Mark Jit
Mark Jit
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Chair and Professor of the Department of Global and Environmental Health
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Professional overview
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Mark Jit is the inaugural chair and a professor in the Department of Global and Environmental Health. He was formerly head of the Department of Infectious Disease Epidemiology & Dynamics and co-director of the Global Health Economics Centre (GHECO) at the London School of Hygiene & Tropical Medicine (LSHTM). He holds honorary appointments at LSHTM as well as the University of Hong Kong (HKU) and the National University of Singapore (NUS).
Dr. Jit’s research focuses on epidemiological and economic modeling of vaccines to support evidence-based public health decision making. He has published papers covering a range of vaccine-preventable or potentially vaccine-preventable diseases including COVID-19, measles, HPV, pneumococcus, rotavirus, influenza, Group B Streptococcus, dengue, EV71 and RSV as well as methodological papers advancing the ways vaccines are evaluated. This work has influenced many of the major changes to immunization policy in countries around the world. Dr. Jit has served on a number of expert advisory committees in the UK as well as for international organizations such as the World Health Organization. He also organises or contributes to academic and professional courses on vaccine modeling, economics and decision science around the world.
Dr. Jit received his BSc and PhD in Mathematics from University College London, specializing in mathematical biology, and a Master of Public Health degree from King’s College London.
Visit Dr. Jit's Google Scholar's page to learn more about his research portfolio.
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Education
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BSc, Mathematics, University College LondonPhD, Mathematics, University College LondonMPH, Public Health, King's College London
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Honors and awards
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Clarivate Highly Cited Researcher (20222023)Fellow of the Academy of Medical Sciences (2023)Training Fund Award, Health Protection Agency (2007)Andrew Rosen Prize, University College London (1999)Institute of Mathematics and its Applications Award (1998)Departmental Research Studentship, University College London (1998)Student Union Commendation, University College London (1997)Fillon Prize, University College London (1996)Pathfinder Award, University College London (1995)
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Publications
Publications
The impact of pandemic influenza H1N1 on health-related quality of life: A prospective population-based study
AbstractVan Hoek, A. J., Underwood, A., Jit, M., Miller, E., & Edmunds, W. J. (n.d.).Publication year
2011Journal title
PloS oneVolume
6Issue
3AbstractBackground: While the H1N1v influenza pandemic in 2009 was clinically mild, with a low case-fatality rate, the overall disease burden measured in quality-adjusted life years (QALY) lost has not been estimated. Such a measure would allow comparison with other diseases and assessment of the cost-effectiveness of pandemic control measures. Methods and Findings: Cases of H1N1v confirmed by polymerase chain reaction (PCR) and PCR negative cases with similar influenza-like illness (ILI controls) in 7 regions of England were sent two questionnaires, one within a week of symptom onset and one two weeks later, requesting information on duration of illness, work loss and antiviral use together with EQ-5D questionnaires. Results were compared with those for seasonal influenza from a systematic literature review. A total QALY loss for the 2009 pandemic in England was calculated based on the estimated total clinical cases and reported deaths. A total of 655 questionnaires were sent and 296 (45%) returned. Symptoms and average illness duration were similar between confirmed cases and ILI controls (8.8 days and 8.7 days respectively). Days off work were greater for cases than ILI controls (7.3 and 4.9 days respectively, p = 0.003). The quality-adjusted life days lost was 2.92 for confirmed cases and 2.74 for ILI controls, with a reduction in QALY loss after prompt use of antivirals in confirmed cases. The overall QALY loss in the pandemic was estimated at 28,126 QALYs (22,267 discounted) of which 40% was due to deaths (24% with discounting). Conclusion: Given the global public health significance of influenza, it is remarkable that no previous prospective study of the QALY loss of influenza using standardised and well validated methods has been performed. Although the QALY loss was minor for individual patients, the estimated total burden of influenza over the pandemic was substantial when compared to other infectious diseases.What types of contacts are important for the spread of infections? Using contact survey data to explore European mixing patterns
