标题： 血清状态检测与登革热疫苗成本效益阈值 显示英文标题

标题： Serostatus Testing & Dengue Vaccine Cost-Benefit Thresholds

摘要： 世界卫生组织目前建议在给予唯一获批的登革热疫苗CYD-TDV之前进行既往感染的筛查。 通过边界分析，我们表明尽管额外的检测成本增加，这种做法可以提高CYD-TDV的经济可行性：有效的检测可减少不必要的接种成本，同时增加接种者的健康收益。 当检测成本足够低时，这些趋势会超过额外的筛查成本，并使检测后接种策略在许多情况下具有净收益。 我们使用一种通用方法来确定检测和接种的价格阈值，以及确定常规检测后接种计划的最佳开始和结束年龄。 这种方法只需要年龄特定的血清流行率和二次感染的成本估计。 我们在通常用于评估CYD-TDV经济性的各种环境中展示了这一方法，并强调了我们简单模型对更详细研究的意义。 我们发现，检测后接种策略在较年轻年龄时通常更具益处，而且在某些情况下，多年检测比仅检测一次更有益，尽管需要更多的检测投资。 显示英文摘要

摘要： The World Health Organisation currently recommends pre-screening for past infection prior to administration of the only licensed dengue vaccine, CYD-TDV. Using a bounding analysis, we show that despite additional testing costs, this approach can improve the economic viability of CYD-TDV: effective testing reduces unnecessary vaccination costs while increasing the health benefit for vaccine recipients. When testing is cheap enough, those trends outweigh additional screening costs and make test-then-vaccinate strategies net-beneficial in many settings. We derived these results using a general approach for determining price thresholds for testing and vaccination, as well as indicating optimal start and end ages of routine test-then-vaccinate programs. This approach only requires age-specific seroprevalence and a cost estimate for second infections. We demonstrate this approach across settings commonly used to evaluate CYD-TDV economics, and highlight implications of our simple model for more detailed studies. We found trends showing test-then-vaccinate strategies are generally more beneficial starting at younger ages, and that in some settings multiple years of testing can be more beneficial than only testing once, despite increased investment in testing.