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Volume 30, Number 12—December 2024
Research

Cost-effectiveness Analysis of Japanese Encephalitis Vaccination for Children <15 Years of Age, Bangladesh

An Nguyen1, Rebeca Sultana1Comments to Author , Elisabeth Vodicka, Zareen Tasnim, Kamran Mehedi, Md. Monjurul Islam, S.M. Abdullah Al Murad, Md. Redowan Ullah, Sharmin Sultana, Tahmina Shirin, and Clint Pecenka
Author affiliation: Program for Appropriate Technology in Health (PATH), Ho Chi Minh City, Vietnam (A. Nguyen); icddr,b, Dhaka, Bangladesh (R. Sultana, Z. Tasnim, M.R. Ullah); PATH, Seattle, Washington, USA (E. Vodicka, C. Pecenka); PATH, Dhaka (K. Mehedi); Maternal, Newborn, Child and Adolescent Health, Dhaka (M.M. Islam, S.M.A. Al Murad); Institute of Epidemiology Diseases Control and Research, Dhaka (S. Sultana, T. Shirin)

Main Article

Figure 1

Markov model simulating costs and outcomes in cost-effectiveness analysis of JE vaccination for children <15 years of age, Bangladesh. All persons enter the model with no JE. Acute JE implies symptomatic JE and is a tunnel state, meaning any person in that state stays there for exactly 1 cycle. Those who had acute JE do have a higher mortality rate but must accrue the costs and disability-adjusted life years (DALYs) of the acute event before transitioning to death. Asymptomatic JE is not associated with higher mortality, costs, or DALYs; rather it eliminates any transition to acute JE. Costs and DALYs for acute and postacute JE are distributed by sequelae presence and severity. Vaccination changes the probability of transitioning from no JE to acute or asymptomatic JE. No other probabilities are changed by presence or absence of vaccination. Each state is associated with an annual cost and disability weight where applicable. This figure was remade from the Markov model in the study conducted in Philippines by the same research group from PATH (31). JE, Japanese encephalitis virus.

Figure 1. Markov model simulating costs and outcomes in cost-effectiveness analysis of JE vaccination for children <15 years of age, Bangladesh. All persons enter the model with no JE. Acute JE implies symptomatic JE and is a tunnel state, meaning any person in that state stays there for exactly 1 cycle. Those who had acute JE do have a higher mortality rate but must accrue the costs and disability-adjusted life years (DALYs) of the acute event before transitioning to death. Asymptomatic JE is not associated with higher mortality, costs, or DALYs; rather it eliminates any transition to acute JE. Costs and DALYs for acute and postacute JE are distributed by sequelae presence and severity. Vaccination changes the probability of transitioning from no JE to acute or asymptomatic JE. No other probabilities are changed by presence or absence of vaccination. Each state is associated with an annual cost and disability weight where applicable. This figure was remade from the Markov model in the study conducted in Philippines by the same research group from PATH (31). JE, Japanese encephalitis virus.

