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This study aimed to assess the costs and clinical benefits of the 13-valent pneumococcal conjugate vaccine (PCV13) administered annually to the 65-year-old cohort in Spain versus the alternative of not vaccinating patients and treating them only when infected.
Cases of pneumococcal disease avoided were calculated through a dynamic model based on the work of Anderson and May (1999). Sixty-six percent of the 65-year-old cohort was assumed to have been vaccinated with one PCV13 dose (304,492 subjects). Base-case estimated vaccine effectiveness and serotype coverage were 58% and 60%, respectively. Disease-related costs were calculated based on published data.
Over the 5-year period, a total of 125,906 cases of pneumococcal disease would be avoided. Net savings of €102 million would be obtained. The cost-saving distribution was not homogeneous, starting in the 2nd year and increasing through the 5th. To demonstrate model robustness, an additional scenario analysis was performed using extreme values of model parameters (vaccination programme coverage, vaccine effectiveness, discount rate and disease costs). Under those scenarios, net savings were always achieved.
Based on the assumptions of the model, the 65-year-cohort pneumococcal vaccination campaign appears to be a cost-saving intervention in the Spanish population under different scenarios.
Budget impact analysis of a pneumococcal vaccination programme in the 65-year-old Spanish cohort using a dynamic model
Roberto Pradas,corresponding author1 Angel Gil de Miguel,2 Alejandro alvaro,2 Ruth Gil-Prieto,2 Reyes Lorente,1 Cristina Mendez,3 Pablo Guijarro,3 and Fernando AntoNanzas1
Business owners in the Republic of Korea must take part in the workers’ general health examination. However, there have been few formal analyses of the uptake of this examination by employees. In the present study, we examined the rates of participation in medical examinations according to age group, health insurance type, and enterprise size, and then compared these results with those of the national general health screening. Furthermore, we determined the distribution of patients with abnormal results for diabetes and hypertension, and outlined the significance and history of domestic health examinations.
We started by comparing participation rates extracted from the among health examination data of the National Health Insurance Service from 2006-2013 by sex, age, insurance type, and enterprise size of workplace health insurance beneficiaries (i.e., those whose insurance is provided by their workplace). In addition, we analyzed the prevalence rates of abnormal results for hypertension and diabetes, and explored the history and significance of health examinations in the Republic of Korea.
The overall participation rate in the primary health examination in 2006 was 56%, and this increased to 72% in 2013. However, the rates of the secondary screening did not increase much. Among workplace policyholders (i.e., those whose insurance is provided by their workplace), the participation rates of workers in enterprises with less than 50 employees were lower than were those in enterprises with 50 or more employees. Notably, the rates and odds ratios of patients with abnormal results for diabetes and hypertension were relatively high, particularly among those working in smaller enterprises.
Although the workers’ general health examination has been replaced with the national general health screening, it remains necessary to ensure uniform health management services among all workers in the Republic of Korea. This can, in turn, promote occupational health and improve working conditions throughout the Republic of Korea.
National health screening system, Worker's general health examination, National general examination, History of periodic health examination, Participation rate, Hypertension prevalence, Diabetes prevalence, Small enterprise, Health inequality
The current condition of the workers’ general health examination in South Korea: a retrospective study
Young Joong Kang, Jun-Pyo Myong, Huisu Eom, Bowha Choi, Jong Heon Park, and Eun-A L Kimcorresponding author
Cardiovascular diseases (CVDs) are the leading cause of non-communicable disease deaths globally, with hypertension being a major risk factor contributing to CVDs. Blood pressure is a heritable trait, with relatively few genetic studies having been performed in Africans. This study aimed to identify genetic variants associated with variance in systolic (SBP) and diastolic (DBP) blood pressure in black South Africans.
Genotyping was performed using the Metabochip in a subset of participants (mixed sex; median age 17.9) and their adult female caregivers (median age 41.0) from the Birth to Twenty cohort (n = 1947). Data were analysed as a merged dataset (all participants and caregivers together) in GEMMA (v0.94.1) using univariate linear mixed models, incorporating a centered relatedness matrix to account for the relatedness between individuals and with adjustments for age, sex, BMI and principal components of the genotype information.
Association analysis identified regions of interest in the NOS1AP (DBP: rs112468105 – p = 7.18 × 10−5 and SBP: rs4657181 – p = 4.04 × 10−5), MYRF (SBP: rs11230796 – p = 2.16 × 10−7, rs400075 – p = 2.88 × 10−7) and POC1B (SBP: rs770373 – p = 7.05 × 10−5, rs770374 – p = 9.05 × 10−5) genes and some intergenic regions (DACH1|LOC440145 (DBP: rs17240498 – p = 4.91 × 10−6 and SBP: rs17240498 – p = 2.10 × 10−5) and INTS10|LPL (SBP: rs55830938 – p = 1.30 × 10−5, rs73599609 – p = 5.78 × 10−5, rs73667448 – p = 6.86 × 10−5)).
The study provided further insight into the contribution of genetic variants to blood pressure in black South Africans. Future functional and replication studies in larger samples are required to confirm the role of the identified loci in blood pressure regulation and whether or not these variants are African-specific.
Electronic supplementary material
The online version of this article (10.1186/s12920-018-0321-6) contains supplementary material, which is available to authorized users.
Birth to Twenty, black South Africans, blood pressure, genetics, Metabochip
Insights into the genetics of blood pressure in black South African individuals: the Birth to Twenty cohort
Liesl M. Hendry,corresponding author1,2 Venesa Sahibdeen,3 Ananyo Choudhury,2 Shane A. Norris,4 Michele Ramsay,2,3 Zane Lombard,1,3 and of the AWI-Gen study and as members of the H3Africa Consortium