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Promoting higher-valent pediatric combination vaccines in China: challenges and recommendations for action

Infectious Diseases of Poverty 2024年第1期13卷 74-84页

作者： Jiuling Li Shu Chen dwin Asturias shenglan tang Fuqiang Cui Global Health Research Center Duke Kunshan UniversityKunshanJiangsuChina ARC Centre of Excellence in Population Ageing Research(CEPAR) Universityof New SouthWalesSydneyAustralia School of Risk and Actuarial Studies University of New South WalesSydneyAustralia Department of Pediatrics University of Colorado School of MedicineAuroraCOUSA Center for Global Health Colorado School of Public HealthAuroraCOUSA Department of Epidemiology Colorado School of Public HealthAuroraCOUSA Duke Global Health Institute Duke UniversityDurhamNCUSA SingHealth Duke-NUS Global Health Institute Duke-NUSSingaporeSingapore Department of Laboratorial Science and Technology School of Public HealthPeking UniversityBeijingChina Vaccine Research Center School of Public HealthPeking UniversityBeijingChina

Many countries have adopted higher-valent pediatric combination vaccines to simplify vaccination schedules and minimize health expenditures and social ***,China is conservative in the use of pediatric combina-tion *** reviewing and synthesizing quantitative and qualitative data,in this commentary we identify gaps and challenges to combination vaccine use and make recommendations for promoting use of higher-valent pediatric combination vaccines in *** are in four dimensions:(1)legislation and regulation,(2)immunization schedule design,(3)vaccine awareness and price,and(4)research and development *** optimize the use of combination vaccines to reduce vaccine-preventable disease burden,we make recommendations that address key challenges:(1)develop policies and regulations to strengthen enforcement of the Vaccine Administration Law and remove regulatory hurdles that hinder combination vaccine research and development,(2)establish an evi-dence-informed policy-making mechanism for combination vaccines,(3)resolve immunization schedule conflicts between monovalent and combination vaccines,and(4)implement effective interventions to increase vaccine awareness and reduce price.

关键词： Combination vaccine National immunization program Childhood immunization Vaccine-preventable disease

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Advancing the National Immunization Program in an era of achieving universal vaccine coverage in China and beyond

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贫困所致传染病(英文) 2024年第2期13卷 1-5页

作者： Chen Shu Rodewald Lance E. Heng Du Anna tang shenglan ARC Centre of Excellence in Population Ageing Research (CEPAR) University of New South Wales Sydney Australia School of Risk and Actuarial Studies University of New South Wales Sydney Australia Department of the National Immunization Program Chinese Center for Disease Control and Prevention National Immunization Program China CDC Beijing China China Country Office Bill &amp Melinda Gates Foundation Beijing China Duke Global Health Institute Duke University Durham NC USA Global Health Research Center Duke Kunshan University No. Duke Avenue Kunshan Jiangsu China SingHealth Duke-NUS Global Health Institute Duke-NUS Singapore Singapore

Background Immunization is a cornerstone of public health. Despite great success, China’s National Immunization Program (NIP) faces challenges, such as the integration of several World Health Organization-recommended vaccines and other systemic issues. The Innovation Laboratory for Vaccine Delivery Research (VaxLab), supported by the Bill & Melinda Gates Foundation and established in 2021 at Duke Kunshan University, focuses on enhancing China’s NIP through research and policy advocacy. This editorial aims to summarize the key findings of the manuscripts published in the collection contributed by VaxLab team and set the future research *** findings The collection contains eleven manuscripts discussing China’s immunization landscape and strategies to improve coverage, particularly for non-NIP vaccines like human papillomavirus vaccine (HPV), pneumococcal conjugate vaccine (PCV),Haemophilus influenzae type b vaccine (Hib), and rotavirus vaccines. Key findings include: (i) The COVID-19 vaccination campaign demonstrated China’s capacity for rapid, large-scale immunization efforts, suggesting potential for broader vaccine coverage improvements; (ii) Efforts in combating cervical cancer through the HPV vaccine indicate progress but also highlight challenges like vaccine supply and equitable access; (iii) The lag in adopting higher-valent paediatric combination vaccines in China needs attention to address regulatory and health system hurdles; (iv) Disparities in access to non-NIP vaccines underscore the need for government initiatives to improve vaccine coverage, especially for remote areas and marginalized populations; (v) Original studies emphasize the influence of caregivers’ knowledge, health workers’ financial incentives, and concerns about vaccine efficacy on immunization rates; (vi) Case studies from the Weifang City of China and Indonesia to introduce PCV offer insights on successful vaccine introduction strategies and the impact of innovative financing and g

