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US CDC and AFENET pilot the DTP Booster Dose Modelling App in Uganda

Activity

The African Field Epidemiology Network (AFENET) in partnership with the United States Centers for Disease Control and Prevention (US-CDC) has extended technical support to the Uganda Ministry of Health Expanded Program on Immunization (UNEPI) in the country’s effort to enhance the evidence that informs new vaccine introduction.

A 3-day meeting was organised with UNEPI to pilot a newly developed model and user interface to estimate the health and economic effects of diphtheria-tetanus-pertussis (DTP) containing vaccines.

Technical assistance and training support from Dr Kirsten Ward, and Dr Nishant Kishore (PhD) on behalf of the DTP Boost collaboration which is composed of Modelling and Simulation Hub Africa (MASHA), AFENET, US-CDC & an independent expert technical reference group of subject matter experts from The World Health Organization (WHO), Gavi and other immunization partners around the world.

In attendance were Dr. Immaculate Ampaire, a senior medical officer with UNEPI, as well as the UNEPI M&E team composed of Sam Ofori, Besigye Albert and Biroma Godfrey.

According to AFENET Epidemiologist Mr Joseph Magoola, during the exercise, the team did a deep dive into the methods used in the model, evaluated the user interface and usability of the application and tested introduction scenarios that allowed interpretation of results.

He adds: “The participants provided valuable feedback to help improve the application including highlighting the need for country data to calibrate and validate the model before generating country-specific predictions on economic and health effects of introducing booster doses of DTP-containing vaccine in Uganda.”

Context

The World Health Organization (WHO) recommends booster doses of diphtheria, tetanus and pertussis-containing vaccine (DTPCV) in the second year of life, at school-entry and early adolescence. In February 2018 the Strategic Advisory Group of Experts (SAGE) and WHO revised and strengthened recommendations for booster doses of DTPCV vaccines, highlighting their importance for Maternal Neonatal Tetanus Elimination (MNTE) and reducing the risk of diphtheria outbreaks. Introduction of DTPCV boosters would also contribute to strengthening the life course approach to vaccination, a recommendation of the Immunization Agenda 2030.

Given the recommendations for introducing booster doses of existing DTPCV and resource limitations faced by Gavi-eligible low- and middle-income countries (LMIC), there is a need for information on country-specific health and economic effects to inform the introduction of DTPCV booster doses. However, there is currently no publicly available model that estimates both the health and economic effects of vaccination against diphtheria, tetanus and pertussis combined.

Description

The DTP Boost model is a first-of-its-kind model developed to jointly estimate the health and economic effects of introducing the WHO-recommended booster doses of diphtheria-tetanus-pertussis containing vaccine (DTPcv). This application allows in-country subject matter experts (SMEs) to set initial conditions and calibrate stochastic compartment models without requiring any coding expertise or experience with non-linear systems. Uniquely built with a web-based user interface it allows countries to generate their own impact estimates of endless scenarios, using their own data and assumptions. The DTP booster modelling tool is being piloted and “first used” in Uganda, after which it will be made available for use globally.