Contributor : Mahidol-Oxford Tropical Medicine Research Unit (MORU)

This study aims to determine the cost utility of introducing typhoid vaccines (Ty21a, ViPS and TCV) compared to no vaccination in Lao PDR and to estimate the financial impact of implementing typhoid vaccination in Lao PDR.

Typhoid fever is an important cause of community-acquired bacteremia and highly endemic in Sub Saharan Africa and South and South-East Asia. In Lao PDR the occurrence of typhoid fever is not well documented. Therefore, determining the national and local incidence still remains challenging. Over 18 years period, from 2010 to May 2019, the annual typhoid cases and deaths were reported from Vientiane and 5 provinces (covering 36.64 % of the total population) found the declining trend of both typhoid incidence 3,975 cases and death, 2 to 6 death per year. In Laos PDR, the typhoid vaccine is currently not part of the national immunization program. Despite these challenges in data availability, Laos officials are currently considering introducing typhoid vaccination throughout the country in the coming years.

A model-based economic evaluation will be performed to estimate the costs and health outcomes utility of introducing different typhoid vaccination strategies combined from three available typhoid vaccines in different age group compared to no vaccination in Lao PDR.

1. To move towards evidence-informed and procedurally fair priority setting in healthcare in lower and middle-income countries
2. To assess the political and technical pitfalls that may get in the way of healthcare priority setting, and consider how they might be overcome;
3. To set a tone and approach to discussion of these issues that creates a basis for collaborative problem-solving in the future.