AbstractMelegaro, A., Jit, M., Gay, N., Zagheni, E., & Edmunds, W. J. (n.d.).Publication year
2011Journal title
EpidemicsVolume
3Issue
3Page(s)
143-151AbstractKnowledge of the determinants of infectious disease transmission is a public health priority as it allows the design of optimal control strategies for endemic or emerging infections. We analyse a detailed dataset on contact patterns across five European countries and use available serological profiles for varicella and parvovirus B19 infections to identify the types of contact that may be most relevant for transmission. We show that models informed by contact data fit well the observed serological profiles of both infections. We find that intimate types of contacts explain the pattern of acquisition of serological markers by age better than other types of social contacts. We observe similar patterns in each of the countries analysed, suggesting that there are consistent biological mechanisms at work.A brief history of economic evaluation for human papillomavirus vaccination policy
AbstractBeutels, P., & Jit, M. (n.d.).Publication year
2010Journal title
Sexual HealthVolume
7Issue
3Page(s)
352-358AbstractBackground: This commentary discusses key issues for health economic evaluation and modelling, applied to human papillomavirus (HPV) vaccine programs. Methods: We outline some of the specific features of HPV disease and vaccination, and associated policy questions in light of a literature search for economic evaluations on HPV vaccination. Results: We observe that some policy questions could not be reliably addressed by many of the 43 published economic evaluations we found. Despite this, policy making on universal HPV vaccination followed shortly after vaccine licensure in many developed countries, so the role economic evaluation played in informing these decisions (pre-dating 2008) seems to have been fairly limited. For more recent decisions, however, economic evaluation is likely to have been used more widely and more intensively. Conclusions: We expect future cost-effectiveness analyses to be more instrumental in policy making regarding vaccines covering more HPV types, therapeutic HPV vaccines, and novel diagnostic tests for biomarkers of HPV infection and disease integrated with cervical screening programs.An update to " The cost-effectiveness of rotavirus vaccination: Comparative analyses for five European countries and transferability in Europe"
AbstractJit, M., Mangen, M. J. J., Melliez, H., Yazdanpanah, Y., Bilcke, J., Salo, H., Edmunds, W. J., & Beutels, P. (n.d.). In Vaccine (1–).Publication year
2010Volume
28Issue
47Page(s)
7457-7459AbstractA cost-effectiveness analysis of rotavirus vaccination in Belgium, England and Wales, Finland, France and the Netherlands published in 2009 was updated based on recent studies on rotavirus burden of disease and vaccine efficacy. All the qualitative conclusions in the previous study were found to remain valid. Vaccination remains cost-effective in Finland only when using plausible tender prices.Estimating progression rates for human papillomavirus infection from epidemiological data
AbstractJit, M., Gay, N., Soldan, K., Hong Choi, Y., & Edmunds, W. J. (n.d.).Publication year
2010Journal title
Medical Decision MakingVolume
30Issue
1Page(s)
84-98AbstractA Markov model was constructed in order to estimate typespecific rates of cervical lesion progression and regression in women with high-risk human papillomavirus (HPV). The model was fitted to age- and type-specific data regarding the HPV DNA and cytological status of women undergoing cervical screening in a recent screening trial, as well as cervical cancer incidence. It incorporates different assumptions about the way lesions regress, the accuracy of cytological screening, the specificity of HPV DNA testing, and the age-specific prevalence of HPV infection. Combinations of assumptions generate 162 scenarios for squamous cell carcinomas and 54 scenarios for adenocarcinomas. Simulating an unscreened cohort of women infected with high-risk HPV indicates that the probability of an infection continuing to persist and to develop into invasive cancer depends on the length of time it has already persisted. The scenarios and parameter sets that produce the best fit to available epidemiological data provide a basis for modeling the natural history of HPV infection and disease.Predicting the life-time benefit of school-based smoking prevention programmes
AbstractJit, M., Aveyard, P., Barton, P., & Meads, C. A. (n.d.).Publication year