关键词： National Immunization Program New vaccine introduction Universal vaccine coverage Health system strengthening

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The coverage and challenges of increasing uptake of non-National Immunization Program vaccines in China:a scoping review

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Infectious Diseases of Poverty 2023年第6期12卷 19-33页

作者： Mingzhu Jiang Shu Chen Xuanxuan Yan Xiaohua Ying shenglan tang School of Public Health Fudan University130 Dong’an RoadXuhui DistrictShanghai 200032China Australian Research Council Centre of Excellence in Population Ageing Research(CEPAR) University of New South WalesSydneyAustralia School of Risk and Actuarial Studies University of New South WalesSydneyAustralia Global Health Research Center Duke Kunshan UniversityKunshanJiangsuChina SingHealth Duke-NUS Global Health Institute Duke-NUSSingaporeSingapore Duke Global Health Institute Duke UniversityDurhamUSA

Background Non-National Immunization Program (NIP) vaccines have played an important role in controlling vaccine-preventable diseases (VPDs) in China. However, these vaccines are paid out of pocket and there is room to increase their coverage. We focused on four selected non-NIP vaccines in this study, namely Haemophilus influenzae type b (Hib) vaccine, human papillomavirus (HPV) vaccine, pneumococcal conjugate vaccine (PCV), and rotavirus vaccine. We aimed to conduct a scoping review of their vaccination rates and the major barriers faced by health systems, providers, and caregivers to increase *** We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We searched five English databases (PubMed, Web of Science, EMBASE, Scopus, and WHO IRIS) and four Chinese databases using the search strategy developed by the study team. Two independent reviewers screened, selected studies, and examined their quality. We summarized the non-NIP vaccine coverage data by vaccine and applied the 5A framework (Access, Affordability, Acceptance, Awareness, Activation) to chart and analyze barriers to increasing *** A total of 28 articles were included in the analysis (nine pertaining to vaccine coverage, and another 19 reporting challenges of increasing uptake). Among the four selected vaccines, coverage for the Hib vaccine was the highest (54.9-55.9% for 1 dose or more from two meta-analyses) in 2016, while the coverage of the other three vaccines was lower than 30%. Eight of the nine included articles mentioned the regional disparity of coverage, which was lower in under-developing regions. For example, the three-dose Hib vaccination rate in eastern provinces was 38.1%, whereas the rate in central and western provinces was 34.3% and 26.2%, respectively in 2017. Within the 5A framework, acceptance, awareness, and affordability stood out as the most prominent themes. Among the 12 identified

关键词： Non-National Immunization Program vaccines HPV Hib PCV Rotavirus Coverage Uptake Barriers Challenges

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苏州生态景观林土壤有机碳储量及活性组分的垂直分布特征

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安徽农业大学学报 2024年第2期51卷 312-318页

