The use of typhoid vaccines in Asia: the DOMI experience.
BACKGROUND
Two currently licensed typhoid vaccines have been evaluated in Asia, yet few Asian countries have considered including typhoid vaccines in their vaccination programs. The Diseases of the Most Impoverished (DOMI) Program was initiated to provide evidence to decide on the introduction of typhoid vaccines in Asian countries.


METHODS
The centerpiece of the program is a multidisciplinary demonstration project with Vi vaccine in 5 Asian countries. The project includes epidemiologic, economic, sociobehavioral, and policy studies.


RESULTS
Policy makers want evidence on which to base their vaccine-related decisions. The DOMI Program has provided updated information on the typhoid fever burden at several Asian sites. Cost-of-illness studies found high costs to governments and individuals. Sociobehavioral studies indicated a positive attitude toward typhoid vaccines. The results of the demonstration projects indicate that mass-immunization campaigns are feasible and acceptable.


CONCLUSIONS
The DOMI Program has begun to provide momentum for the evidence-based, rational introduction of typhoid vaccines into the public health programs of several Asian countries.
Ochiai
R Leon
RL
International Vaccine Institute, Kwanak-gu, Seoul, Korea. rlochiai@ivi.int
Acosta
Camilo J
CJ
Agtini
Magdarina
M
Bhattacharya
Sujit K
SK
Bhutta
Zulfiqar A
ZA
Do
Canh Gia
CG
Dong
Baiqing
B
Chen
Xinguang
X
Stanton
Bonita
B
Kaljee
Linda
L
Nyamete
Andrew
A
Galindo
Claudia M
CM
von Seidlein
Lorenz
L
DeRoeck
Denise
D
Jodar
Luis
L
Clemens
John D
JD
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001208:Asia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003906:Developing Countries; D004334:Drug Administration Schedule; D016021:Epidemiologic Studies; D019317:Evidence-Based Medicine; D006291:Health Policy; D006801:Humans; D017589:Immunization Programs; D032541:Mass Vaccination; D008875:Middle Aged; D011135:Polysaccharides, Bacterial / Q000008:administration & dosage*; D011204:Poverty Areas; D011446:Prospective Studies; D014435:Typhoid Fever / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D014436:Typhoid-Paratyphoid Vaccines / Q000008:administration & dosage*; D014613:Vaccines, Attenuated; D003313:Zea mays
D011135:Polysaccharides, Bacterial; D014436:Typhoid-Paratyphoid Vaccines; D014613:Vaccines, Attenuated; C057664:Vi polysaccharide vaccine, typhoid