Model-guided assessment of rotavirus vaccine impact in developing countries

轮状病毒疫苗对发展中国家影响的模型引导评估

• 批准号: 9001247
• 负责人: VIRGINIA E PITZER
• 金额: $ 37.25万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9001247
• 关键词: Accounting; Address; Adoption; Affect; Africa; Age; Asia; Bangladesh; Birth; Case-Control Studies; Child; Childhood; Cohort Studies; Country; Data; Data Set; Demography; Developed Countries; Developing Countries; Development; Diarrhea; Dose; Epidemiology; Exhibits; Gastroenteritis; Ghana; Goals; Health; Household; Immune; Immunity; Immunization Schedule; Incidence; India; Individual; Infant; Infection; Malawi; Mexico; Modeling; Morbidity - disease rate; Natural History; Natural Immunity; Patients; Pattern; Risk; Rotavirus; Rotavirus Vaccines; Scheme; Series; Severities; Source; Statistical Models; Structure; Time; Vaccination; Vaccines; base; case control; cohort; cost; cost effectiveness; evidence base; improved; markov model; mathematical model; mortality; reproductive; surveillance data; tool; transmission process; vaccine effectiveness; vaccine efficacy; vaccine-induced immunity

 DESCRIPTION (provided by applicant): Rotavirus is the leading cause of severe diarrhea in children, and a major source of morbidity and mortality in developing countries. Vaccination has proven to be a safe and effective means of controlling the burden of rotavirus-associated gastroenteritis in developed countries, but logistical constraints and concerns over the reduced efficacy of the vaccines in developing country settings have hindered their wider adoption. Better evidence is needed to support the expected impact of vaccination in developing countries to overcome the barriers to vaccine introduction. We seek to address these concerns using a combination of statistical and mathematical modeling to gain a better understanding of the factors affecting the direct and indirect effects of rotavirus vaccination in developing countries. First, we will reanalyze data from pivotal birth cohort studies conducted in Mexico and India to explore the hypothesis that higher rates of rotavirus transmission and the younger age at infection in India compared to Mexico may help to explain the differences in protection from natural infection in these settings. Second, we will use mathematical models to examine the important drivers of rotavirus transmission dynamics in Bangladesh, Malawi, and Ghana. We will use the models to predict the impact of rotavirus vaccination in these settings accounting for both the direct and indirect effects of vaccination. Finally, we will validate and refine model predictions by comparing to data collected as part of ongoing studies of the impact of vaccination in Blantyre, Malawi and Accra and Navrongo, Ghana. These projects will improve our understanding of how the underlying transmission dynamics of rotavirus affect the expected direct and indirect effects of vaccination in developing countries, and will provide a validated platform for extending the modeling analyses to other countries to provide evidence-based support for rotavirus vaccine introduction.

 描述（由适用提供）：轮状病毒是儿童严重腹泻的主要原因，也是发展中国家发病率和死亡率的主要来源。事实证明，疫苗接种是控制发达国家轮状病毒相关胃肠炎的燃烧的一种安全有效手段，但是对疫苗在发展中国家环境中疫苗效率降低的后勤限制和担忧却阻碍了其更广泛的采用。需要更好的证据来支持疫苗对发展中国家的预期影响，以克服疫苗引入的障碍。我们试图通过统计和数学建模的结合来解决这些问题，以更好地了解影响发展中国家轮状病毒疫苗的直接和间接影响的因素。 首先，我们将重新分析从墨西哥和印度进行的关键性出生队列研究的数据，以探讨与墨西哥相比，轮状病毒传播率较高的率和印度感染年龄较大的率可能有助于解释这些环境中自然感染的保护差异。其次，我们将使用数学模型来检查孟加拉国，马拉维和加纳轮状病毒传输动力学的重要驱动因素。我们将使用模型来预测轮状病毒疫苗接种在这些情况下的影响 疫苗的直接和间接作用。最后，我们将通过比较收集的数据作为对疫苗对Blantyre，Malayi，Malayi和Accra以及加纳的Navrongo的影响的一部分进行比较来验证和完善模型的预测。这些项目将提高我们对轮状病毒的基本传输动态如何影响发展中国家的预期直接和间接影响的理解，并将提供一个经过验证的平台，以将建模分析扩展到其他国家，以提供基于证据的轮状病毒疫苗的支持。