BACKGROUND: Rotavirus is among the leading causes of severe gastroenteritis in children. Effective vaccines enable universal mass vaccination (UMV) which incurs high expenditure and therefore economic justification is needed.

OBJECTIVE: This study aimed to evaluate the cost-effectiveness of UMV with Rotarix ® versus no vaccination program in the Philippines.

METHODS: A four-state decision tree model was used to estimate costs and health outcomes subject to annual discount rate of 3.5% Local and international published data and experts opinions were used for epidemiology, efficacy and resource use input parameters. Analyses were reported as estimated total costs, quality adjusted life years (QALYs) gained, and incremental cost-effectiveness ratio (ICER) in Philippines Peso (PHP) per QALY gained between rotavirus UMV and no vaccination.

RESULTS: From a payer (societal) perspective, the ICER is PHP 12, 835/QALY (PHP12,059/QALY). Sensitivity analyses showed the ICERs below PHP 80,000/QALY, well below 1 time 2012 GDP per capita at PHP 103,366 with the main drivers of uncertainty being the probabilities of mild and moderate diarrhoea and vaccine costs

CONCLUSION: Rotavirus UMV reduces both health and economic burden of rotavirus induced gastroenteritis. Based on the WHO's recommended thresholds, Rotarix® vaccination is projected to be very cost-effective in the Philippines in comparison with no vaccination.

Human ; Child Preschool ; Infant ; Cost-Benefit Analysis ; Vaccination ; Rotavirus ; viruses ; Gastroenteritis ; Rotavirus Vaccines ; Viral Vaccines

We report 13 children fulfilling criteria of Alagille syndrome. All had chronic cholestasis secondary to paucity of intrahepatic bile ducts and triangular facies. Eight children had associated congenital heart disease (six pulmonic stenosis, one each tetralogy of Fallot and patent ductus arteriosus), seven with butterfly vertebrae and one with posterior embryotoxon. Seven of the 13 children are alive and jaundice-free but three with concomitant hypercholesterolemia; the six other children died of liver-related complications.
Butterflies ; Bile Ducts, Intrahepatic ; Jaundice ; Musculoskeletal Abnormalities ; Spine

Purpose: The present international survey among healthcare providers aimed to collect data on theoretical knowledge and clinical practices in the diagnosis and management of cow’s milk protein allergy (CMPA) and lactose intolerance (LI) in infants. Methods: A global survey was conducted in several countries with diverse health care settings. The survey consisted of multiple-choice questions in 3 main domains: (1) understanding and clinical practices around CMPA and LI; (2) case scenarios; and (3) diseasespecific knowledge and potential educational needs. Results: Responses were available from 1,663 participants. About 62% of respondents were general practitioners or general pediatricians, and the remainder were pediatric allergists/ gastroenterologists (18%) or other health practitioners (20%). The survey identified knowledge gaps regarding the types of CMPA (IgE-mediated vs. non-IgE-mediated) and the clinical overlap with LI. The survey suggested diverse clinical practices regarding the use of hypoallergenic formulas, as well as misconceptions about the prebiotic benefits of lactose in extensively hydrolyzed formulas in non-breastfed infants with CMPA. Responses to the two case scenarios highlighted varying levels of awareness of the relevant clinical practice guidelines. While respondents generally felt confident in managing infants with CMPA and LI, about 80% expressed an interest for further training in this area. Conclusion The current survey identified some knowledge gaps and regional differences in the management of infants with CMPA or LI. Local educational activities among general and pediatric healthcare providers may increase the awareness of clinical practice guidelines for the diagnosis and treatment of both conditions and help improve clinical outcomes.

In this double-blind, randomized single-dose study, 194 healthy Filipino children aged 12-24 months were randomized into three groups (1:1:1) to receive one of the three lots of live-attenuated measles-mumps-rubella (MMR) vaccine to assess lot-to-lot consistency in safety and immunogenicity. Adverse events were recorded during 43-day post-vaccination follow-up period. Antibody levels were measured using ELISA pre-vaccination and on Day-60. No statistically significant differences were observed across groups for overall incidences of local and general symptoms (p>0.05) or immune response rates against the three antigens (p=0.835, 0.458 and 0.222 for anti-measles, anti-mumps and anti-rubella, respectively). The three lots demonstrated consistency in their reactogenicity and immunogenicity profile.
Human ; Male ; Female ; Infant ; MEASLES-MUMPS-RUBELLA VACCINE ; ENZYME-LINKED IMMUNOSORBENT ASSAY