Main Article

References
  1. Campbell  GL, Hills  SL, Fischer  M, Jacobson  JA, Hoke  CH, Hombach  JM, et al. Estimated global incidence of Japanese encephalitis: a systematic review. Bull World Health Organ. 2011;89:766–74, 74A–74E. DOIGoogle Scholar
  2. Solomon  T, Dung  NM, Kneen  R, Gainsborough  M, Vaughn  DW, Khanh  VT. Japanese encephalitis. J Neurol Neurosurg Psychiatry. 2000;68:405–15. DOIPubMedGoogle Scholar
  3. Kumar  R, Mathur  A, Singh  KB, Sitholey  P, Prasad  M, Shukla  R, et al. Clinical sequelae of Japanese encephalitis in children. Indian J Med Res. 1993;97:9–13.PubMedGoogle Scholar
  4. WHO. WHO position paper, February 2015—recommendations. Vaccine. 2016;34:302–3. DOIPubMedGoogle Scholar
  5. UNICEF. Japanese encephalitis vaccine: market and supply update [cited 2023 Apr 14]. https://www.unicef.org/supply/reports/japanese-encephalitis-vaccine-market-and-supply-update
  6. PATH. Safety of CD-JEV: a proven tool for JE prevention [cited 2023 Sep 4]. https://media.path.org/documents/CVIA_Safety_CD_JEV_fs.pdf
  7. Feroldi  E, Pancharoen  C, Kosalaraksa  P, Chokephaibulkit  K, Boaz  M, Meric  C, et al. Primary immunization of infants and toddlers in Thailand with Japanese encephalitis chimeric virus vaccine in comparison with SA14-14-2: a randomized study of immunogenicity and safety. Pediatr Infect Dis J. 2014;33:643–9. DOIPubMedGoogle Scholar
  8. Kim  DS, Houillon  G, Jang  GC, Cha  SH, Choi  SH, Lee  J, et al. A randomized study of the immunogenicity and safety of Japanese encephalitis chimeric virus vaccine (JE-CV) in comparison with SA14-14-2 vaccine in children in the Republic of Korea. Hum Vaccin Immunother. 2014;10:2656–63. DOIPubMedGoogle Scholar
  9. Ahaduzzaman  M, Hassan  M, Alam  M, Islam  SKM, Uddin  I. Antimicrobial resistance pattern against Staphylococcus aureus in environmental effluents. Res J Vet Pract. 2014;2:13–6. DOIGoogle Scholar
  10. Bista  MB, Banerjee  MK, Shin  SH, Tandan  JB, Kim  MH, Sohn  YM, et al. Efficacy of single-dose SA 14-14-2 vaccine against Japanese encephalitis: a case control study. Lancet. 2001;358:791–5. DOIPubMedGoogle Scholar
  11. Khan  SA, Choudhury  P, Kakati  S, Doley  R, Barman  MP, Murhekar  MV, et al. Effectiveness of a single dose of Japanese encephalitis vaccine among adults, Assam, India, 2012-2018. Vaccine. 2021;39:4973–8. DOIPubMedGoogle Scholar
  12. Kumar  R, Tripathi  P, Rizvi  A. Effectiveness of one dose of SA 14-14-2 vaccine against Japanese encephalitis. N Engl J Med. 2009;360:1465–6. DOIPubMedGoogle Scholar
  13. Li  X, Ma  SJ, Liu  X, Jiang  LN, Zhou  JH, Xiong  YQ, et al. Immunogenicity and safety of currently available Japanese encephalitis vaccines: a systematic review. Hum Vaccin Immunother. 2014;10:3579–93. DOIPubMedGoogle Scholar
  14. Ohrr  H, Tandan  JB, Sohn  YM, Shin  SH, Pradhan  DP, Halstead  SB. Effect of single dose of SA 14-14-2 vaccine 1 year after immunisation in Nepalese children with Japanese encephalitis: a case-control study. Lancet. 2005;366:1375–8. DOIPubMedGoogle Scholar
  15. Hossain  MJ, Gurley  ES, Montgomery  S, Petersen  L, Sejvar  J, Fischer  M, et al. Hospital-based surveillance for Japanese encephalitis at four sites in Bangladesh, 2003-2005. Am J Trop Med Hyg. 2010;82:344–9. DOIPubMedGoogle Scholar