2010Journal title
AddictionVolume
105Issue
6Page(s)
1109-1116AbstractAim School-based smoking prevention programmes may delay the age of smoking initiation, but do not appear to achieve lasting reductions in smoking prevalence beyond school-leaving age. We explored whether delaying the age at which someone initiates smoking may have life-time benefits by increasing the likelihood of quitting in later life. Design and setting Data from the General Household Survey of Great Britain were used in a logistic regression model to examine the association between age at which someone initiates regular smoking and the probability that the person will quit smoking later in life. The effect of confounding variables (sex, ethnicity, socio-economic class, education and geographical location) was taken into account. The predicted relationship was used in a cohort model to estimate the life-time reduction in smoking prevalence and all-cause mortality of a school-based smoking prevention programme. Results Age of regular smoking initiation was associated strongly with the probability of quitting later in life (coefficient -0.103, P < 0.001). The strength of the association was slightly reduced but still significant when confounding variables were included (coefficient -0.075, P < 0.001). An intervention that delays smoking initiation without decreasing smoking prevalence at age 18 may reduce adult smoking prevalence by 0.13-0.32% (depending on age) and all-cause mortality by 0.09% over the life-time of the sample. Conclusion School-based smoking prevention programmes have potential for a beneficial effect over the life-time of the participants even if they have no apparent effect at school-leaving age.The cost-effectiveness of vaccinating pregnant women against seasonal influenza in England and Wales
AbstractJit, M., Cromer, D., Baguelin, M., Stowe, J., Andrews, N., & Miller, E. (n.d.).Publication year
2010Journal title
VaccineVolume
29Issue
1Page(s)
115-122AbstractWe assessed the cost-effectiveness of vaccinating pregnant women against seasonal influenza in England and Wales, taking into account the timing of vaccination relative to both the influenza season and trimester of pregnancy. Women were assumed to be vaccinated in their second or third trimester. Vaccination between September and December was found to have an incremental cost-effectiveness ratio of £23,000 per quality adjusted life year (QALY) (95% CI £10,000-£140,000) if it is assumed that infants are partially protected through their mothers, and of £28,000 per QALY gained (95% CI £13,000-£200,000) if infants are not protected. If some vaccine protection lasts for a second season, then the ratio is only £15,000 per QALY gained (95% CI £6,000-£93,000). Most of the benefit of vaccination is in preventing symptomatic episodes, regardless of health care resource use. Extending vaccination beyond December is unlikely to be cost-effective unless there is good protection into a second influenza season. Key sources of uncertainty are the cost of vaccine delivery and the quality of life detriment due to a clinically apparent episode of confirmed influenza. The cost of vaccine purchase itself is relatively low.The risk of sequelae due to pneumococcal meningitis in high-income countries: A systematic review and meta-analysis
AbstractJit, M. (n.d.).Publication year
2010Journal title
Journal of InfectionVolume
61Issue
2Page(s)
114-124AbstractObjectives: To determine the risk of various kinds of sequelae in survivors of meningitis due to Streptococcus pneumoniae, as well as the influence of co-factors such as study design, study population and treatment on this risk. Methods: MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 1 September 1991 to 18 June 2009 for original articles on pneumococcal meningitis sequelae. Prevalence of sequelae was pooled using random effects meta-analysis. Studies were appraised for the influence of referral bias, external validity of study populations, testing procedure and publication bias. Results: Data were extracted from 63 studies involving 3408 pneumococcal meningitis survivors. The pooled prevalence of any reported sequelae from 48 studies was 31.7% (95% confidence interval 27.2-36.3%) using a random effects model (Cochran-Q = 277, p < 0.01). Differences in studies due to design, study population and treatment were not significant. The pooled prevalence of hearing loss, seizures, hydrocephalus, spasticity/paresis, cranial nerve palsies and visual impairment was 20.9% (17.1-24.7%), 6.5% (3.3-9.7%), 6.8% (3.3-10.2%), 8.7% (6.4-11.0%), 12.2% (5.3-19.1%) and 2.4% (0-5.7%) respectively. Conclusions: The burden of sequelae due to pneumococcal meningitis remains high in the reviewed studies.Transmission dynamic modelling of the impact of human papillomavirus vaccination in the United Kingdom
