Vaccine value profile for Chikungunya.

Chikungunya virus (CHIKV) a mosquito-borne alphavirus is the causative agent of Chikungunya (CHIK), a disease with low mortality but high acute and chronic morbidity resulting in a high overall burden of disease. After the acute disease phase, chronic disease including persistent arthralgia is very common, and can cause fatigue and pain that is severe enough to limit normal activities. On average, around 40% of people infected with CHIKV will develop chronic arthritis, which may last for months or years. Recommendations for protection from CHIKV focus on infection control through preventing mosquito proliferation. There is currently no licensed antiviral drug or vaccine against CHIKV. Therefore, one of the most important public health impacts of vaccination would be to decrease burden of disease and economic losses in areas impacted by the virus, and prevent or reduce chronic morbidity associated with CHIK. This benefit would particularly be seen in Low and Middle Income Countries (LMIC) and socio-economically deprived areas, as they are more likely to have more infections and more severe outcomes. This 'Vaccine Value Profile' (VVP) for CHIK is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of vaccines in the development pipeline and vaccine-like products.This VVP was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships, and multi-lateral organizations. All contributors have extensive expertise on various elements of the CHIK VVP and collectively aimed to identify current research and knowledge gaps.The VVP was developed using only existing and publicly available information.

An investigation of Reablement or restorative homecare interventions and outcome effects: A systematic review of randomised control trials.

The effect of Reablement, a multi-faceted intervention is unclear, specifically, which interventions improve outcomes. This Systematic Review evaluates randomised controlled trials (RCTs) describing Reablement investigating the population, interventions, who delivered them, the effect and sustainability of outcomes. Database search from inception to August 2021 included AMED, ASSIA, BNI, CINHALL, EMBASE, HMIC, MEDLINE, PUBMED, PsycINFO, Google Scholar, Web of Science, Clinicaltrials.gov. Two researchers undertook data collection and quality assessment, following the PRISMA (2020) statement. They measured effect by changed primary or secondary outcomes: no ongoing service, functional ability, quality of life and mobility. The reviewers reported the analysis narratively, due to heterogeneity of outcome measures, strengthened by the SWiM reporting guideline. The search criteria resulted in eight international studies, five studies had a risk of bias limitations in either design or method. Ongoing service requirement decreased in five studies, with improved effect at 3 months shown in studies with occupational therapist involvement. Functional ability increased statistically in four studies at 3 months. Increase in quality of life was statistically significant in three studies, at 6 and 7 months. None of the studies reported a statistically significant improvement in functional mobility. Reablement is effective in the context of Health and Social Care. The outcomes were sustained at 3 months, with less sustainability at 6 months. There was no statistical result for the professional role regarding assessment, delivery and evaluation of interventions, and further research is justified.