作者：姚新华唐建毕雷雷唐盛兰夏秀丽顾海波袁在翔关庆伟苏州市林业站苏州215128 南京林业大学生物与环境学院南方现代林业协同创新中心南京210037

为探究生态景观林类型对土壤有机碳(SOC)固持的影响,选择苏州市香樟人工林(Cinnamomum camphora plantation)、喜树人工林(Camptotheca acuminata plantation)、水杉人工林(Metasequoia glyptostroboides plantation)、栾树人工林(Koelreuteria paniculata plantation)和池杉人工林(Taxodium distichum *** plantation)5种生态景观林为研究对象,测定分析了各林分的0~20 cm、20~40 cm、40~60 cm和60~80 cm、80~100 cm 5个土壤层次有机碳、可溶性有机碳(DOC)、微生物生物量碳(MBC)以及易氧化有机碳(EOC)的含量与储量。结果表明:(1)各土层有机碳含量及储量分别在3.34~18.91 g·kg^(-1)和12.98~66.99 t·hm^(-2)之间,并且在不同林分之间差异显著,尤其是表层土壤有机碳;并且,香樟和喜树人工林0~100 cm土壤有机碳储量要显著高于其余3种林分。(2)不同生态景观林土壤可溶性有机碳、微生物生物量碳和易氧化有机碳差异显著,且具有明显的表聚效应;在不同林分之间,栾树和水杉人工林0~100 cm土壤可溶性有机碳与微生物生物量碳的储量最高,喜树和香樟人工林0~100 cm土壤易氧化有机碳储量最高。(3)试验地土壤有机碳及其活性组分主要与全氮、全磷极显著正相关,与容重极显著负相关。生态景观林类型显著影响0~100 cm土壤有机碳及活性组分的含量和储量;相较于水杉、栾树和池杉人工林,香樟和喜树人工林更有利于试验区土壤有机碳固持。

关键词：土壤有机碳活性有机碳生态景观林土壤层次垂直分布

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Tackling challenges of TB/MDRTB in China: concerted actions are imperative

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Infectious Diseases of Poverty 2015年第1期4卷 165-167页

作者： shenglan tang Duke Global Health Institute Duke UniversityDurhamUSA Duke Kunshan University Global Health Research CenterKunshanChina

China is the second largest TB epidemic with the most number of people infected with multi-drug resistant(MDR).Over the past decade,a large number of TB control projects have been funded by the government of China and international organizations,and epidemic in China has been effectively *** TB control in China still faced many *** to address these challenges may include integrating the national TB control program into health insurance schemes,strengthening TB case management through involving the Chinese hospital in national TB control program,and reforming payment methods for TB care as part of health system reform in China.

关键词： Tuberculosis China

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China’s biggest, most neglected health challenge: non-communicable diseases

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Infectious Diseases of Poverty 2013年第1期2卷 47-52页

作者： shenglan tang John Ehiri Qian Long Duke Global Health Institute Duke UniversityDurhamNCUSA Mel and Enid Zuckerman College of Public Health University of ArizonaTucsonAZUSA School of Public Health and Management Chongqing Medical UniversityChongqingPR China

Background:Over the past two decades,international health policies focusing on the fight against the human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS),tuberculosis(TB),malaria,and those diseases that address maternal and child health problems,among others,have skewed disease control priorities in China and other Asian *** these are important health problems,an epidemic of chronic,non-communicable diseases(NCDs)in China has accounted for a much greater burden of disease due to the ongoing rapid socioeconomic and demographic ***:Although NCDs currently account for more than 80%of the overall disease burden in China,they remain very low on the nation’s disease control priorities,attracting marginal investment from central and local *** leaves the majority of patients with chronic conditions without effective *** organizations and national governments have recognized the devastating social and economic consequences caused by NCDs in low-and middle-income countries,including ***,few donor-funded projects that address NCDs have been implemented in these countries over the past *** to a lack of strong support from international organizations and national governments for fighting against NCDs,affected persons in China,especially the poor and those who live in rural and less developed regions,continue to have limited access to the needed *** associated with frequent health facility visits and regular treatment have become a major factor in medical impoverishment in *** article argues that although China's ongoing health system reform would provide a unique opportunity to tackle current public health problems,it may not be sufficient to address the emerging threat of NCDs unless targeted steps are taken to assure that adequate financial and human resources are mapped for effective control and management of NCDs in the ***:The Chinese government need