AbstractChoi, Y. H., Jit, M., Gay, N., Cox, A., Garnett, G. P., & Edmunds, W. J. (n.d.).Publication year
2010Journal title
VaccineVolume
28Issue
24Page(s)
4091-4102AbstractMany countries are considering vaccination against human papillomavirus (HPV). However, the long-term impact of vaccination is difficult to predict due to uncertainty about the prevalence of HPV infection, pattern of sexual partnerships, progression of cervical neoplasias, accuracy of screening as well as the duration of infectiousness and immunity. Dynamic models of human papillomavirus (HPV) transmission were developed to describe the infection spread and development of cervical neoplasia, cervical cancer (squamous cell and adenocarcinoma) and anogenital warts. Using different combinations of assumptions, 9900 scenarios were created. Each scenario was then fitted to epidemiological data and the best-fitting scenarios used to predict the impact of vaccination. Results suggest that vaccinating 12-year-old girls at 80% coverage will result in a 38-82% reduction in cervical cancer incidence and 44-100% reduction in anogenital warts incidence after 60 years of an ongoing vaccination programme if vaccine protection lasts 20 years on average. The marginal benefit of vaccinating boys depends on the degree of protection achieved by vaccinating girls.Vaccination against pandemic influenza A/H1N1v in England: A real-time economic evaluation
AbstractBaguelin, M., Hoek, A. J. V., Jit, M., Flasche, S., White, P. J., & Edmunds, W. J. (n.d.).Publication year
2010Journal title
VaccineVolume
28Issue
12Page(s)
2370-2384AbstractDecisions on how to mitigate an evolving pandemic are technically challenging. We present a real-time assessment of the effectiveness and cost-effectiveness of alternative influenza A/H1N1v vaccination strategies. A transmission dynamic model was fitted to the estimated number of cases in real-time, and used to generate plausible autumn scenarios under different vaccination options. The proportion of these cases by age and risk group leading to primary care consultations, National Pandemic Flu Service consultations, emergency attendances, hospitalisations, intensive care and death was then estimated using existing data from the pandemic. The real-time model suggests that the epidemic will peak in early November, with the peak height being similar in magnitude to the summer wave. Vaccination of the high-risk groups is estimated to prevent about 45 deaths (80% credibility interval 26-67), and save around 2900 QALYs (80% credibility interval 1600-4500). Such a programme is very likely to be cost-effective if the cost of vaccine purchase itself is treated as a sunk cost. Extending vaccination to low-risk individuals is expected to result in more modest gains in deaths and QALYs averted. Extending vaccination to school-age children would be the most cost-effective extension. The early availability of vaccines is crucial in determining the impact of such extensions. There have been a considerable number of cases of H1N1v in England, and so the benefits of vaccination to mitigate the ongoing autumn wave are limited. However, certain groups appear to be at significantly higher risk of complications and deaths, and so it appears both effective and cost-effective to vaccinate them. The United Kingdom was the first country to have a major epidemic in Europe. In countries where the epidemic is not so far advanced vaccination of children may be cost-effective. Similar, detailed, real-time modelling and economic studies could help to clarify the situation.Cost of treatment and QALYs lost due to genital warts: Data for the economic evaluation of HPV vaccines in the United Kingdom
AbstractWoodhall, S. C., Jit, M., Cai, C., Ramsey, T., Zia, S., Crouch, S., Birks, Y., Newton, R., Edmunds, W. J., & Lacey, C. J. (n.d.).Publication year
2009Journal title
Sexually Transmitted DiseasesVolume
36Issue
8Page(s)
515-521AbstractBACKGROUND: Data on the burden of genital warts in terms of treatment costs and detriment to quality of life (QoL) are required to assess cost-effectiveness of quadrivalent human papillomavirus vaccination. We investigated the cost of treatment and period of time for which QoL is affected to obtain estimates of quality-adjusted life year (QALY) loss associated with an episode of genital warts. METHODS: Adults diagnosed with genital warts attending the York sexually transmitted disease clinic during two 3-month periods in 2006 and 2007 were enrolled (n = 189). Data on cost of treatment and duration of episode of care were collected from a retrospective case note review. QALY loss was calculated by applying estimates of the duration of time for which QoL was affected to the previously reported detriment to QoL associated with genital warts. RESULTS: The average cost per episode of care was $286 (£139, 95% CI: $246-$327). Estimated loss of QALYs ranged from 0.0045 (95% CI: 0.0014-0.0078) to 0.023 (95% CI: 0.0072-0.039). CONCLUSIONS: Genital warts present a significant burden both to individuals and to the health service. Data on the burden of genital warts should be incorporated into economic evaluations of human papillomavirus vaccination strategies.The cost-effectiveness of rotavirus vaccination: Comparative analyses for five European countries and transferability in Europe