  16. Khan  AM, Khan  AQ, Dobrzynski  L, Joshi  GP, Myat  A. A Japanese encephalitis focus in Bangladesh. J Trop Med Hyg. 1981;84:41–4.PubMedGoogle Scholar
  17. Paul  KK, Sazzad  HMS, Rahman  M, Sultana  S, Hossain  MJ, Ledermann  JP, et al. Hospital-based surveillance for Japanese encephalitis in Bangladesh, 2007-2016: Implications for introduction of immunization. Int J Infect Dis. 2020;99:69–74. DOIPubMedGoogle Scholar
  18. Sultana  R, Slavkovsky  R, Ullah  MR, Tasnim  Z, Sultana  S, Khan  S, et al. Cost of acute and sequelae care for Japanese encephalitis patients, Bangladesh, 2011–2021. Emerg Infect Dis. 2023;29:2488–97. DOIPubMedGoogle Scholar
  19. World Health Organization. Immunization in Bangladesh [cited 2024 May 14]. https://www.who.int/bangladesh/health-topics/immunization
  20. Vannice  KS, Hills  SL, Schwartz  LM, Barrett  AD, Heffelfinger  J, Hombach  J, et al.; Japanese encephalitis vaccination experts panel. The future of Japanese encephalitis vaccination: expert recommendations for achieving and maintaining optimal JE control. NPJ Vaccines. 2021;6:82. DOIPubMedGoogle Scholar
  21. Integrated efforts crucial to prevent JE disease [cited 2023 Aug 1]. https://www.bssnews.net/news/104208
  22. Akram  A. Japanese encephalitis—emerging disease in Bangladesh. Bangladesh J Med Microbiol. 2018;12:21–3. DOIGoogle Scholar
  23. Haider  MS, Youngkong  S, Thavorncharoensap  M, Thokala  P. Priority setting of vaccine introduction in Bangladesh: a multicriteria decision analysis study. BMJ Open. 2022;12:e054219. DOIPubMedGoogle Scholar
  24. Paul  RC, Rahman  M, Gurley  ES, Hossain  MJ, Diorditsa  S, Hasan  AM, et al. A novel low-cost approach to estimate the incidence of Japanese encephalitis in the catchment area of three hospitals in Bangladesh. Am J Trop Med Hyg. 2011;85:379–85. DOIPubMedGoogle Scholar
  25. Zahid  SH. Thrust on joint efforts to contain JE. The Financial Express [cited 2023 Apr 14]. https://today.thefinancialexpress.com.bd/country/thrust-on-joint-efforts-to-contain-je-1673277777
  26. Kosen  S, Khoe  LC, Indriasih  E, Tarigan  I, Iriawan  RW, Agustiya  RI, et al. Expanding japanese encephalitis vaccination to selected endemic indonesia provinces: A cost-effectiveness analysis. Vaccine X. 2022;11:100179. DOIPubMedGoogle Scholar
  27. Siraprapasiri  T, Sawaddiwudhipong  W, Rojanasuphot  S. Cost benefit analysis of Japanese encephalitis vaccination program in Thailand. Southeast Asian J Trop Med Public Health. 1997;28:143–8.PubMedGoogle Scholar
  28. Suraratdecha  C. A cost-effectiveness analysis of strategies for controlling Japanese encephalitis in Andhra Pradesh, India. J Pharm Finance Econ Policy. 2006;15:21–40. DOIGoogle Scholar
  29. Touch  S, Suraratdecha  C, Samnang  C, Heng  S, Gazley  L, Huch  C, et al. A cost-effectiveness analysis of Japanese encephalitis vaccine in Cambodia. Vaccine. 2010;28:4593–9. DOIPubMedGoogle Scholar
  30. Vodicka  E, Zimmermann  M, Lopez  AL, Silva  MW, Gorgolon  L, Kohei  T, et al. Japanese encephalitis vaccination in the Philippines: A cost-effectiveness analysis comparing alternative delivery strategies. Vaccine. 2020;38:2833–40. DOIPubMedGoogle Scholar
  31. Yin  Z, Beeler Asay  GR, Zhang  L, Li  Y, Zuo  S, Hutin  YJ, et al.; Guizhou JE Study Group. An economic evaluation of the use of Japanese encephalitis vaccine in the expanded program of immunization of Guizhou province, China. Vaccine. 2012;30:5569–77. DOIPubMedGoogle Scholar
