Evaluating the cost-effectiveness of HPV vaccination in Africa: a scoping review for Markov model development

被引：0

作者：

Moses C. Simuyemba ^{[1
]}

Carla Chibwesha ^{[2
]}

Chomba Sinyangwe ^{[3
]}

机构：

[1] University of Zambia School of Public Health,Department of Community and Family Medicine

[2] University of North Carolina Global Women’s Health,undefined

来源：

Discover Health Systems | / 3卷 / 1期

关键词：

HPV vaccine; Markov Model; Cervical cancer; Adolescent girls; Human papilloma virus; Zambia;

D O I：

10.1007/s44250-024-00170-x

中图分类号：

学科分类号：

摘要：

This scoping review synthesized the parameters integral to the cost-effectiveness studies on HPV vaccination programs in Africa, specifically aimed at informing a Markov model for Zambia. Out of an initial pool of 100 articles reviewed from 2010, eight met the stringent inclusion criteria. These studies established HPV vaccination as a cost-effective intervention against cervical cancer across different African contexts. However, the optimal vaccination strategy was found to depend upon varying assumptions, methodologies, and contextual factors such as location, vaccine efficacy, coverage rates, and costs. Some models recognized herd immunity effects, and duration of protection was generally assumed to be lifelong, with an analysis time horizon between 10 to 100 years. In developing a Markov model for the African context, identifying relevant inputs is essential. Despite some limitations, such as inconsistencies in costing perspectives, the reviewed studies provided valuable insights for model parameters. Evidence strongly supports the use of Markov models in assessing HPV vaccination cost-effectiveness, with most studies adhering to the CHEERS checklist guidelines. However, limitations in the current literature include assumptions unreflective of the local context, a focus on vaccinating young girls to the exclusion of boys or older demographics, lack of consideration for all HPV strains in newer vaccines, unattainable assumptions of vaccine coverage, and disregard for the impact of vaccine hesitancy. This review underscores the necessity for further research, particularly in understanding the influence of different modelling assumptions, expanding our comprehension of cost-effectiveness across diverse demographics, HPV strains, and realistic vaccine coverage. A nuanced understanding of these factors can empower the public health community to better tailor and optimize HPV vaccination strategies in Africa, ultimately curbing the burden of HPV-related diseases.

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