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Dengue fever, caused by the dengue virus (DENV), poses a significant global health threat, with a dramatic increase in cases driven by climate change, urbanization, and mosquito resistance. In Pakistan, a country with a population of 240 million, the world's fifth largest, dengue has emerged as an escalating public health crisis, with seasonal outbreaks severely straining the healthcare system. Despite decades of vector control efforts, there has not been much success, necessitating the introduction of dengue vaccination to boost population immunity. Recent advancements in vaccine development demonstrate promising efficacy and safety profiles, even in dengue-naive individuals. Implementing a dengue vaccination program in Pakistan could significantly reduce the disease burden, lower healthcare costs, and prevent future outbreaks. Integrating vaccination with existing public health initiatives can achieve high coverage and improve overall public health outcomes. [ABSTRACT FROM AUTHOR]

Dengue fever, caused by the dengue virus (DENV), poses a significant global health threat, with a dramatic increase in cases driven by climate change, urbanization, and mosquito resistance. In Pakistan, a country with a population of 240 million, the world’s fifth largest, dengue has emerged as an escalating public health crisis, with seasonal outbreaks severely straining the healthcare system. Despite decades of vector control efforts, there has not been much success, necessitating the introduction of dengue vaccination to boost population immunity. Recent advancements in vaccine development demonstrate promising efficacy and safety profiles, even in dengue-naive individuals. Implementing a dengue vaccination program in Pakistan could significantly reduce the disease burden, lower healthcare costs, and prevent future outbreaks. Integrating vaccination with existing public health initiatives can achieve high coverage and improve overall public health outcomes.

Abstract A mathematical model of Dengue virus transmission between mosquitoes and humans, incorporating a control strategy of imperfect vaccination and vector maturation delay, is proposed in this paper. By using some analytical skills, we obtain the threshold conditions for the global attractiveness of two disease-free equilibria and prove the existence of a positive equilibrium for this model. Further, we investigate the sensitivity analysis of threshold conditions. Additionally, using the Pontryagin maximum principle, we obtain the optimal control strategy for the disease. Finally, numerical simulations are delivered to verify the correctness of the theoretical results, the feasibility of a vaccination control strategy, and the influences of the controlling parameters on the control and elimination of this disease. Theoretical results and numerical simulations show that the vaccination rate and effectiveness of vaccines are two key factors for the control of Dengue spread, and the manufacture of the Dengue vaccine is also architecturally significant.

Objective: This study sets an example of an economic evaluation of a model dengue vaccination strategy for Sri Lanka, following a mandatory pre-vaccination screening strategy.Methods: A decision analytic Markov model was developed to estimate the cost-effectiveness of a predicted dengue vaccination strategy over a time horizon of 10 years. The cost effectiveness of dengue vaccination strategy for seropositive individuals was estimated in terms of incremental cost effectiveness ratio (ICER) (cost per additional quality adjusted life-year [QALY]). District-specific ICER values and the budget impact for dengue vaccine were estimated with appropriate sensitivity analyses, also taking the variability of the pre-vaccination screening test performance into consideration.Results: The ICER for the predicted vaccination strategy following pre-vaccination screening was 4,382 USD/QALY for Sri Lanka. There was a significant regional variation in vaccine cost effectiveness. The disaggregated regional incidence of dengue and the need to perform pre-vaccination screening affects the cost effectiveness estimates significantly, where a safer version of the vaccine has the potential to become cost saving in high incidence districts.Conclusions: The cost effectiveness of the predicted dengue vaccination strategy following pre-vaccination screening showed a significant regional variation across the districts of Sri Lanka. District-wise disease incidence and the need for pre-vaccination screening was found to be the most significant factors affecting the cost effectiveness of the vaccine. [ABSTRACT FROM AUTHOR]

A mathematical model of Dengue virus transmission between mosquitoes and humans, incorporating a control strategy of imperfect vaccination and vector maturation delay, is proposed in this paper. By using some analytical skills, we obtain the threshold conditions for the global attractiveness of two disease-free equilibria and prove the existence of a positive equilibrium for this model. Further, we investigate the sensitivity analysis of threshold conditions. Additionally, using the Pontryagin maximum principle, we obtain the optimal control strategy for the disease. Finally, numerical simulations are delivered to verify the correctness of the theoretical results, the feasibility of a vaccination control strategy, and the influences of the controlling parameters on the control and elimination of this disease. Theoretical results and numerical simulations show that the vaccination rate and effectiveness of vaccines are two key factors for the control of Dengue spread, and the manufacture of the Dengue vaccine is also architecturally significant. [ABSTRACT FROM AUTHOR]

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Background The first dengue vaccine (DV) has been licensed in some countries, but an assessment of the public's acceptance of DV is widely lacking. This study aimed to explore and understand DV acceptance and its associated explanatory variables among healthy inhabitants of Aceh, Indonesia. Methods A community-based cross-sectional survey was conducted from November 2014 to March 2015 in nine regencies of Aceh that were selected randomly. A set of validated questionnaires covering a range of explanatory variables and DV acceptance was used to conduct the interviews. A multi-step logistic regression analysis and Spearman's rank correlation were employed to assess the role of explanatory variables in DV acceptance. Results We included 652 community members in the final analysis and found that 77.3% of them were willing to accept the DV. Gender, monthly income, socioeconomic status (SES), attitude toward dengue fever (DF) and attitude toward vaccination practice were associated with DV acceptance in bivariate analyses ( P < 0.05). A correlation analysis confirmed that attitude toward vaccination practice and attitude toward DF were strongly correlated with DV acceptance, r s = 0.41 and r s = 0.39, respectively ( P < 0.001). The multivariate analysis revealed that a high monthly income, high SES, and a good attitude toward vaccination practice and toward DF were independent predictors of DV acceptance. Conclusion The acceptance rate of the DV among inhabitants of Aceh, Indonesia was relatively high, and the strongest associated factors of higher support for the DV were a good attitude toward vaccination practices and a good attitude toward DF. [ABSTRACT FROM AUTHOR]

Dengue is a major public health concern in tropical and subtropical areas of the world. The prospects for dengue prevention have recently improved with the results of efficacy trials of a tetravalent dengue vaccine. Although partially effective, once licensed, its introduction can be a public health priority in heavily affected countries because of the perceived public health importance of dengue. This review explores the most immediate economic considerations of introducing a new dengue vaccine and evaluates the published economic analyses of dengue vaccination. Findings indicate that the current economic evidence base is of limited utility to support country-level decisions on dengue vaccine introduction. There are a handful of published cost-effectiveness studies and no country-specific costing studies to project the full resource requirements of dengue vaccine introduction. Country-level analytical expertise in economic analyses, another gap identified, needs to be strengthened to facilitate evidence-based decision-making on dengue vaccine introduction in endemic countries. [ABSTRACT FROM PUBLISHER]

The complex interaction between dengue viruses and the human immune system means that development of a safe, effective dengue vaccine was never going to be simple. The only currently licenced dengue vaccine (Dengvaxia®) does, indeed, have a complex immune profile depending on recipients’ immune status, meaning that use of this vaccine is not straightforward. This commentary reviews the recommendations for vaccine use to date, and discusses issues and opportunities related to the implementation of vaccination programmes in light of these recommendations. Future dengue vaccines may also have similar profiles, so it is vital that these issues are addressed now to ensure optimal use of vaccination in the fight against dengue globally. [ABSTRACT FROM AUTHOR]