The Knowledge Hub

What is the Knowledge Hub?

Explore the VoICE Knowledge Hub—a searchable database featuring the latest peer-reviewed research on immunization benefits, especially in low- and middle-income countries. Browse the Knowledge Hub using a variety of different filters to find vaccine evidence based on country, region, topic, or disease. Click on a tag to find more evidence on a specific area, such as the return on investment of vaccines or impacts of infectious disease outbreaks.

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During a meningitis outbreak in Burkina Faso, families spent $90 on treatment, causing financial strain and loss of income

During a meningococcal meningitis epidemic in Burkina Faso, households spent, on average, US$90 for treatment and other direct costs for family members with the disease. These costs, the equivalent of one third of the country’s annual GDP per capita, were in addition to the loss of income and assets from family members caring for patients.

Colombini A, Badolo O, Gessner BD et al.. 2011. Costs and impact of meningitis epidemics for the public health system of Burkina Faso. Vaccine. 29(33).

Immunization can prevent costly outbreaks and save money for the healthcare system

A large meningococcal meningitis epidemic in Burkina Faso cost the health system an estimated US$7.1 million, representing nearly 2% of the country’s entire annual health budget.

In this study of a 2007 outbreak, 86% of the health system cost covered a reactive vaccination campaign using older polysaccharide vaccines. Routine vaccination with new, conjugate vaccines are expected to prevent or limit future outbreaks and thus reduce these costs.

Colombini A, Badolo O, Gessner BD et al.. 2011. Cost and impact of meningitis epidemics for the public health system in Burkina Faso. Vaccine. 29.

Meningitis epidemics in Burkina Faso caused major disruptions in healthcare services and increased misdiagnoses

Meningococcal meningitis epidemics in Burkina Faso “… disrupted all health services from national to operational levels,…” according to a 2011 study. Impacts included a shortage of available hospital beds and medicines, a reduction or delay in routine lab analyses for other diseases, longer wait times, and an increase in misdiagnoses by overtaxed health workers.

Colombini A, Badolo O, Gessner BD et al.. 2011. Cost and impact of meningitis epidemics for the public health system in Burkina Faso. Vaccine. 29.

Immunization can prevent costly meningitis outbreaks and protect households from financial burden and lost income

A 2006-07 meningococcal meningitis epidemic in Burkina Faso cost households an average of US$90 for each case of meningitis that occurred. These costs — representing nearly 2.5 months of the average per capita income for that year — included direct and indirect costs of treatment and lost income to caretakers.

Colombini A, Bationo F, Zongo S, et al.. 2009. Costs for households and community perception of meningitis outbreaks in Burkina Faso. Clinical Infectious Disease. 49(10).

Migration can increase measles risk for unvaccinated children

Researchers investigating the causes of a measles outbreak in Burkina Faso that occurred despite a recent mass vaccination campaign found that migration to and from Cote d’Ivoire was a major risk factor for children. Unvaccinated children who developed measles were 8.5x more likely to have recently traveled to Cote d’Ivoire than unvaccinated children who had not traveled across the border. Children returning to Burkina Faso after a period of time in Cote d’Ivoire were less likely to have been vaccinated due to low routine coverage of measles vaccines in Cote d’Ivoire. Conversely, unvaccinated children from Burkina Faso who traveled to Cote d’Ivoire and returned were more likely to be exposed to measles and thus had a higher rate of disease than children who never visited Cote d’Ivoire.

Yameogo, K.R., Perry, R.T., Yameogo, A., et al.. 2005. Migration as a risk factor for measles after a mass vaccination campaign, Burkina Faso, 2002. International Journal of Epidemiology. 34(3).

Vaccines are most cost-effective in low income countries

An analysis of the impact of rotavirus vaccine in 25 countries found that the rates of vaccination in all countries were highest and risk mortality lowest in the top two wealth quintile’s coverage. Countries differed in the relative inequities in these two underlying variables. Cost per DALYs averted in substantially greater in the higher quintiles. In all countries, the greatest potential vaccine benefit was in the poorest quintiles; however, reduced vaccination coverage lowered the projected vaccine benefit.

Rheingans, R., Atherly, D., and Anderson, J.. 2012. Distributional impact of rotavirus vaccination in 25 GAVI countries: Estimating disparities in benefits and cost-effectiveness. Vaccine. 30(1).

Pediatric pneumococcal or Hib meningitis surviviors had a higher likelihood for neuropsychological deficits

In a systematic literature review of studies in Africa, it was found that 25% of children who survived pneumococcal or Hib meningitis had neuropsychological deficits.

Ramakrishnan, M., Ulland, A.J., Steinhardt, L.C., et al. 2009. Sequelae due to bacterial meningitis among African children: a systematic literature review. BMC Medicine. 7(47).

Bacterial meningitis is associated with long-term neurophysiological impacts

A systematic literature review analyzing data from 21 African countries revealed that bacterial meningitis is associated with high case fatality and frequent neurophysiological sequelae. Pneumococcal and Hib meningitis contribute to one third of disease related mortality. They also cause clinically evident sequalae in 25% of survivors prior to hospital discharge. The three main causes of bacterial meningitis- Haemophilus influenzae type B; Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are vaccine preventable, routine use of conjugate vaccines have potential for significant health and economic benefits.

Neuropsychological sequelae includes hearing loss, vision loss, cognitive delay, speech/language disorder, behavioural problems, motor delays/impairment, and seizures.

Ramakrishnan, M., Ulland, A.J., Steinhardt, L.C., et al. 2009. Sequelae due to bacterial meningitis among African children: a systematic literature review. BMC Medicine. 7(47).