ABSTRACT
The human and public health costs of meningococcal disease are substantial, with 201 cases reported in England between April and June 2013. It is estimated that serogroup B accounts for 85-90% of all cases of meningococcal disease. A vaccine against serogroup B meningococcal disease was approved by the European Medicines Agency in November 2012. In March 2014 the UK Joint Committee on Vaccination and Immunisation recommended that the vaccine be offered to babies at 2, 4 and 12 months of age, provided it can be procured at a cost effective price. Using a real cluster of two cases of meningococcal infection in the UK, we estimate that the cost of managing two cases was 17 times more than the cost of managing a single case (£5584.39 versus £317.72, respectively). We recommend that vaccine cost effectiveness models should take a full account of the costs involved in managing cases and clusters of meningococcal disease.
Subject(s)
Disease Outbreaks/economics , Health Care Costs , Meningococcal Infections/economics , Meningococcal Vaccines/economics , Child , Cost-Benefit Analysis , Disease Outbreaks/prevention & control , England , Female , Humans , Meningococcal Infections/prevention & control , Meningococcal Vaccines/therapeutic use , Neisseria meningitidis, Serogroup B , Public Health/economics , Vaccination/economicsABSTRACT
A 1-year longitudinal study with three testing points was conducted with 215 British Asian children aged 5 to 11 years to test hypotheses from Berry's acculturation framework. Using age-appropriate measures of acculturation attitudes and psychosocial outcomes, it was found that (a) children generally favored an "integrationist" attitude, and this was more pronounced among older (8-10 years) than in younger (5-7 years) children and (b) temporal changes in social self-esteem and peer acceptance were associated with different acculturation attitudes held initially, as shown by latent growth curve analyses. However, a supplementary time-lagged regression analysis revealed that children's earlier "integrationist" attitudes may be associated with more emotional symptoms (based on teachers' ratings) 6 months later. The implications of these different outcomes of children's acculturation attitudes are discussed.
