formulations currently supplied/to be supplied by the global TB drug facility, Geneva. 2007, [http://​www.​stoptb.​org/​gdf/​]
34.
35.
Baumann S, Nasser Eddine A, Kaufmann SH: Progress in tuberculosis vaccine development. Curr Opin Immunol. 2006, 18: 438-448. 10.1016/j.coi.2006.05.016. Epub 2006 Jun 13CrossRefPubMed
36.
37.
Bhunu CP, Garira W, Mukandavire Z, Magombedze G: Modelling the effects of pre-exposure and post-exposure vaccines in tuberculosis control. Journal of Theoretical Biology. 2008, 254: 633-649. 10.1016/j.jtbi.2008.06.023.CrossRefPubMed
38.
Abu-Raddad LJ, Sabatelli L, Achterberg JT, Sugimoto JD, Longini IM, Dye C, Halloran ME: Epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnostics. Proc Natl Acad Sci USA. 2009, 106: 13980-13985. 10.1073/pnas.0901720106. Epub 2009 Aug 3CrossRefPubMedPubMedCentral
39.
Aronson NE, Santosham M, Comstock GW, Howard RS, Moulton LH, Rhoades ER, Harrison LH: Long-term efficacy of BCG vaccine in American Indians and Alaska Natives: A 60-year follow-up study. JAMA. 2004, 291: 2086-2091. 10.1001/jama.291.17.2086.CrossRefPubMed
40.
Fine PE: Variation in protection by BCG: implications of and for heterologous immunity. Lancet. 1995, 346: 1339-1345. 10.1016/S0140-6736(95)92348-9.CrossRefPubMed
41.
Sander CR, Pathan AA, Beveridge NE, Poulton I, Minassian A, Alder N, Hill AV, McShane H: Safety and immunogenicity of a new tuberculosis vaccine, MVA85A, in Mycobacterium tuberculosis-infected individuals. Am J Respir Crit Care Med. 2009, 179: 724-733. 10.1164/rccm.200809-1486OC.CrossRefPubMedPubMedCentral
42.
Casanova JL, Jouanguy E, Lamhamedi S, Blanche S, Fischer A: Immunological conditions of children with BCG disseminated infection. Lancet. 1995, 346: 581-10.1016/S0140-6736(95)91421-8.CrossRefPubMed
43.
WHO: Revised BCG vaccination guidelines for infants at risk for HIV infection. Weekly Epidemiological Record. 2007, 82: 193-196.
44.
Hesseling AC, Marais BJ, Gie RP, Schaaf HS, Fine PE, Godfrey-Faussett P, Beyers N: The risk of disseminated Bacille Calmette-Guerin (BCG) disease in HIV-infected children. Vaccine. 2007, 25: 14-18. 10.1016/j.vaccine.2006.07.020. Epub 2006 Aug 1CrossRefPubMed
45.
Brisson M, Edmunds WJ: Economic evaluation of vaccination programs: The impact of herd-immunity. Med Decis Making. 2003, 23: 76-82. 10.1177/0272989X02239651.CrossRefPubMed
46.
Brooks JV, Frank AA, Keen MA, Bellisle JT, Orme IM: Boosting vaccine for tuberculosis. Infect Immun. 2001, 69: 2714-2717. 10.1128/IAI.69.4.2714-2717.2001.CrossRefPubMedPubMedCentral
47.
Goonetilleke NP, McShane H, Hannan CM, Anderson RJ, Brookes RH, Hill AV: Enhanced immunogenicity and protective efficacy against Mycobacterium tuberculosis of bacille Calmette-Guérin vaccine using mucosal administration and boosting with a recombinant modified vaccinia virus Ankara. J Immunol. 2003, 171: 1602-1609.CrossRefPubMed
48.
Wang J, Thorson L, Stokes RW, Santosuosso M, Huygen K, Zganiacz A, Hitt M, Xing Z: Single mucosal, but not parenteral, immunization with recombinant adenoviral-based vaccine provides potent protection from pulmonary tuberculosis. J Immunol. 2004, 173: 6357-6365.CrossRefPubMed
49.
Cohen T, Colijn C, Murray M: Modeling the effects of strain diversity and mechanisms of strain competition on the potential performance of new tuberculosis vaccines. PNAS. 2008, 105: 16302-16307. 10.1073/pnas.0808746105.CrossRefPubMedPubMedCentral
50.
van Leth F, van der Werf MJ, Borgdorff MW: Prevalence of tuberculous infection and incidence of tuberculosis: a re-assessment of the Styblo rule. Bull World Health Organ. 2008, 86: 20-26. 10.2471/BLT.06.037804.CrossRefPubMedPubMedCentral
51.
Egwaga SM, Cobelens FG, Muwinge H, Verhage C, Kalisvaart N, Borgdorff MW: The impact of the HIV epidemic on tuberculosis transmission in Tanzania. AIDS. 2006, 20: 915-921. 10.1097/01.aids.0000218557.44284.83.CrossRefPubMed
52.
Fletcher HA, Hawkridge T, McShane H: A new vaccine for Tuberculosis: The challenges of development and deployment. J Bioeth Inq. 2009, 6: 219-228. 10.1007/s11673-009-9153-6.CrossRefPubMedPubMedCentral
53.
Wallis RS, Wang C, Doherty TM, Onyebujoh P, Vahedi M, Laang H, Olesen O, Parida S, Zumla A: Biomarkers for tuberculosis disease activity, cure, and relapse. Lancet Infect Dis. 2009, 9: 162-72. 10.1016/S1473-3099(09)70042-8.CrossRefPubMed
54.
Aagaard C, Dietrich J, Doherty M, Andersen P: TB vaccines: current status and future perspectives Immunol Cell Biol. 2009, 87: 279-286. Epub 2009 Apr 7
55.
56.
57.
58.
59.
60.
Anti-tuberculosis drug resistance in the world. WHO report 2004, Geneva. 2004
61.
Zignol M, Hosseini MS, Wright A, Weezenbeek CL, Nunn P, Watt CJ, Williams BG, Dye C: Global incidence of multidrug-resistant tuberculosis. J Infect Dis. 2006, 194: 479-485. 10.1086/505877.CrossRefPubMed
62.
Deschamps MM, Fitzgerald DW, Pape JW, Johnson WD: HIV infection in Haiti: natural history and disease progression. AIDS. 2000, 14: 2515-2521. 10.1097/00002030-200011100-00014.CrossRefPubMed
63.
Grzybowski S, Barnett GD, Styblo K: Contacts of cases of active pulmonary tuberculosis. Bull Int Union Tuberc. 1975, 50: 90-106.PubMed
64.
Menzies D: Issues in the management of contacts of patients with active pulmonary tuberculosis. Can J Public Health. 1997, 88: 197-201.PubMed
65.
Stead WW: Management of health care workers after inadvertent exposure to tuberculosis: a guide for the use of preventive therapy. Ann Intern Med. 1995, 122: 906-12.CrossRefPubMed
66.
Whalen CC, Johnson JL, Okwera A, Hom DL, Huebner R, Mugyenyi P, Mugerwa RD, Ellner JJ: A trial of three regimens to prevent tuberculosis in Ugandan adults infected with the human immunodeficiency virus. Uganda-Case Western Reserve University Research Collaboration. Engl J Med. 1997, 337: 801-808. 10.1056/NEJM199709183371201.CrossRef
67.
Guelar A, Gatell JM, Verdejo J, Podzamczer D, Lozano L, Aznar E, Miro JM, Mallolas J, Zamora L, Gonzalez J, Sorano E: A prospective study of the risk of tuberculosis among HIV-infected patients. AIDS. 1993, 7: 1345-1349. 10.1097/00002030-199310000-00007.CrossRefPubMed
68.
Beck-Sagué C, Dooley SW, Hutton MD, Otten J, Breeden A, Crawford JT, Pitchenik AE, Woodley C, Cauthen G, Jarvis WR: Hospital outbreak of multidrug-resistant Mycobacterium tuberculosis infections. Factors in transmission to staff and HIV-infected patients. JAMA. 1992, 268: 1280-1286.CrossRefPubMed
69.
Fischl MA, Uttamchandani RB, Daikos GL, Poblete RB, Moreno JN, Reyes RR, Boota AM, Thompson LM, Cleary TJ, Lai S: An outbreak of tuberculosis caused by multiple-drug-resistant tubercle bacilli among patients with HIV infection. Ann Intern Med. 1992, 117: 177-183.CrossRefPubMed
70.
Small PM, Shafer RW, Hopewell PC, Singh SP, Murphy MJ, Desmond E, Sierra MF, Schoolnik GK: Exogenous reinfection with multidrug-resistant Mycobacterium tuberculosis in patients with advanced HIV infection. N Engl J Med. 1993, 328: 1137-1144. 10.1056/NEJM199304223281601.CrossRefPubMed
71.