关键词： Non-communicable diseases Infectious diseases Evidence-based public health interventions Health system reform China

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Schistosomiasis control and the health system in P.R. China

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Infectious Diseases of Poverty 2012年第1期1卷 76-83页

作者： Charles Collins Jing Xu shenglan tang Liverpool School of Tropical Medicine University of LiverpoolLiverpoolUK National Institute of Parasitic Diseases Chinese Centre for Disease Control and PreventionShanghaiP.R.China Duke Global Health Institute Duke UniversityDurhamNC 27708USA

Over the last sixty years advances have been made in the control of schistosomiasis in *** are,however,difficult challenges still to be *** paper looks at the extent to which the health system offers a positive environment for the control of the *** starts by tracing three phases in schistosomiasis control:disease elimination strategy through snail control(1950s-early 1980s);morbidity control strategy based on chemotherapy(mid 1980s to 2003);integrated control strategy(2004+).Each one of these phases took place in distinct policy-making *** paper partly draws on these phases to set out five issues of disease control and discusses them in the context of the health system and its recent *** cover the policy-making process,intersectoral action for health,equity and access to health services,funding for public goods and externalities,and strengthening resource management and *** issues form the basis of an agenda for integrating research and capacity strengthening in the Chinese health system with a view to creating a more positive enabling environment for schistosomiasis *** so doing it is important to emphasize the role and integrity of the public sector against its commercialization,the underlying value of equity,a systems wide perspective,and the role of advocacy.

关键词： Schistosomiasis control Health system P.R.China

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Access to and affordability of healthcare for TB patients in China: issues and challenges

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Infectious Diseases of Poverty 2016年第1期5卷 82-86页

作者： shenglan tang Lixia Wang Hong Wang Daniel P.Chin Duke Global Health Institute Duke UniversityDurhamUSA Global Health Research Center Duke Kunshan UniversityKunshanChina National Center for TB control and prevention China CDCNo 155 Changbai RoadChangping DistrictBeijing 102206People’s Republic of China Bill&Melinda Gates Foundation SeattleWashingtonUSA Bill&Melinda Gates Foundation Beijing officeBeijingChina

This paper introduces the background,aim and objectives of the project entitled“China—the Gates Foundation Collaboration on TB Control in China”that has been underway for many *** also summarizes the key findings of the nine papers included in this special issue,which used data from the baseline survey of Phase II of the *** were collected from the survey of TB and MDR-TB patients,from designated hospitals,health insurance agencies and the routine health information systems,as well as key informant interviews and focus group discussions with relevant key *** issues discussed in this series of papers include the uses of TB services and anti-TB medicines and their determining factors related to socio-economic and health systems development;expenditures on TB care and the financial burden incurred on TB patients;and the impact of health insurance schemes implemented in China on financial protection.

关键词： China-Gates TB project TB control Healthcare financing China

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Implementing a “free” tuberculosis (TB) care policy under the integrated model in Jiangsu, China: practices and costs in the real world

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Infectious Diseases of Poverty 2016年第1期5卷 1-8页

作者： Xinxin Jia Jiaying Chen Siyuan Zhang Bing Dai Qian Long shenglan tang Center for Health Policy Studies Nanjing Medical UniversityHanzhong Road 140210029 NanjingChina The Second Affiliated Hospital of Soochow University SuzhouJiangsu ProvinceChina Zhenjiang Center for Disease Control and Prevention ZhenjiangJiangsu ProvinceChina Duke Global Health Institute Duke UniversityDurhamNCUSA Global Health Research Center Duke Kunshan UniversityKunshanChina