AbstractJit, M., Bilcke, J., Mangen, M. J. J., Salo, H., Melliez, H., Edmunds, W. J., Yazdan, Y., & Beutels, P. (n.d.).Publication year
2009Journal title
VaccineVolume
27Issue
44Page(s)
6121-6128AbstractCost-effectiveness analyses are usually not directly comparable between countries because of differences in analytical and modelling assumptions. We investigated the cost-effectiveness of rotavirus vaccination in five European Union countries (Belgium, England and Wales, Finland, France and the Netherlands) using a single model, burden of disease estimates supplied by national public health agencies and a subset of common assumptions. Under base case assumptions (vaccination with Rotarix®, 3% discount rate, health care provider perspective, no herd immunity and quality of life of one caregiver affected by a rotavirus episode) and a cost-effectiveness threshold of €30,000, vaccination is likely to be cost effective in Finland only. However, single changes to assumptions may make it cost effective in Belgium and the Netherlands. The estimated threshold price per dose for Rotarix® (excluding administration costs) to be cost effective was €41 in Belgium, €28 in England and Wales, €51 in Finland, €36 in France and €46 in the Netherlands.Economic evaluation of human papillomavirus vaccination in the United Kingdom
AbstractJit, M., Yoon, H. C., & Edmunds, W. J. (n.d.).Publication year
2008Journal title
BMJVolume
337Issue
7665Page(s)
331-335AbstractObjective: To assess the cost effectiveness of routine vaccination of 12 year old schoolgirls against human papillomavirus infection in the United Kingdom. Design: Economic evaluation. Setting UK. Population: Schoolgirls aged 12 or older. Main outcome measures: Costs, quality adjusted life years (QALYs), and incremental cost effectiveness ratios fora range of vaccination options. Results: Vaccinating 12 year old schoolgirls with a quadrivalent vaccine at 80% coverage is likely to be cost effective at a willingness to pay threshold of £30 000 (€37 700; $59 163) per QALY gained, if the average duration of protection from the vaccine is more than 10 years. Implementing a catch-up campaign of girls up to age 18 is likely to be cost effective. Vaccination of boys is unlikely to be cost effective. A bivalent vaccine with the same efficacy against human papillomavirus types 16 and 18 costing £13-£21 less per dose (depending on the duration of vaccine protection) may be as cost effective as the quadrivalent vaccine although less effective in terms of health benefits. Conclusions: Routine vaccination of 12 year old schoolgirls combined with an initial catch-up campaign up to age 18 is likely to be cost effective in the UK. The results are robust to uncertainty in many parameters and processes. A key influential variable is the duration of vaccine protection.Estimation of the impact of genital warts on health-related quality of life
AbstractWoodhall, S., Ramsey, T., Cai, C., Crouch, S., Jit, M., Birks, Y., Edmunds, W. J., Newton, R., & Lacey, C. J. (n.d.).Publication year
2008Journal title
Sexually transmitted infectionsVolume
84Issue
3Page(s)
161-166AbstractObjectives: One of the two new human papillomavirus (HPV) vaccines protects against HPV types 6 and 11, which cause over 95% of genital warts, in addition to protecting against HPV types 16 and 18. In anticipation of HPV vaccine implementation, the impact of genital warts on health-related quality of life (HRQoL) was measured to assess the potential benefits of the quadrivalent over the bivalent vaccine. Methods: Genitourinary medicine clinic patients aged 18 years and older with a current diagnosis of genital warts were eligible; 81 consented and were interviewed by a member of the research team. A generic HRQoL questionnaire, the EQ-5D (comprising EQ-5D index and EQ visual analogue scale (VAS) scores) and a disease-specific HRQoL instrument, the CECA10, were administered. Previously established UK population norms were used as a control group for EQ-5D comparisons. Results: Cases (with genital warts) had lower EQ VAS and EQ-5D index scores than controls. After adjusting for age a mean difference between cases and controls 30 years of age and under (n = 70) of 13.9 points (95% CI 9.9 to 17.6, p<0.001 ) for the EQ VAS and 0.039 points (95% CI 0.005 to 0.068, p = 0.02) on the EQ-5D index (also adjusted for sex) was observed. The difference between cases and controls for the EQ VAS was especially notable in young women. Conclusions: Genital warts are associated with a significant detriment to HRQoL. The potential added benefit of preventing most cases of genital warts by HPV vaccination should be considered in decisions about which HPV vaccine to implement in the United Kingdom.Restructuring routine elective services to reduce overall capacity requirements within a local health economy
