title: Costs of Neisseria meningitidis Group A Disease and Economic Impact of Vaccination in Burkina Faso.
abstract: BACKGROUND
  Five years since the successful introduction of MenAfriVac in a mass vaccination campaign targeting 1- to 29-year-olds in Burkina Faso, consideration must be given to the optimal strategies for sustaining population protection. This study aims to estimate the economic impact of a range of vaccination strategies in Burkina Faso.
  
  
  METHODS
  We performed a cost-of-illness study, comparing different vaccination scenarios in terms of costs to both households and health systems over a 26-year time horizon. These scenarios are (1) reactive vaccination campaign (baseline comparator); (2) preventive vaccination campaign; (3) routine immunization at 9 months; and (4) a combination of routine and an initial catchup campaign of children under 5. Costs were estimated from a literature review, which included unpublished programmatic documents and peer-reviewed publications. The future disease burden for each vaccination strategy was predicted using a dynamic transmission model of group A Neisseria meningitidis.
  
  
  RESULTS
  From 2010 to 2014, the total costs associated with the preventive campaign targeting 1- to 29-year-olds with MenAfriVac were similar to the estimated costs of the reactive vaccination strategy (approximately 10 million US dollars [USD]). Between 2015 and 2035, routine immunization with or without a catch-up campaign of 1- to 4-year-olds is cost saving compared with the reactive strategy, both with and without discounting costs and cases. Most of the savings are accrued from lower costs of case management and household costs resulting from a lower burden of disease. After the initial investment in the preventive strategy, 1 USD invested in the routine strategy saves an additional 1.3 USD compared to the reactive strategy.
  
  
  CONCLUSIONS
  Prevention strategies using MenAfriVac will be significantly cost saving in Burkina Faso, both for the health system and for households, compared with the reactive strategy. This will protect households from catastrophic expenditures and increase the development capacity of the population.
authors.affiliation: Independent Consultant, World Health Organization Initiative for Vaccine Research, Geneva, Switzerland.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Colombini
authors.affiliation: Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, United Kingdom.
authors.forename: Caroline
authors.initials: C
authors.lastname: Trotter
authors.affiliation: Independent Consultant.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Madrid
authors.affiliation: Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, United Kingdom.
authors.forename: Andromachi
authors.initials: A
authors.lastname: Karachaliou
authors.affiliation: Meningitis Vaccine Project, Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland Meningitis Vaccine Project, PATH, Ferney-Voltaire, France.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Preziosi
mesh_terms: D000293:Adolescent; D000328:Adult; D002050:Burkina Faso; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D022401:Meningococcal Vaccines / Q000008:administration & dosage / Q000191:economics*; D038381:Neisseria meningitidis, Serogroup A / Q000302:isolation & purification*; D014611:Vaccination / Q000191:economics*; D055815:Young Adult
chemical_list: C573970:MenAfriVac; D022401:Meningococcal Vaccines
keywords: Burkina Faso; case management; economic impact; meningitis; vaccination