Background:In the 1990s,China introduced a“free”tuberculosis(TB)care policy under the national TB control ***,as a part of a new TB diagnosis and treatment model,it has been recommended that the integrated model scale *** paper examines whether or not TB designated hospitals in the selected project sites have provided TB care according to the national and local guidelines,and analyzes the actual practices and expenditures involved in completing TB *** also explores the reasons why“free”TB care in China cannot be effectively implemented under the integrated ***:This study was conducted in three counties of Zhenjiang city,Jiangsu *** methods were used,which comprised reviewing the national and local TB control guidelines,conducting TB patient surveys,collecting TB inpatient and outpatient hospital records,and conducting qualitative interviews with *** statistics were used for quantitative data analysis across counties and in order to compare patients who received only outpatient care and those who received both outpatient and inpatient *** chi-square test and analysis of variance were performed where *** data were analyzed using the framework ***:Although the national TB care guidelines recommend outpatient care as a basis for TB treatment in China,we found high hospital admission rates for TB patients ranging from 39%in Yangzhong county to 83%in Dantu *** all outpatient TB patients paid for lab tests and over 80%paid for liver protection drugs and around 70%paid for image *** three components accounted for three-quarters of the total outpatient *** patients who received only outpatient care,the total expenditure upon completion of TB treatment was on average 1,135 Chinese *** patients who received outpatient and inpatient care,the total expenditure upon completion of TB treatment was 11,117 Chinese ***:The“free”

关键词： Tuberculosis Anti-TB treatment practice guidelines Free Expenditure Jiangsu province China

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Impact of the national hepatitis B immunization program in China:a modeling study

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Infectious Diseases of Poverty 2022年第5期11卷 99-100页

作者： Zhixi Liu Mengying Li David W.Hutton Abram L.Wagner Ye Yao Wenlong Zhu Lingsheng Cao shenglan tang Jinhua Pan Yesheng Wang Qi Zhao Hong Ren Ying Wang Weibing Wang School of Public Health Shanghai Institute of Infectious Disease and BiosecurityFudan UniversityShanghaiChina Department of Social Medicine School of Public HealthFudan UniversityShanghaiChina 不详

Background:Elimination of hepatitis B virus(HBV)is a striking challenge for countries with high or moderate disease ***,using China as a practical case to share experiences for similar countries may accelerate the achievement of the WHO 2030 target of 90%reduction in HBV-related *** aim to evaluate the impact of national HBV immunization strategies in China;and the feasibility to achieve WHO 2030 targets under diferent ***:We constructed an expanded Susceptible-Exposed-Infectious-Recovered(SEIR)model and decision treeMarkov model to estimate the epidemic of HBV in China,assess the feasibility of 2030 Elimination Goals through the projections and conduct the economic *** square method was used to calibrate the expanded SEIR model by yearly data of laboratory-confrmed HBV cases from 1990 to *** models were separately used to evaluate the impact and cost-efectiveness of HBV vaccine by comparing prevalence of chronic HBV infections,qualityadjusted life-years(QALYs),incremental cost efectiveness ratio and beneft–cost ratio(BCR)under various intervention options,providing a basis for exploring new containment ***:Between 1990 and 2020,the number of chronic HBV infections decreased by 33.9%.The current status quo would lead to 55.73 million infections(3.95%prevalence)in 2030,compared to 90.63 million(6.42%prevalence)of the“Without the NIP”scenario(NIP:National Immunization Program),114.78 million(8.13%prevalence)without any *** prevention of mother to child transmission(PMTCT)strategy showed a net beneft as 12,283.50 dollars per person,with BCR as 12.66,which is higher than that of universal vaccination at *** with no screening and no vaccination,the PMTCT strategy could save 7726.03 dollars for each QALY ***:Our fndings proved the HBV vaccination has demonstrated a substantial positive impact on controlling the epidemic of HBV in terms of efectiveness and economy af

关键词： Hepatitis B National immunization program Prevalence Economic analysis Susceptible-ExposedInfectious-Recovered modeling

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