AbstractUtley, M., Jit, M., & Gallivan, S. (n.d.).Publication year
2008Journal title
Health Care Management ScienceVolume
11Issue
3Page(s)
240-247AbstractThe UK Government has introduced a new class of health service providers called Treatment Centres that provide routine elective services but that do not deal with emergency cases or non-routine elective patients. The introduction of these centres provides a possible mechanism for improving the efficiency of service delivery in terms of overall capacity requirements. In this paper we discuss a mathematical modelling approach that has been used to examine circumstances under which such benefits might be realised. As an illustration of the analysis, we present results obtained using data concerning urological services, for which there would seem to be benefits associated with the introduction of a TC in only a limited range of circumstances.Social contacts and mixing patterns relevant to the spread of infectious diseases
AbstractMossong, J., Hens, N., Jit, M., Beutels, P., Auranen, K., Mikolajczyk, R., Massari, M., Salmaso, S., Tomba, G. S., Wallinga, J., Heijne, J., Sadkowska-Todys, M., Rosinska, M., & Edmunds, W. J. (n.d.).Publication year
2008Journal title
PLoS MedicineVolume
5Issue
3Page(s)
381-391AbstractBackground: Mathematical modelling of infectious diseases transmitted by the respiratory or close-contact route (e.g., pandemic influenza) is increasingly being used to determine the impact of possible interventions. Although mixing patterns are known to be crucial determinants for model outcome, researchers often rely on a priori contact assumptions with little or no empirical basis. We conducted a population-based prospective survey of mixing patterns in eight European countries using a common paper-diary methodology. Methods and Findings: 7,290 participants recorded characteristics of 97,904 contacts with different individuals during one day, including age, sex, location, duration, frequency, and occurrence of physical contact. We found that mixing patterns and contact characteristics were remarkably similar across different European countries. Contact patterns were highly assortative with age: schoolchildren and young adults in particular tended to mix with people of the same age. Contacts lasting at least one hour or occurring on a daily basis mostly involved physical contact, while short duration and infrequent contacts tended to be nonphysical. Contacts at home, school, or leisure were more likely to be physical than contacts at the workplace or while travelling. Preliminary modelling indicates that 5- to 19-year-olds are expected to suffer the highest incidence during the initial epidemic phase of an emerging infection transmitted through social contacts measured here when the population is completely susceptible. Conclusions: To our knowledge, our study provides the first large-scale quantitative approach to contact patterns relevant for infections transmitted by the respiratory or close-contact route, and the results should lead to improved parameterisation of mathematical models used to design control strategies.A computational algorithm associated with patient progress modelling
AbstractGallivan, S., Utley, M., Jit, M., & Pagel, C. (n.d.).Publication year
2007Journal title
Computational Management ScienceVolume
4Issue
3Page(s)
283-299AbstractPatient progress modelling, which was first introduced to provide an alternative to traditional randomised control trials, has now been used in numerous contexts including evaluation of screening programmes and assessment of the public health impact of large scale developments such as waste disposal incinerators. The method uses stochastic compartmental models whose solutions may depend on solving large sets of matrix differential equations. Although specialist software packages are available for this purpose, we propose an alternative method for deriving the solution to such equations that is simple to implement.Estimating the number of deaths with rotavirus as a cause in England and Wales
AbstractJit, M., Pebody, R., Chen, M., Andrews, N., & Edmunds, W. J. (n.d.).Publication year
2007Journal title
Human VaccinesVolume
3Issue
1Page(s)
