Vaccine
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We present the burden of human papillomavirus (HPV)-related cancers (cancers of the cervix, anogenital areas, and oral cavity and pharynx) in terms of incidence and mortality, for the countries of the Asia Pacific region. The region contains more than half of the world population, and manifests a wide geographic diversity in the prevalence of infection with HPV, and of incidence (and mortality) rates of cancer of the cervix. ⋯ The incidence of other anogenital cancers is low, especially in Asian populations; however, cancers of the mouth and pharynx show a wide range of rates, determined by exposures such as oral tobacco and alcohol and for cancer of the lip, ultraviolet radiation. We also present the estimates of the occurence of genital warts--largely caused by HPV 6 and 11--and the HPV type distribution in the spectrum of women with normal cytology, cervical lesions, and cervical cancer in the region.
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Randomized Controlled Trial Multicenter Study
Phase I and II randomised trials of the safety and immunogenicity of a prototype adjuvanted inactivated split-virus influenza A (H5N1) vaccine in healthy adults.
The primary objective was to evaluate the safety and immunogenicity of a prototype inactivated, split-virus H5N1 (avian influenza A) vaccine. A secondary objective was to assess the cross-reactivity of immune responses to two variant clade 2 H5N1 strains. ⋯ CSL Limited, Australia].
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The risk of dying from cervical cancer is disproportionately borne by women in developing countries. Two new vaccines are highly effective in preventing HPV 16,18 infection, responsible for approximately 70% of cervical cancer, in girls not previously infected. The GAVI Alliance (GAVI) provides technical assistance and financial support for immunization in the world's poorest countries. ⋯ Taking into account country-specific assumptions (per capita GNI, DPT3 coverage, percentage of girls who are enrolled in fifth grade) for the year of introduction, percent coverage achieved in the first year, and years to maximum coverage, a 10-year modeled scenario prevented the future deaths of approximately 2 million women vaccinated as adolescents. Despite favorable cost-effectiveness, assessment of financial costs raised concerns about affordability; as the cost per vaccinated girl was increased from I$10 to I$25 (approximately $2 to $5 per dose), the financial costs for the 10-year scenario increased from >US$ 900 million to US$ 2.25 billion. Provided high coverage of young adolescent girls is feasible, and vaccine costs are lowered, HPV 16,18 vaccination could be very cost-effective even in the poorest countries, and provide comparable value for resources to other new vaccines such as rotavirus.
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Using mathematical models of cervical cancer for the northern and southern regions of Vietnam, we assessed the cost-effectiveness of cervical cancer prevention strategies and the tradeoffs between a national and region-based policy in Vietnam. With 70% vaccination and screening coverage, lifetime risk of cancer was reduced by 20.4-76.1% with vaccination of pre-adolescent girls and/or screening of older women. ⋯ When optimal policies differed between regions, implementing a national strategy resulted in health and economic inefficiencies. HPV vaccination appears to be an attractive cervical cancer prevention strategy for Vietnam, provided high coverage can be achieved in young pre-adolescent girls, cost per vaccinated girl is
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This study evaluated the physician compliance with tetanus prophylaxis and immunization practices for patients with wounds attending Emergency Departments (EDs) of four randomly selected non-academic acute care public hospitals in Italy. ⋯ Health policies and programs should be aimed at improving the quality of health care.