Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
3.
PLoS Negl Trop Dis ; 9(6): e0003810, 2015.
Article in English | MEDLINE | ID: mdl-26030922

ABSTRACT

BACKGROUND: The rise in dengue fever cases and the absence of dengue vaccines will likely cause governments to consider various types of effective means for controlling the disease. Given strong public interests in potential dengue vaccines, it is essential to understand the private economic benefits of dengue vaccines for accelerated introduction of vaccines into the public sector program and private markets of high-risk countries. METHODOLOGY/PRINCIPAL FINDINGS: A contingent valuation study for a hypothetical dengue vaccine was administered to 400 households in a multi-country setting: Vietnam, Thailand, and Colombia. All respondents received a description of the hypothetical dengue vaccine scenarios of 70% or 95% effectiveness for 10 or 30 years with a three dose series. Five price points were determined after pilot tests in order to reflect different local situations such as household income levels and general perceptions towards dengue fever. We adopted either Poisson or negative binomial regression models to calculate average willingness-to-pay (WTP), as well as median WTP. We found that there is a significant demand for dengue vaccines. The parametric median WTP is $26.4 ($8.8 per dose) in Vietnam, $70.3 ($23.4 per dose) in Thailand, and $23 ($7.7 per dose) in Colombia. Our study also suggests that respondents place more value on vaccinating young children than school age children and adults. CONCLUSIONS/SIGNIFICANCE: Knowing that dengue vaccines are not yet available, our study provides critical information to both public and private sectors. The study results can be used to ensure broad coverage with an affordable price and incorporated into cost benefit analyses, which can inform prioritization of alternative health interventions at the national level.


Subject(s)
Dengue Vaccines/economics , Dengue/epidemiology , Patient Acceptance of Health Care/psychology , Colombia/epidemiology , Commerce , Humans , Regression Analysis , Surveys and Questionnaires , Thailand/epidemiology , Vietnam/epidemiology
4.
J Travel Med ; 20(1): 54-6, 2013.
Article in English | MEDLINE | ID: mdl-23279233

ABSTRACT

Rickettsial spotted fever is common in southeastern Brazil. Differential diagnosis of pathogens can be performed with proper laboratory methods. A traveler arriving from Portugal developed a fatal febrile hemorrhagic syndrome diagnosed as spotted fever rickettsiosis. We isolated the agent, which was identified as Rickettsia conorii conorii by sequencing rickettsial genes.


Subject(s)
Boutonneuse Fever , DNA, Bacterial , Genes, Bacterial , Rickettsia conorii , Sequence Analysis, DNA/methods , Animals , Boutonneuse Fever/epidemiology , Boutonneuse Fever/microbiology , Boutonneuse Fever/transmission , Brazil/epidemiology , Disease Reservoirs/microbiology , Dogs , Fatal Outcome , Humans , Male , Middle Aged , Portugal , Rickettsia conorii/genetics , Rickettsia conorii/isolation & purification , Rickettsia conorii/pathogenicity , Sequence Homology, Nucleic Acid , Time-to-Treatment , Travel , Zoonoses/epidemiology , Zoonoses/microbiology , Zoonoses/transmission
5.
Transfusion ; 50(1): 208-12, 2010 Jan.
Article in English | MEDLINE | ID: mdl-19788513

ABSTRACT

BACKGROUND: Dengue is a mosquito-borne viral disease with an increasing incidence worldwide. Thrombocytopenia is a common finding in dengue virus (DV) infection; however, the underlying mechanisms remain unknown. CASE REPORT: Here we provide the first evidence of a case of antibody formation against ADAMTS13 (ADAMTS13 inhibitor) in the course of a severe acute DV infection resulting in thrombotic microangiopathy (TMA). The patient presented with classical dengue symptoms (positive epidemiology, high fever, myalgia, predominantly in the lower limbs and lumbar region for 1 week) and, after 11 days of initial symptoms, developed TMA. Clinical and laboratorial investigation of dengue and TMA was performed. RESULTS: The patient presented with ADAMTS13 inhibitor (IgG) during the acute phase of the disease, without anti-platelet antibodies detectable. Dengue infection had laboratorial confirmation. There were excellent clinical and laboratory responses to 11 serial plasma exchanges. Anti-ADAMTS13 inhibitor disappeared after remission of TMA and dengue resolution. No recurrence of TMA symptoms was observed after 2-year follow-up. CONCLUSIONS: Although the real incidence of dengue-related TMA is unknown, this case provides the basis for future epidemiologic studies on acquired ADAMTS13 deficiency in DV infection. The prompt clinical recognition of this complication and early installment of specific therapy with plasma exchange are likely to improve the outcome of severe cases of dengue.


