UNASSIGNED: PubMed and Scopus were searched to identify relevant studies from inception up to May 2021 using topic-specific key words in various combinaiton. Full EE studies comparing HAV vaccination to no vaccine or immunoglobulin were included. The risk of bias was assessed by using the ECOBIAS checklist.
UNASSIGNED: Among the 1984 identified studies, 43 were found eligible. Of these, 27 were from high-income countries (HICs), 15 from middle-income countries (MICs), and one from low income country. Majority of the studies used Markov model and/or decision tree (n=26). Eight studies used a dynamic model. The discount rate, perspective and time horizon varied across the studies. Universal HAV vaccination without screening was cost-effective among children (14/16, 87.5%) and adolescents (1/5, 20%) but not in adults (0/4, 0%). Analysis by the level of income found that universal HAV vaccination among children without screening was cost-effective in 81.8 per cent of the studies conducted in MICs (9/11) as compared to 66.7 per cent in HICs (4/6). About one-third of the studies conducted among children found that screening and HAV vaccination were cost-effective compared to no vaccination.
UNASSIGNED: The finding of this review suggest that universal vaccination of children without screening was likely to be cost-effective, especially in MICs. Nevertheless, it should be noted that the methodology varied across studies. Several aspects should also be considered in transferring the EE results across jurisdictions.
UNASSIGNED:对PubMed和Scopus进行了搜索,以使用各种组合中特定主题的关键词来确定从开始到2021年5月的相关研究。包括将HAV疫苗接种与无疫苗或免疫球蛋白进行比较的完整EE研究。使用ECOBIAS检查表评估偏倚风险。
未经批准:在1984年确定的研究中,有43人符合条件。其中,27人来自高收入国家(HIC),15个来自中等收入国家(MICs),还有一个来自低收入国家。大多数研究使用马尔可夫模型和/或决策树(n=26)。八项研究使用了动态模型。贴现率,不同的研究视角和时间范围各不相同。在儿童(14/16,87.5%)和青少年(1/5,20%)中没有筛查的普及HAV疫苗接种具有成本效益,但在成人(0/4,0%)中没有。按收入水平进行的分析发现,在中等收入国家(9/11)中进行的研究中,81.8%的儿童在没有筛查的情况下普遍接种HAV疫苗具有成本效益,而在中等收入国家中,这一比例为66.7%(4/6)。在儿童中进行的研究中约有三分之一发现,与不接种疫苗相比,筛查和HAV疫苗具有成本效益。
UNASSIGNED:这项审查的发现表明,没有筛查的儿童普遍接种疫苗可能具有成本效益,尤其是中等收入国家。然而,应该指出的是,研究的方法各不相同。在跨司法管辖区转移EE结果时,还应考虑几个方面。