23-26AbstractThe precise number of deaths due to rotavirus infection in England and Wales is difficult to determine because mortality is usually low and reported simply as death due to gastrointestinal disease. We have used two independent methods to estimate this figure. Firstly, we obtained records from the Office for National Statistics of deaths in children with any mention of gastroenteritis. For deaths with uncertain aetiology, we estimated the proportion attributable to rotavirus using a linear model with monthly laboratory reports of gastrointestinal micro-organisms as predictors. Secondly, we calculated the case-fatality ratio of records in Hospital Episode Statistics with rotavirus indicated, and applied this ratio to an estimate of the actual number of rotavirus hospital admissions. The two methods gave estimates of 3.3 and 3.2 rotavirus deaths a year respectively.Evaluating rotavirus vaccination in England and Wales. Part I. Estimating the burden of disease
AbstractHarris, J. P., Jit, M., Cooper, D., & Edmunds, W. J. (n.d.).Publication year
2007Journal title
VaccineVolume
25Issue
20Page(s)
3962-3970AbstractRotavirus is a major cause of gastroenteritis in young children. New vaccines for rotavirus are now available and countries need to establish the health and economic burden of rotavirus disease to assess whether vaccine introduction is advisable. This study assesses the fraction of acute gastroenteritis in children under 5 years that may be attributable to rotavirus using multiple linear regression. Results suggest around 45% of hospitalisations, 25% of GP consultations, 27% of NHS Direct calls and 20% of accident and emergency (A&E) attendances for acute gastroenteritis in this age group may be attributable to rotavirus. The annual incidence is estimated to be 4.5 hospitalisations, 9.3 A&E consultations, and 28-44 GP consultations per 1000 children under five years of age. The cost to the health service is estimated to be £14.2 m per annum. Rotavirus vaccination has the potential to reduce this burden of disease. This study provides a sound basis on which to make this assessment and serves as a baseline against which any reductions that do occur if vaccination is introduced can be measured against.Evaluating rotavirus vaccination in England and Wales. Part II. The potential cost-effectiveness of vaccination
AbstractJit, M., & Edmunds, W. J. (n.d.).Publication year
2007Journal title
VaccineVolume
25Issue
20Page(s)
3971-3979AbstractAim: Rotavirus is the leading cause of acute gastroenteritis in children. Two rotavirus vaccines (RotaTeq® and Rotarix®) have recently completed clinical trials. We investigated whether routine infant immunisation with either vaccine can be cost effective. Methods: We compared costs and outcomes of vaccination using a cohort model, following children over the first 5 years of life. We estimated health provider costs, economic costs and quality adjusted life years (QALYs) lost due to rotavirus-related deaths, hospital admissions, nosocomial infections, accident and emergency attendances, general practioner consultations and calls to NHS Direct. Results: Under base case assumptions, a programme using RotaTeq® (priced at £25 a dose) would cost the health provider £79,900 per QALY gained. Using Rotarix® (priced at £35 a dose) would cost £61,000 per QALY gained. Univariate and multivariate sensitivity analysis indicate that at these prices an immunisation programme would be unlikely to be cost-effective for any realistic value of the key parameters. Conclusions: Rotavirus immunisation could reduce the substantial short-term morbidity burden due to rotavirus, but is unlikely to be deemed cost effective unless the vaccine is competitively priced.Prevalence of human papillomavirus antibodies in young female subjects in England
AbstractJit, M., Vyse, A., Borrow, R., Pebody, R., Soldan, K., & Miller, E. (n.d.).Publication year
2007Journal title
British Journal of CancerVolume
97Issue
7Page(s)
989-991AbstractSera from 1483 female subjects in England aged 10-29 years were tested. The age-standardised seroprevalence was 10.7% (95% confidence intervals 9.0-12.3) for human papillomavirus (HPV) 6, 2.7% (1.8-3.6) for HPV 11, 11.9% (10.2-13.6) for HPV 16, 4.7% (3.5-5.8) for HPV 18, and 20.7% (18.6-22.7) for any of the four types.A stochastic model to evaluate options for antenatal genetic screening
AbstractGallivan, S., Jit, M., & Utley, M. (n.d.).Publication year
2006Journal title
Health Care Management ScienceVolume
9Issue
2Page(s)