Subject(s)
ADAM Proteins/immunology , Autoantibodies/blood , Dengue/immunology , Thrombotic Microangiopathies/immunology , ADAMTS13 Protein , Acute Disease , Blood Platelets/immunology , Dengue/blood , Dengue/complications , Humans , Immunoglobulin G/blood , Male , Middle Aged , Plasma Exchange , Thrombotic Microangiopathies/etiology , Thrombotic Microangiopathies/therapy
6.
J Health Popul Nutr ; 26(4): 388-96, 2008 Dec.
Article in English | MEDLINE | ID: mdl-19069617

ABSTRACT

The study was done to evaluate the cost-effectiveness of a national rotavirus vaccination programme in Brazilian children from the healthcare system perspective. A hypothetical annual birth-cohort was followed for a five-year period. Published and national administrative data were incorporated into a model to quantify the consequences of vaccination versus no vaccination. Main outcome measures included the reduction in disease burden, lives saved, and disability-adjusted life-years (DALYs) averted. A rotavirus vaccination programme in Brazil would prevent an estimated 1,804 deaths associated with gastroenteritis due to rotavirus, 91,127 hospitalizations, and 550,198 outpatient visits. Vaccination is likely to reduce 76% of the overall healthcare burden of rotavirus-associated gastroenteritis in Brazil. At a vaccine price of US$ 7-8 per dose, the cost-effectiveness ratio would be US$ 643 per DALY averted. Rotavirus vaccination can reduce the burden of gastroenteritis due to rotavirus at a reasonable cost-effectiveness ratio.


Subject(s)
Gastroenteritis/economics , Rotavirus Infections/economics , Rotavirus Vaccines/economics , Brazil , Child, Preschool , Cohort Studies , Cost-Benefit Analysis/statistics & numerical data , Female , Gastroenteritis/prevention & control , Humans , Infant , Male , Rotavirus/drug effects , Rotavirus Infections/prevention & control
7.
Am J Trop Med Hyg ; 77(6): 1051-3, 2007 Dec.
Article in English | MEDLINE | ID: mdl-18165520

ABSTRACT

Many aspects of the human asymptomatic visceral leishmaniasis (VL) remain not elucidated, and moreover, almost all the data come from highly endemic areas. The recent appearance of American VL (AVL) in the northeastern region of the state of São Paulo, Brazil, offered a good opportunity for further understanding. We present the preliminary results from a seroprevalence study on AVL in humans in Araçatuba, São Paulo. This was a cross-sectional survey on a random sample of the population (one-stage simple random sampling) in two areas, using rK39 dipstick tests. The sex ratios and age distributions in the two areas were comparable. Detectable antibodies were found in 23 subjects (20%) in area A1 and in 6 subjects (4.8%) in area A2. There was no significant difference in age distribution of seropositivity between the areas. We observed a difference in asymptomatic infection rates between the two areas, possibly associated with socioeconomic levels and transmission intensity.


Subject(s)
Antibodies, Protozoan/blood , Leishmania infantum/immunology , Leishmaniasis, Visceral/epidemiology , Urban Population , Adolescent , Adult , Aged , Animals , Antigens, Protozoan/immunology , Brazil/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Dogs , Female , Humans , Leishmaniasis, Visceral/immunology , Male , Middle Aged , Protozoan Proteins/immunology , Seroepidemiologic Studies
8.
J Am Board Fam Pract ; 15(5): 432; author reply 432, 2002.
Article in English | MEDLINE | ID: mdl-12350069
SELECTION OF CITATIONS
SEARCH DETAIL
...