Daley CL, Small PM, Schecter GF, Schoolnik GK, McAdam RA, Jacobs WR, Hopewell PC: An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus: An analysis using restriction-fragment-length polymorphisms. N Engl J Med. 1992, 326: 231-235. 10.1056/NEJM199201233260404.CrossRefPubMed
72.
Grzybowski S, Enarson DA: The fate of cases of pulmonary tuberculosis under various treatment programmes. Bull Int Union Tuberc. 1978, 53: 70-74.PubMed
73.
Horwitz O: Public health aspects of relapsing tuberculosis. Am Rev Respir Dis. 1969, 99: 183-193.PubMed
74.
Reider HL: Epidemiologic basis of tuberculosis control. 1999, Paris, France, International Union Against Tuberculosis and Lung Disease, 1-162. First
75.
Cohn DL, Catlin BJ, Peterson KL, Judson FN, Sbarbaro JA: A 62-dose, 6-month therapy for pulmonary and extrapulmonary tuberculosis. A twice-weekly, directly observed, and cost-effective regimen. Ann Intern Med. 1990, 112: 407-415.CrossRefPubMed
76.
East African Tuberculosis Investigation Centre, British Medical Research Council Tuberculosis and Chest Diseases Unit: Results at 5 years of a controlled comparison of a 6-month and a standard 18-month regimen of chemotherapy for pulmonary tuberculosis. Am Rev Respir Dis. 1977, 116: 3-8.
77.
Somner AR: Short-course chemotherapy in pulmonary tuberculosis. A controlled trial by the British Thoracic Association (third report). Lancet. 1980, 1: 1182-1183.PubMed
78.
Algerian Working Group, British Medical Research Council: Controlled clinical trial comparing a 6-month and a 12-month regimen in the treatment of pulmonary tuberculosis in the Algerian Sahara. Am Rev Respir Dis. 1984, 129: 921-928.
79.
Benator D, Bhattacharya M, Bozeman L, Burman W, Cantazaro A, Chaisson R, Gordin F, Horsburgh CR, Horton J, Khan A, Lahart C, Metchock B, Pachucki C, Stanton L, Vernon A, Villarino ME, Wang YC, Weiner M, Weis S, Tuberculosis Trials Consortium: Rifapentine and isoniazid once a week versus rifampicin and isoniazid twice a week for treatment of drug-susceptible pulmonary tuberculosis in HIV-negative patients: a randomised clinical trial. Lancet. 2002, 360: 528-534. 10.1016/S0140-6736(02)09742-8.CrossRefPubMed
80.
Chee CBE, Boudville IC, Chan SP, Zee YK, Wang YT: Patient and disease characteristics, and outcome of treatment defaulters from the Singapore TB control unit - a one-year retrospective survey. Int J Tuber Lung Dis. 2000, 4: 496-503.
81.
Parthasarathy R, Prabhakar R, Somasundaram PR: A controlled clinical trial of 3- and 5- month regimens in the treatment of sputum-positive pulmonary tuberculosis in South India. Am Rev Respir Dis. 1986, 134: 27-33.
82.
East African Tuberculosis Investigation Centre, British Medical Research Council: Controlled clinical trial of five short-course (4-month) chemotherapy regimens in pulmonary tuberculosis: Second report of the 4th study. Am Rev Respir Dis. 1981, 123: 165-170.
83.
Singapore Tuberculosis Service, British Medical Research Council: Long-term Follow-up of a clinical trial of six-month and four-month regimens of chemotherapy in the treatment of pulmonary tuberculosis. Am Rev Respir Dis. 1986, 133: 779-83.
84.
Espinal MA, Kim SJ, Suarez PG, Kam KM, Khomenko AG, Migliori GB, Baéz J, Kochi A, Dye C, Raviglione MC: Standard short-course chemotherapy for drug-resistant tuberculosis: treatment outcomes in 6 countries. JAMA. 2000, 283: 2537-2545. 10.1001/jama.283.19.2537.CrossRefPubMed
85.
Nathanson E, Lambregts-van Weezenbeek C, Rich ML, Gupta R, Bayona J, Blöndal K, Caminero JA, Cegielski JP, Danilovits M, Espinal MA, Hollo V, Jaramillo E, Leimane V, Mitnick CD, Mukherjee JS, Nunn P, Pasechnikov A, Tupasi T, Wells C, Raviglione MC: Multidrug-resistant tuberculosis management in resource-limited settings. Emerg Infect Dis. 2006, 12: 1389-1397.CrossRefPubMedPubMedCentral
