RESUMO
Dengue is endemic in Brazil. Several dengue vaccine candidates, including one at the Butantan Institute in Sao Paulo, are being evaluated in clinical trials and may be licensed in several years. This study estimates the potential doses of dengue vaccine needed in Brazil under different scenarios in the first 5 years after vaccine introduction. Estimates were based on 2015-2022 country population projections. An estimated country population of 200-209 million with an annual 3.3-3.5 million cohort in the 12 to 23 month age group was included in the analysis. Computations were made for vaccines requiring one, two and three doses. A total of 7.8-62.9 million doses would be needed for only routine vaccination of 12-23 months cohort in first five years with different vaccination schedules. A combination of country-wide routine 12-23 month-old vaccination plus catch-up vaccination of individuals up to 40 years age is an appropriate strategy to control dengue. For this combination strategy, 129-425 million doses would be needed in the first five years after introduction. If vaccination is not provided to areas with low incidence of dengue, an estimated 108-360 million doses would be needed. This study provides a range of vaccine uptake estimates under different scenarios based on disease epidemiology. Actual demand and uptake will depend on the country vaccine introduction policy and strategies, vaccine supply capacity, cost, and vaccine profile. We consider one option based on the availability of vaccine from different sources. A more advanced vaccine uptake model based on estimates of vaccine impact under various scenarios should be developed.
Assuntos
Vacinas contra Dengue/administração & dosagem , Vacinas contra Dengue/provisão & distribuição , Dengue/epidemiologia , Dengue/prevenção & controle , Vacinação em Massa/estatística & dados numéricos , Brasil/epidemiologia , Vírus da Dengue/imunologia , HumanosRESUMO
El término tecnología adecuada se refiere a la tecnología sanitaria que se crea, produce, ofrece y monitorea en un contexto general donde se toman en cuenta los sistemas, las personas y la comunidad. Esta tecnología abarca el diseño, desarrollo y adopción de productos sanitarios, entre ellos nuevos medicamentos, vacunas y métodos diagnósticos, y de medios computadorizados aplicables a la genómica funcional, vigilancia epidemiológica, evaluación de la carga de morbilidad, adjudicación de recursos sanitarios, creación de modelos matemáticos y análisis de efectividad en función del costo. En conjunto, estos medios son especialmente promisorios para el control y la eliminación de diversas enfermedades tropicales que han recibido escasa atención. Actualmente, buena parte de la investigación y el desarrollo en torno a tecnologías adecuadas está a cargo de alianzas formadas recientemente entre los sectores público y privado. No obstante, es preciso incrementar la investigación y el entrenamiento en este campo en las escuelas de salud pública de América del Norte en vista de los efectos sanitarios y económicos que se calcula que tendrá la tecnología adecuada en países en desarrollo.
Assuntos
Humanos , Biotecnologia , Saúde Pública/educação , Faculdades de Saúde Pública , Medicina Tropical/educação , Doenças Transmissíveis , Efeitos Psicossociais da Doença , América Latina , Estados UnidosRESUMO
Gross inequities in disease burden between developed and developing countries are now the subject of intense global attention. Public and private donors have marshaled resources and created organizational structures to accelerate the development of new health products and to procure and distribute drugs and vaccines for the poor. Despite these encouraging efforts directed primarily from and funded by industrialized countries, sufficiency and sustainability remain enormous challenges because of the sheer magnitude of the problem. Here we highlight a complementary and increasingly important means to improve health equity: the growing ability of some developing countries to undertake health innovation.