Your browser doesn't support javascript.
loading
The public health impact and cost-effectiveness of the R21/Matrix-M malaria vaccine: a mathematical modelling study.
Schmit, Nora; Topazian, Hillary M; Natama, H Magloire; Bellamy, Duncan; Traoré, Ousmane; Somé, M Athanase; Rouamba, Toussaint; Tahita, Marc Christian; Bonko, Massa Dit Achille; Sourabié, Aboubakary; Sorgho, Hermann; Stockdale, Lisa; Provstgaard-Morys, Samuel; Aboagye, Jeremy; Woods, Danielle; Rapi, Katerina; Datoo, Mehreen S; Lopez, Fernando Ramos; Charles, Giovanni D; McCain, Kelly; Ouedraogo, Jean-Bosco; Hamaluba, Mainga; Olotu, Ally; Dicko, Alassane; Tinto, Halidou; Hill, Adrian V S; Ewer, Katie J; Ghani, Azra C; Winskill, Peter.
Afiliación
  • Schmit N; UK Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK. Electronic address: n.schmit17@imperial.ac.uk.
  • Topazian HM; UK Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
  • Natama HM; Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso.
  • Bellamy D; The Jenner Institute Laboratories, University of Oxford, Oxford, UK.
  • Traoré O; Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso.
  • Somé MA; Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso.
  • Rouamba T; Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso.
  • Tahita MC; Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso.
  • Bonko MDA; Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso.
  • Sourabié A; Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso.
  • Sorgho H; Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso.
  • Stockdale L; The Jenner Institute Laboratories, University of Oxford, Oxford, UK.
  • Provstgaard-Morys S; The Jenner Institute Laboratories, University of Oxford, Oxford, UK.
  • Aboagye J; The Jenner Institute Laboratories, University of Oxford, Oxford, UK.
  • Woods D; The Jenner Institute Laboratories, University of Oxford, Oxford, UK.
  • Rapi K; The Jenner Institute Laboratories, University of Oxford, Oxford, UK.
  • Datoo MS; The Jenner Institute Laboratories, University of Oxford, Oxford, UK.
  • Lopez FR; The Jenner Institute Laboratories, University of Oxford, Oxford, UK.
  • Charles GD; UK Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
  • McCain K; UK Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
  • Ouedraogo JB; Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso; Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso.
  • Hamaluba M; Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
  • Olotu A; Clinical Trials and Interventions Unit, Ifakara Health Institute, Bagamoyo, Tanzania.
  • Dicko A; The Malaria Research and Training Centre, University of Science, Technology, and Techniques of Bamako, Bamako, Mali.
  • Tinto H; Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso; Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso.
  • Hill AVS; The Jenner Institute Laboratories, University of Oxford, Oxford, UK.
  • Ewer KJ; The Jenner Institute Laboratories, University of Oxford, Oxford, UK; GSK Vaccines Institute for Global Health (Global Health Vaccines R&D), GSK, Siena, Italy.
  • Ghani AC; UK Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
  • Winskill P; UK Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
Lancet Infect Dis ; 24(5): 465-475, 2024 May.
Article en En | MEDLINE | ID: mdl-38342107
ABSTRACT

BACKGROUND:

The R21/Matrix-M vaccine has demonstrated high efficacy against Plasmodium falciparum clinical malaria in children in sub-Saharan Africa. Using trial data, we aimed to estimate the public health impact and cost-effectiveness of vaccine introduction across sub-Saharan Africa.

METHODS:

We fitted a semi-mechanistic model of the relationship between anti-circumsporozoite protein antibody titres and vaccine efficacy to data from 3 years of follow-up in the phase 2b trial of R21/Matrix-M in Nanoro, Burkina Faso. We validated the model by comparing predicted vaccine efficacy to that observed over 12-18 months in the phase 3 trial. Integrating this framework within a mathematical transmission model, we estimated the cases, malaria deaths, and disability-adjusted life-years (DALYs) averted and cost-effectiveness over a 15-year time horizon across a range of transmission settings in sub-Saharan Africa. Cost-effectiveness was estimated incorporating the cost of vaccine introduction (dose, consumables, and delivery) relative to existing interventions at baseline. We report estimates at a median of 20% parasite prevalence in children aged 2-10 years (PfPR2-10) and ranges from 3% to 65% PfPR2-10.

FINDINGS:

Anti-circumsporozoite protein antibody titres were found to satisfy the criteria for a surrogate of protection for vaccine efficacy against clinical malaria. Age-based implementation of a four-dose regimen of R21/Matrix-M vaccine was estimated to avert 181 825 (range 38 815-333 491) clinical cases per 100 000 fully vaccinated children in perennial settings and 202 017 (29 868-405 702) clinical cases per 100 000 fully vaccinated children in seasonal settings. Similar estimates were obtained for seasonal or hybrid implementation. Under an assumed vaccine dose price of US$3, the incremental cost per clinical case averted was $7 (range 4-48) in perennial settings and $6 (3-63) in seasonal settings and the incremental cost per DALY averted was $34 (29-139) in perennial settings and $30 (22-172) in seasonal settings, with lower cost-effectiveness ratios in settings with higher PfPR2-10.

INTERPRETATION:

Introduction of the R21/Matrix-M malaria vaccine could have a substantial public health benefit across sub-Saharan Africa.

FUNDING:

The Wellcome Trust, the Bill & Melinda Gates Foundation, the UK Medical Research Council, the European and Developing Countries Clinical Trials Partnership 2 and 3, the NIHR Oxford Biomedical Research Centre, and the Serum Institute of India, Open Philanthropy.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Salud Pública / Malaria Falciparum / Análisis Costo-Beneficio / Vacunas contra la Malaria / Modelos Teóricos Tipo de estudio: Health_economic_evaluation / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Africa Idioma: En Revista: Lancet Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Salud Pública / Malaria Falciparum / Análisis Costo-Beneficio / Vacunas contra la Malaria / Modelos Teóricos Tipo de estudio: Health_economic_evaluation / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Africa Idioma: En Revista: Lancet Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos