ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization, 2001. Introduction of Hepatitis B Vaccine into Childhood Immunization Services. Geneva, Switzerland: WHO.
-
2.
Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP, 2006. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 45: 529–538.
-
3.
Goldstein ST, Zhou F, Hadler SC, Bell BP, Mast EE, Margolis HS, 2005. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol 34: 1329–1339.
-
4.
Van Damme P, Ward J, Shouval D, Wiersma S, Zanetti A, 2013. Hepatitis B Vaccines. Plotkin SA, Orenstein WA, Offit PA, Edwards KM, eds. Vaccines. Philadelphia, PA: Elsevier, 205–234.
-
5.
World Health Organization, 2017. Hepatitis B vaccines: WHO position paper–July 2017. Wkly Epidemiol Rec 92: 369–392.
-
6.
Gavi, Sao Tome and Principe country fact sheet. Available at: http://www.gavi.org/country/sao-tome-and-principe/. Accessed July 3, 2016.
-
7.
Instituto Nacional de Estatística de São Tomé e Príncipe (INE), Ministério da Saúde de São Tomé e Príncipe, Macro Health, 2010. Inquérito Demográfico e Sanitário, São Tomé e Príncipe (IDS STP) 2008–2009. Calverton, MD: INE.
-
8.
World Health Organization, UNICEF. WHO-UNICEF Estimate of HepB-BD Coverage. Available at: http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tswucoveragehepb_bd.html. Accessed January 1, 2016.
-
9.
Programa das Nações Unidas para o Desenvolvimento - PNUD/São Tomé e Príncipe, and ICF Macro, 2015. Resultados dos Biomarcadores do Inquérito de Indicadores Múltiplos (MICS) São Tomé e Príncipe 2014. São Tomé, São Tomé e Príncipe: PNUD/São Tomé e Príncipe and ICF Macro.
-
10.
Team RC, 2014. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing.
-
11.
Lien TX, Tien NT, Chanpong GF, Cuc CT, Yen VT, Soderquist R, Laras K, Corwin A, 2000. Evaluation of rapid diagnostic tests for the detection of human immunodeficiency virus types 1 and 2, hepatitis B surface antigen, and syphilis in Ho Chi Minh City, Vietnam. Am J Trop Med Hyg 62: 301–309.
-
12.
Lawn JE et al. 2016. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet 387: 587–603.
-
13.
Ekra D, Herbinger KH, Konate S, Leblond A, Fretz C, Cilote V, Douai C, Da Silva A, Gessner BD, Chauvin P, 2008. A non-randomized vaccine effectiveness trial of accelerated infant hepatitis B immunization schedules with a first dose at birth or age 6 weeks in Cote d’Ivoire. Vaccine 26: 2753–2761.
-
14.
Shivkumar S, Peeling R, Jafari Y, Joseph L, Pai NP, 2012. Rapid point-of-care first-line screening tests for hepatitis B infection: a meta-analysis of diagnostic accuracy (1980–2010). Am J Gastroenterol 107: 1306–1313.
-
15.
Edmunds WJ, Medley GF, Nokes DJ, O’Callaghan CJ, Whittle HC, Hall AJ, 1996. Epidemiological patterns of hepatitis B virus (HBV) in highly endemic areas. Epidemiol Infect 117: 313–325.
-
16.
Margolis HS, Coleman PJ, Brown RE, Mast EE, Sheingold SH, Arevalo JA, 1995. Prevention of hepatitis B virus transmission by immunization. An economic analysis of current recommendations. JAMA 274: 1201–1208.
-
17.
Beasley RP, Hwang LY, Lin CC, Chien CS, 1981. Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22 707 men in Taiwan. Lancet 2: 1129–1133.
-
18.
Harvard T.H. Chan School of Public Health–Center for Health Decision Sciences, 2015. 3. Original EPIC-1 Data Source: Harvard Dataverse. Cambridge, MA: Chan School of Public Health–Center for Health Decision Sciences.
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19.
Schackman BR, Neukermans CP, Fontain SN, Nolte C, Joseph P, Pape JW, Fitzgerald DW, 2007. Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti. PLoS Med 4: e183.
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20.
Kuznik A, Lamorde M, Nyabigambo A, Manabe YC, 2013. Antenatal syphilis screening using point-of-care testing in sub-Saharan African countries: a cost-effectiveness analysis. PLoS Med 10: e1001545.
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21.
Ott JJ, Stevens GA, Wiersma ST, 2012. The risk of perinatal hepatitis B virus transmission: hepatitis B e antigen (HBeAg) prevalence estimates for all world regions. BMC Infect Dis 12: 131.
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22.
Beasley RP, Trepo C, Stevens CE, Szmuness W, 1977. The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol 105: 94–98.
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23.
de Franchis R et al. EASL Jury, 2003. EASL international consensus conference on hepatitis B. 13–14 september, 2002 Geneva, Switzerland. Consensus statement (long version). J Hepatol 39 (Suppl 1): S3–S25.
-
24.
Griffiths UK, Hutton G, Das Dores Pascoal E, 2005. The cost-effectiveness of introducing hepatitis B vaccine into infant immunization services in Mozambique. Health Policy Plan 20: 50–59.
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25.
Klingler C, Thoumi AI, Mrithinjayam VS, 2012. Cost-effectiveness analysis of an additional birth dose of Hepatitis B vaccine to prevent perinatal transmission in a medical setting in Mozambique. Vaccine 31: 252–259.
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26.
UNICEF, 2018. UNICEF Vaccine Price Data. Available at: http://www.unicef.org/supply/index_57476.html. Accessed November 14, 2018.
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27.
Griffiths UK, Korczak VS, Ayalew D, Yigzaw A, 2009. Incremental system costs of introducing combined DTwP-hepatitis B-Hib vaccine into national immunization services in Ethiopia. Vaccine 27: 1426–1432.
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28.
Malcolm D, Roseboom J, Clark C, 1959. Application of a technique for research and development program evaluation. Operations Res 7: 646–669.
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29.
World Health Organization, 1996. Hepatitis B and Breastfeeding. Geneva, Switzerland: WHO.
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Shillcutt SD, Walker DG, Goodman CA, Mills AJ, 2019. Cost effectiveness in low-and middle-income countries a review of the debates surrounding decision rules. Pharmacoeconomics 27: 903–917.
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World Bank. Open Data Catalogue. Available at: http://data.worldbank.org/. Accessed January 1, 2016.
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32.
World Bank, 2014. GDP Per Capita, PPP (Current International $) International Comparison Database. Available at: http://data.worldbank.org/indicator/NY.GDP.PCAP.PP.CD?locations=BJCIST. Accessed June 1, 2016.
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33.
Borresen ML, Koch A, Biggar RJ, Ladefoged K, Melbye M, Wohlfahrt J, Krause TG, 2012. Effectiveness of the targeted hepatitis B vaccination program in Greenland. Am J Public Health 102: 277–284.
-
34.
Edmond KM, Zandoh C, Quigley MA, Amenga-Etego S, Owusu-Agyei S, Kirkwood BR, 2006. Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics 117: e380–e386.
-
35.
Schillie S, Vellozzi C, Reingold A, Harris A, Haber P, Ward JW, Nelson NP, 2018. Prevention of hepatitis B virus infection in the United States: recommendations of the advisory committee on immunization practices. MMWR Recomm Rep 67: 1–31.
-
36.
Chen SC, Toy M, Yeh JM, Wang JD, Resch S, 2013. Cost-effectiveness of augmenting universal hepatitis B vaccination with immunoglobin treatment. Pediatrics 131: e1135–e1143.
-
37.
World Health Organization, 2018. Implementation of hepatitis B birth dose vaccination–worldwide, 2016. Wkly Epidemiol Rec 93: 61–72.
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38.
World Health Organization, 2017. Global Health Sector Strategy on Viral Hepatitis 2016–2021. Geneva, Switzerland: WHO.
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39.
Gavi, 2019. Gavi Board Starts Framing Alliance’s Approach to 2021–2025 Period. Geneva, Switzerland: Gavi.
-
40.
Nayagam S, Thursz M, Sicuri E, Conteh L, Wiktor S, Low-Beer D, Hallett TB, 2016. Requirements for global elimination of hepatitis B: a modelling study. Lancet Infect Dis 16: 1399–1408.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 880 | 578 | 10 |
| Full Text Views | 768 | 15 | 0 |
| PDF Downloads | 320 | 15 | 0 |
Selective Hepatitis B Birth-Dose Vaccination in São Tomé and Príncipe: A Program Assessment and Cost-Effectiveness Study
José E. Hagan
José E. Hagan
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia;
Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Elizabeth Carvalho
Elizabeth Carvalho
São Tomé and Príncipe Ministry of Health, São Tomé, São Tomé and Príncipe;
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Vladimir Souza
Vladimir Souza
São Tomé and Príncipe Ministry of Health, São Tomé, São Tomé and Príncipe;
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Maria Queresma dos Anjos
Maria Queresma dos Anjos
São Tomé and Príncipe Country Office, World Health Organization, São Tomé, São Tomé and Príncipe;
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Taiwo O. Abimbola
Taiwo O. Abimbola
Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Sarah W. Pallas
Sarah W. Pallas
Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia;
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M. Carole Tevi Benissan
M. Carole Tevi Benissan
Regional Office for Africa, World Health Organization, Brazzaville, Congo;
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Stephanie Shendale
Stephanie Shendale
Expanded Programme on Immunizations, World Health Organization, Geneva, Switzerland
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Karen Hennessey
Karen Hennessey
Expanded Programme on Immunizations, World Health Organization, Geneva, Switzerland
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Minal K. Patel
Minal K. Patel
Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia;
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São Tomé and Príncipe (STP) uses a selective hepatitis B birth-dose vaccination (HepB-BD) strategy targeting infants born to mothers who test positive for hepatitis B virus (HBV) surface antigen. We conducted a field assessment and economic analysis of the HepB-BD strategy to provide evidence to guide development of cost-effective policies to prevent perinatal HBV transmission in STP. We interviewed national stakeholders and key informants to understand policies, knowledge, and practices related to HepB-BD, vaccine management, and data recording/reporting. Cost-effectiveness of the existing strategy was compared with an alternate approach of universal HepB-BD to all newborns using a decision analytic model. Incremental cost-effectiveness ratios (ICERs) were calculated in 2015 USD per HBV-associated death and per chronic HBV case prevented, from the STP health-care system perspective. We found that STP lacked national or facility-specific written policies and procedures related to HepB-BD. Timely HepB-BD to eligible newborns was considered a high priority, although timeliness of HepB-BD was not monitored. Compared with the existing selective vaccination strategy, universal HepB-BD would result in a 19% decrease in chronic HBV infections per year at overall cost savings of approximately 44% (savings of USD 5,441 each year). We estimate an ICER of USD 5,012 saved per HBV-associated death averted. The existing selective HepB-BD strategy in STP could be improved through documentation of policies, procedures, and timeliness of HepB-BD. Expansion to universal newborn HepB-BD without maternal screening is feasible and could result in cost savings if actual implementation costs and effectiveness fall within the ranges modeled.
Author Notes
Financial support: This study was funded by the Centers for Disease Control and Prevention and by the World Health Organization.
Authors’ addresses: José E. Hagan, Taiwo O. Abimbola, Sarah W. Pallas, and Minal K. Patel, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: esp3@cdc.gov, iip2@cdc.gov, xgx4@cdc.gov, and hgo9@cdc.gov. Elizabeth Carvalho and Vladimir Souza, São Tomé and Príncipe Ministry of Health, São Tomé, São Tomé and Príncipe, E-mails: bethmaria74@lotuail.com and vladimirsousa-@hotmail.com. Maria Queresma dos Anjos, World Health Organization, Luanda, Angola, E-mail: quaresmam@who.int. M. Carole Tevi Benissan and Stephanie Shendale, Expanded Programme on Immunizations, World Health Organization, Geneva, Switzerland, E-mails: tevibenissanc@who.int and shendales@who.int. Karen Hennessey, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: keh7@cdc.gov.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization, 2001. Introduction of Hepatitis B Vaccine into Childhood Immunization Services. Geneva, Switzerland: WHO.
-
2.
Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP, 2006. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 45: 529–538.
-
3.
Goldstein ST, Zhou F, Hadler SC, Bell BP, Mast EE, Margolis HS, 2005. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol 34: 1329–1339.
-
4.
Van Damme P, Ward J, Shouval D, Wiersma S, Zanetti A, 2013. Hepatitis B Vaccines. Plotkin SA, Orenstein WA, Offit PA, Edwards KM, eds. Vaccines. Philadelphia, PA: Elsevier, 205–234.
-
5.
World Health Organization, 2017. Hepatitis B vaccines: WHO position paper–July 2017. Wkly Epidemiol Rec 92: 369–392.
-
6.
Gavi, Sao Tome and Principe country fact sheet. Available at: http://www.gavi.org/country/sao-tome-and-principe/. Accessed July 3, 2016.
-
7.
Instituto Nacional de Estatística de São Tomé e Príncipe (INE), Ministério da Saúde de São Tomé e Príncipe, Macro Health, 2010. Inquérito Demográfico e Sanitário, São Tomé e Príncipe (IDS STP) 2008–2009. Calverton, MD: INE.
-
8.
World Health Organization, UNICEF. WHO-UNICEF Estimate of HepB-BD Coverage. Available at: http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tswucoveragehepb_bd.html. Accessed January 1, 2016.
-
9.
Programa das Nações Unidas para o Desenvolvimento - PNUD/São Tomé e Príncipe, and ICF Macro, 2015. Resultados dos Biomarcadores do Inquérito de Indicadores Múltiplos (MICS) São Tomé e Príncipe 2014. São Tomé, São Tomé e Príncipe: PNUD/São Tomé e Príncipe and ICF Macro.
-
10.
Team RC, 2014. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing.
-
11.
Lien TX, Tien NT, Chanpong GF, Cuc CT, Yen VT, Soderquist R, Laras K, Corwin A, 2000. Evaluation of rapid diagnostic tests for the detection of human immunodeficiency virus types 1 and 2, hepatitis B surface antigen, and syphilis in Ho Chi Minh City, Vietnam. Am J Trop Med Hyg 62: 301–309.
-
12.
Lawn JE et al. 2016. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet 387: 587–603.
-
13.
Ekra D, Herbinger KH, Konate S, Leblond A, Fretz C, Cilote V, Douai C, Da Silva A, Gessner BD, Chauvin P, 2008. A non-randomized vaccine effectiveness trial of accelerated infant hepatitis B immunization schedules with a first dose at birth or age 6 weeks in Cote d’Ivoire. Vaccine 26: 2753–2761.
-
14.
Shivkumar S, Peeling R, Jafari Y, Joseph L, Pai NP, 2012. Rapid point-of-care first-line screening tests for hepatitis B infection: a meta-analysis of diagnostic accuracy (1980–2010). Am J Gastroenterol 107: 1306–1313.
-
15.
Edmunds WJ, Medley GF, Nokes DJ, O’Callaghan CJ, Whittle HC, Hall AJ, 1996. Epidemiological patterns of hepatitis B virus (HBV) in highly endemic areas. Epidemiol Infect 117: 313–325.
-
16.
Margolis HS, Coleman PJ, Brown RE, Mast EE, Sheingold SH, Arevalo JA, 1995. Prevention of hepatitis B virus transmission by immunization. An economic analysis of current recommendations. JAMA 274: 1201–1208.
-
17.
Beasley RP, Hwang LY, Lin CC, Chien CS, 1981. Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22 707 men in Taiwan. Lancet 2: 1129–1133.
-
18.
Harvard T.H. Chan School of Public Health–Center for Health Decision Sciences, 2015. 3. Original EPIC-1 Data Source: Harvard Dataverse. Cambridge, MA: Chan School of Public Health–Center for Health Decision Sciences.
-
19.
Schackman BR, Neukermans CP, Fontain SN, Nolte C, Joseph P, Pape JW, Fitzgerald DW, 2007. Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti. PLoS Med 4: e183.
-
20.
Kuznik A, Lamorde M, Nyabigambo A, Manabe YC, 2013. Antenatal syphilis screening using point-of-care testing in sub-Saharan African countries: a cost-effectiveness analysis. PLoS Med 10: e1001545.
-
21.
Ott JJ, Stevens GA, Wiersma ST, 2012. The risk of perinatal hepatitis B virus transmission: hepatitis B e antigen (HBeAg) prevalence estimates for all world regions. BMC Infect Dis 12: 131.
-
22.
Beasley RP, Trepo C, Stevens CE, Szmuness W, 1977. The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol 105: 94–98.
-
23.
de Franchis R et al. EASL Jury, 2003. EASL international consensus conference on hepatitis B. 13–14 september, 2002 Geneva, Switzerland. Consensus statement (long version). J Hepatol 39 (Suppl 1): S3–S25.
-
24.
Griffiths UK, Hutton G, Das Dores Pascoal E, 2005. The cost-effectiveness of introducing hepatitis B vaccine into infant immunization services in Mozambique. Health Policy Plan 20: 50–59.
-
25.
Klingler C, Thoumi AI, Mrithinjayam VS, 2012. Cost-effectiveness analysis of an additional birth dose of Hepatitis B vaccine to prevent perinatal transmission in a medical setting in Mozambique. Vaccine 31: 252–259.
-
26.
UNICEF, 2018. UNICEF Vaccine Price Data. Available at: http://www.unicef.org/supply/index_57476.html. Accessed November 14, 2018.
-
27.
Griffiths UK, Korczak VS, Ayalew D, Yigzaw A, 2009. Incremental system costs of introducing combined DTwP-hepatitis B-Hib vaccine into national immunization services in Ethiopia. Vaccine 27: 1426–1432.
-
28.
Malcolm D, Roseboom J, Clark C, 1959. Application of a technique for research and development program evaluation. Operations Res 7: 646–669.
-
29.
World Health Organization, 1996. Hepatitis B and Breastfeeding. Geneva, Switzerland: WHO.
-
30.
Shillcutt SD, Walker DG, Goodman CA, Mills AJ, 2019. Cost effectiveness in low-and middle-income countries a review of the debates surrounding decision rules. Pharmacoeconomics 27: 903–917.
-
31.
World Bank. Open Data Catalogue. Available at: http://data.worldbank.org/. Accessed January 1, 2016.
-
32.
World Bank, 2014. GDP Per Capita, PPP (Current International $) International Comparison Database. Available at: http://data.worldbank.org/indicator/NY.GDP.PCAP.PP.CD?locations=BJCIST. Accessed June 1, 2016.
-
33.
Borresen ML, Koch A, Biggar RJ, Ladefoged K, Melbye M, Wohlfahrt J, Krause TG, 2012. Effectiveness of the targeted hepatitis B vaccination program in Greenland. Am J Public Health 102: 277–284.
-
34.
Edmond KM, Zandoh C, Quigley MA, Amenga-Etego S, Owusu-Agyei S, Kirkwood BR, 2006. Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics 117: e380–e386.
-
35.
Schillie S, Vellozzi C, Reingold A, Harris A, Haber P, Ward JW, Nelson NP, 2018. Prevention of hepatitis B virus infection in the United States: recommendations of the advisory committee on immunization practices. MMWR Recomm Rep 67: 1–31.
-
36.
Chen SC, Toy M, Yeh JM, Wang JD, Resch S, 2013. Cost-effectiveness of augmenting universal hepatitis B vaccination with immunoglobin treatment. Pediatrics 131: e1135–e1143.
-
37.
World Health Organization, 2018. Implementation of hepatitis B birth dose vaccination–worldwide, 2016. Wkly Epidemiol Rec 93: 61–72.
-
38.
World Health Organization, 2017. Global Health Sector Strategy on Viral Hepatitis 2016–2021. Geneva, Switzerland: WHO.
-
39.
Gavi, 2019. Gavi Board Starts Framing Alliance’s Approach to 2021–2025 Period. Geneva, Switzerland: Gavi.
-
40.
Nayagam S, Thursz M, Sicuri E, Conteh L, Wiktor S, Low-Beer D, Hallett TB, 2016. Requirements for global elimination of hepatitis B: a modelling study. Lancet Infect Dis 16: 1399–1408.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 880 | 578 | 10 |
| Full Text Views | 768 | 15 | 0 |
| PDF Downloads | 320 | 15 | 0 |