Cost effectiveness of a pentavalent rotavirus vaccine in Oman.

BACKGROUND: Rotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden. We propose to formally assess the potential cost effectiveness of implementing universal vaccination with a pentavalent rotavirus vaccine (RV5) on reducing the health care burden and costs associated with rotavirus gastroenteritis (RGE) in Oman METHODS: A Markov model was used to compare two birth cohorts, including children who were administered the RV5 vaccination versus those who were not, in a hypothetical group of 65,500 children followed for their first 5 years of life in Oman. The efficacy of the vaccine in reducing RGE-related hospitalizations, emergency department (ED) and office visits, and days of parental work loss for children receiving the vaccine was based on the results of the Rotavirus Efficacy and Safety Trial (REST). The outcome of interest was cost per quality-adjusted life year (QALY) gained from health care system and societal perspectives. RESULTS: A universal RV5 vaccination program is projected to reduce, hospitalizations, ED visits, outpatient visits and parental work days lost due to rotavirus infections by 89%, 80%, 67% and 74%, respectively. In the absence of RV5 vaccination, RGE-related societal costs are projected to be 2,023,038 Omani Rial (OMR) (5,259,899 United States dollars [USD]), including 1,338,977 OMR (3,481,340 USD) in direct medical costs. However, with the introduction of RV5, direct medical costs are projected to be 216,646 OMR (563,280 USD). Costs per QALY saved would be 1,140 OMR (2,964 USD) from the health care payer perspective. An RV5 vaccination program would be considered cost saving, from the societal perspective. CONCLUSIONS: Universal RV5 vaccination in Oman is likely to significantly reduce the health care burden and costs associated with rotavirus gastroenteritis and may be cost-effective from the payer perspective and cost saving from the societal perspective.

Dengue epidemiological trend in Oman: a 13-year national surveillance and strategic proposition of imported cases.

Dengue fever has emerged as a major public health problem globally in the past three decades. A 13-year national surveillance data analysis was done to describe the epidemiology and its trend of dengue disease in Oman reported between 2001 and 2013. Laboratory-confirmed dengue virus infections reported were studied retrospectively during the study period. A total of 64 laboratory confirmed cases were reported. All the patients contracted the disease during their visit to South-East Asian countries, hence classified as imported cases. The majority of the cases were reported in the year 2012 (23.4%). The most important clinical characteristics were fever (90.6%), myalgia (35.9%) and rash/petechial rash (20.3%). Thrombocytopenia was seen in 31.2% of the study subjects. The mortality was nearly 4.6% and all other patients made a full recovery. The most effective measure for travellers is taking precautions to avoid mosquito bites.

Epidemiology of invasive pneumococcal infection among hospitalized children aged less than 5 years in Oman.

The objective of this study was to describe the epidemiology of invasive pneumococcal disease (IPD) in Omani children. We retrospectively reviewed cases admitted in children <5 years of age who were admitted in one of 4 tertiary care facilities within the Muscat Governorate. These cases represented nearly 95% of all IPD admissions recorded throughout the country from 1 January 2006 to 31 December 2006. Cases of IPD were identified using the ICD-10 discharge code. Case definition required microbiological confirmation (i.e., isolation of Streptococcus pneumoniae from blood, cerebrospinal fluid or any other normally sterile biological fluid) or clinical diagnosis in the absence of a specimen. A total of 41 cases of IPD were identified. The annual incidence of IPD was 26.1 per 100,000 in children <2 years old and 18.6 per 100,000 in children <5 years old. Among the reported IPD cases, 22 (54%) isolates were resistant to at least one antibiotic and 15 (37%) of patients had a known comorbid medical condition. These results demonstrate that the incidence of IPD in Oman during 2006 was high compared to many of the neighboring countries and provides baseline data on the incidence of IPD in an era before the introduction of the pneumococcal conjugate vaccine (PCV). In light of evidence for a significant incidence of IPD, we recommended that a nationwide surveillance system be put in place to monitor the incidence of IPD in children <5 years of age in Oman and to document the impact of PCV.