111-124AbstractHaemoglobinopathies are a group of genetic disorders which are particularly prevalent among certain risk groups such as ethnic groups. Antenatal screening of potential haemoglobinopathy carriers allows early diagnosis for affected fetuses, leading to therapeutic intervention or termination. However, it has drawbacks such as screening costs and possible miscarriage as a result of fetal testing. This paper describes a model that allows the outcomes of a screening programme to be estimated for different risk groups. The model has been implemented as a computer package that can be used to inform decisions made by health care planners.Reduction in wound infection rates by wound surveillance with postdischarge follow-up and feedback
AbstractWilson, A. P., Hodgson, B., Liu, M., Plummer, D., Taylor, I., Roberts, J., Jit, M., & Sherlaw-Johnson, C. (n.d.).Publication year
2006Journal title
British Journal of SurgeryVolume
93Issue
5Page(s)
630-638AbstractBackground: Surgical wound surveillance with postdischarge follow-up is rarely done in the UK as it is seen as expensive. The aim of this study was to determine whether employing a dedicated team was effective and reduced costs. Methods: Infection data were collected prospectively with postdischarge follow-up at 2-3 months, and fed back to surgeons. Wound infection was defined using both ASEPSIS wound scoring and criteria of the US Centers for Disease Control (CDC) definitions. Results: Over 4 years, 15 548 patient episodes were included. Postdischarge surveillance data were available for 79.9 per cent of the 15 154 records of patients who survived. There was a significant reduction in the rate of wound infection between the first and fourth years by ASEPSIS and CDC definitions: odds ratio 0.77 (95 per cent confidence interval (c.i.) 0.64 to 0.92) and 0.69 (95 per cent c.i. 0.57 to 0.83), respectively. The proportion of infections fell significantly in orthopaedic, cardiac and thoracic surgery. The annual budget for wound surveillance was £91 600. Changes in infection rates contributed £347 491 to the reduction in cost among the patients surveyed. Conclusion: Wound surveillance was associated with a reduction in rates of wound infection within 4 years. The cost reduction as a result of fewer infections exceeded the cost of surveillance after 2 years.How to take variability into account when planning the capacity for a new hospital unit
AbstractUtley, M., Gallivan, S., & Jit, M. (n.d.). In Health Operations Management (1–).Publication year
2005Page(s)
146-161AbstractProviding the appropriate level of capacity for post-operative care to cater for the activity planned in operating theatres is an important planning issue affecting staffing levels as well as the provision of physical bed capacity and ward space. Over-provision of post-operative capacity is wasteful of resources while underprovision can cause operations to be cancelled and expensive operating theatre time to be wasted.This chapter addresses the problem faced by the planner who wishes to take account of unpredictable variability in post-operative length of stay. This planning problem is discussed with specific reference to planning capacity requirements for post-operative recovery within one of the new generation of health care centres being introduced within the UK NHS.TNF-α neutralization in cytokine-driven diseases: A mathematical model to account for therapeutic success in rheumatoid arthritis but therapeutic failure in systemic inflammatory response syndrome
AbstractJit, M., Henderson, B., Stevens, M., & Seymour, R. M. (n.d.).Publication year
2005Journal title
RheumatologyVolume
44Issue
3Page(s)
323-331AbstractObjectives. Neutralization of TNF-α with either monoclonal antibodies or soluble receptors, although not curative, has significant clinical benefit in patients with rheumatoid arthritis (RA). In contrast, blockade of TNF-α has little clinical benefit in the majority of patients with systemic inflammatory response syndrome (SIRS) in spite of the identification of TNF-α as a key factor in its pathology. It is not clear why there is such a significant difference in the responses to TNF-α neutralization in these two conditions. Here we use mathematical modelling to investigate this discrepancy. Methods. Using the known pharmacokinetic and pharmacodynamic properties of TNF-α-blocking biological agents, we constructed a mathematical model of the biological actions of soluble (s)TNFR2, Etanercept and Infliximab. Results. Our model predicts that all three inhibitors, but especially Etanercept, are effective at controlling TNF-α levels in RA, which we propose is a condition in which TNF-α production and inhibition are in equilibrium. However, when free TNF-α drops to a low level, as can occur in SIRS, which we propose is a non-equilibrium condition, the sequestered TNF-α can act as a slow-release reservoir, thereby sabotaging its effectiveness. Conclusions. These results may explain the effectiveness of TNF-α blockade in the equilibrium condition RA and the ineffectiveness in the non-equilibrium condition SIRS.