86.
Chaisson RE, Clermont HC, Holt EA, Cantave M, Johnson MP, Atkinson J, Davis H, Boulos R, Quinn TC, Halsey NA: Six-month supervised intermittent tuberculosis therapy in Haitian patients with and without HIV infection. Am J Respir Crit Care Med. 1996, 154: 1034-1038.CrossRefPubMed
87.
Desvarieux M, Hyppolite PR, Johnson WD, Pape JW: A novel approach to directly observed therapy for tuberculosis in an HIV-endemic area. Am J Public Health. 2001, 91: 138-141. 10.2105/AJPH.91.10.1547.CrossRefPubMedPubMedCentral
88.
Johnson JL, Okwera A, Vjecha MJ, Byekwaso F, Nakibali J, Nyole S, Milberg J, Aisu T, Whalen CC, Mugerwa RD, Ellner JJ: Risk factors for relapse in human immunodeficiency virus type 1 infected adults with pulmonary tuberculosis. Int J Tuberc Lung Dis. 1997, 1: 446-453.PubMed
89.
Sonnenberg P, Murray J, Glynn JR, Shearer S, Kambashi B, Godfrey-Faussett P: HIV-1 and recurrence, relapse, and reinfection of tuberculosis after cure: a cohort study in South African mineworkers. Lancet. 2001, 358: 1687-1693. 10.1016/S0140-6736(01)06712-5.CrossRefPubMed
90.
Pulido F, Peña JM, Rubio R, Moreno S, González J, Guijarro C, Costa JR, Vázquez JJ: Relapse of tuberculosis after treatment in human immunodeficiency virus-infected patients. Arch Intern Med. 1997, 157: 227-231. 10.1001/archinte.157.2.227.CrossRefPubMed
91.
Cummings KC, Mohle-Boetani J, Royce SE, Chin DP: Movement of tuberculosis patients and the failure to complete antituberculosis treatment. Am J Respir Crit Care Med. 1998, 157: 1249-1252.CrossRefPubMed
92.
Roos BR, van Cleeff MRA, Githui WA, Kivihya-Ndugga L, Odhiambo JA, Kibuga DK, Klatser PR: Cost-effectiveness of the polymerase chain reaction versus smear examination for the diagnosis of tuberculosis in Kenya: a theoretical model. Int J Tuber Lung Dis. 1997, 2: 235-241.
93.
Trunz BB, Fine P, Dye C: Effect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-effectiveness. Lancet. 2006, 367: 1173-1180. 10.1016/S0140-6736(06)68507-3.CrossRefPubMed
Metadata
Title
Cost-effectiveness of novel vaccines for tuberculosis control: a decision analysis study
Authors
Chia-Lin Tseng
Olivia Oxlade
Dick Menzies
Anne Aspler
Kevin Schwartzman
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-55

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue

Research article

Behavioural interventions for weight management in pregnancy: A systematic review of quantitative and qualitative data

Research article

A comparison of the effectiveness of three parenting programmes in improving parenting skills, parent mental-well being and children's behaviour when implemented on a large scale in community settings in 18 English local authorities: the parenting early intervention pathfinder (PEIP)

Study protocol

The effect of a periodontal intervention on cardiovascular risk markers in Indigenous Australians with periodontal disease: the PerioCardio study

Study protocol

Study protocol: a randomised controlled trial investigating the effect of a healthy lifestyle intervention for people with severe mental disorders

Research article

Work-related pesticide poisoning among farmers in two villages of Southern China: a cross-sectional survey

Research article

Physical activity behaviours of Culturally and Linguistically Diverse (CALD) women living in Australia: A qualitative study of socio-cultural influences