  32. Bangladesh Directorate General of Health Services. EPI Coverage Evaluation Survey 2019 [cited 2023 Apr 20]. https://dghs.gov.bd/images/docs/vpr/Coverage_Evaluation_Survey_2019.pdf
  33. Bangladesh Bureau of Statistics. Population and housing census 2022: preliminary report [cited 2023 Sep 15]. https://sid.portal.gov.bd/sites/default/files/files/sid.portal.gov.bd/publications/01ad1ffe_cfef_4811_af97_594b6c64d7c3/PHC_Preliminary_Report_(English)_August_2022.pdf
  34. Bangladesh Bureau of Statistics. Report on Bangladesh sample vital statistics 2018 [cited 2023 Sep 15]. https://bbs.portal.gov.bd/sites/default/files/files/bbs.portal.gov.bd/page/b343a8b4_956b_45ca_872f_4cf9b2f1a6e0/2021-06-28-07-11-c1784c6fe700cf52ff934e8dd7cf9147.pdf
  35. World Bank. Official exchange rate (LCU per US$, period average)—Bangladesh [cited 2022 Oct 5]. https://data.worldbank.org/indicator/PA.NUS.FCRF
  36. Rothenberg  CM. Estimating the incidence of Japanese encephalitis in divisions of Bangladesh [cited 2024 May 9]. https://elischolar.library.yale.edu/ysphtdl/1251
  37. Institute of Epidemiology, Disease Control and Research. Disease surveillance systems of Bangladesh: acute meningo-encephalitis surveillance (AMES) [cited 2023 Sep 15]. https://www.iedcr.org/Default.aspx
  38. Salomon  JA, Haagsma  JA, Davis  A, de Noordhout  CM, Polinder  S, Havelaar  AH, et al. Disability weights for the Global Burden of Disease 2013 study. Lancet Glob Health. 2015;3:e712–23. DOIPubMedGoogle Scholar
  39. Misra  UK, Kalita  J. Overview: Japanese encephalitis. Prog Neurobiol. 2010;91:108–20. DOIPubMedGoogle Scholar
  40. World Health Organization. WHO vaccine reaction rates information sheets: Japanese encephalitis vaccine information sheet [cited 2024 Aug 20]. https://www.who.int/publications/m/item/je-vaccine-information-sheet
  41. Sarker  AR, Khan  AI, Islam  MT, Chowdhury  F, Khanam  F, Kang  S, et al. Cost of oral cholera vaccine delivery in a mass immunization program for children in urban Bangladesh. Vaccine X. 2022;12:100247. DOIPubMedGoogle Scholar
  42. Ding  D, Kilgore  PE, Clemens  JD, Wei  L, Zhi-Yi  X. Cost-effectiveness of routine immunization to control Japanese encephalitis in Shanghai, China. Bull World Health Organ. 2003;81:334–42.PubMedGoogle Scholar
  43. Hegde  ST, Salje  H, Sazzad  HMS, Hossain  MJ, Rahman  M, Daszak  P, et al. Using healthcare-seeking behaviour to estimate the number of Nipah outbreaks missed by hospital-based surveillance in Bangladesh. Int J Epidemiol. 2019;48:1219–27. DOIPubMedGoogle Scholar
  44. Akter  M, Kabir  H. Health inequalities in rural and urban Bangladesh: the implications of digital health. Mayo Clin Proc Digit Health. 2023;1:201–2. DOIGoogle Scholar
  45. Institute of Epidemiology, Disease Control and Research. Estimation from IEDCR 10-year JE surveillance.
  46. Alera  MT, Velasco  JM, Ypil-Cardenas  CA, Jarman  RG, Nisalak  AN, Thaisomboonsuk  B, et al. Hospital-based surveillance of Japanese encephalitis at a tertiary hospital in Manila. Southeast Asian J Trop Med Public Health. 2013;44:791–8.PubMedGoogle Scholar

Main Article

1These first authors contributed equally to this article.

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