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Meta-Analysis
. 2019 Apr 17;37(17):2311-2321.
doi: 10.1016/j.vaccine.2019.02.026. Epub 2019 Mar 19.

A systematic review of vaccine preventable disease surveillance cost studies

Ngozi Adaeze Erondu  1 , Lisa Ferland  2 , Betiel Hadgu Haile  2 , Taiwo Abimbola  3
Affiliations
Meta-Analysis

A systematic review of vaccine preventable disease surveillance cost studies

Ngozi Adaeze Erondu et al. Vaccine. .

Abstract

Background: Planning and monitoring vaccine introduction and effectiveness relies on strong vaccine-preventable disease (VPD) surveillance. In low and middle-income countries (LMICs) especially, cost is a commonly reported barrier to VPD surveillance system maintenance and performance; however, it is rarely calculated or assessed. This review describes and compares studies on the availability of cost information for VPD surveillance systems in LMICs to facilitate the design of future cost studies of VPD surveillance.

Methods: PubMed, Web of Science, and EconLit were used to identify peer-reviewed articles and Google was searched for relevant grey literature. Studies selected described characteristics and results of VPD surveillance systems cost studies performed in LMICs. Studies were categorized according to the type of VPD surveillance system, study aim, the annual cost of the system, and per capita costs.

Results: Eleven studies were identified that assessed the cost of VPD surveillance systems. The studies assessed systems from six low-income countries, two low-middle-income countries, and three middle-income countries. The majority of the studies (n = 7) were conducted in sub-Saharan Africa and fifteen distinct VPD surveillance systems were assessed across the studies. Most studies aimed to estimate incremental costs of additional surveillance components and presented VPD surveillance system costs as mean annual costs per resource category, health structure level, and by VPD surveillance activity. Staff time/personnel cost represents the largest cost driver, ranging from 21% to 61% of total VPD surveillance system costs across nine studies identifying a cost driver.

Conclusions: This review provides a starting point to guide LMICs to invest and advocate for more robust VPD surveillance systems. Critical gaps were identified including limited information on the cost of laboratory surveillance, challenges with costing shared resources, and missing data on capital costs. Appropriate guidance is needed to guide LMICs conducting studies on VPD surveillance system costs.

Keywords: Cost analysis; Low income; Middle income; Public health surveillance; Systematic review; Vaccine preventable diseases.

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Conflict of interest statement

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
PRISMA Flow chart for selection of included studies.
See this image and copyright information in PMC

References

    1. Butler D Disease surveillance needs a revolution Available from:. Nature 2006;440(7080):6–7. 10.1038/440006a. - DOI - PubMed
    1. World Health Organization. Strengthening immunization to achieve the goals of the global vaccine action plan draft resolution from the The Seventieth World Health Assembly. A70/A/CONF./1 2017 Available from: <http://apps.who.int/gb/ebwha/pdf_files/WHA70/A70_ACONF1-en.pdf?ua=1&ua=1>.
    1. Herida M, Dervaux B, Desenclos J-C. Economic Evaluations of public health surveillance systems: a systematic review Available from. Eur J Public Health 2016;26(4):674–80. https://academic.oup.com/eurpub/article-lookup/doi/10.1093/eurpub/ckv250. - DOI - PMC - PubMed
    1. Tandon A, Cashin C. Assessing public expenditure on health from a fiscal space perspective HNP discussion paper; 2010. [cited 2018 Oct 1]. Available from: <www.worldbank.org/hnppublications>.
    1. Thacker SB, Berkelman RL. Public health surveillance in the United States Available from. Epidemiol Rev 1988;10:164–90. http://www.ncbi.nlm.nih.gov/pubmed/3066626. - PubMed

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