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
Prevalence of human papillomavirus antibodies in males and females in England
AbstractDesai, S., Chapman, R., Jit, M., Nichols, T., Borrow, R., Wilding, M., Linford, C., Lowndes, C. M., Nardone, A., Pebody, R., & Soldan, K. (n.d.).Publication year
2011Journal title
Sexually Transmitted DiseasesVolume
38Issue
7Page(s)
622-629AbstractBackground: Most studies of human papillomavirus (HPV) epidemiology have employed DNA testing, which measures current infections. Serum antibodies offer a longer-term marker of infection in individuals who seroconvert and can therefore provide additional information about the exposure of populations to HPV. Methods: Sera from a population-based sample of males and females aged 10 to 49 years, in England, were tested for type-specific HPV antibodies using a multiplexed competitive Luminex assay and previously defined cutoffs of 20, 16, 20, and 24 mMU mL -1 for HPV 6, 11, 16, and 18, respectively. Seropositivity and geometric mean titers of seropositives were analyzed by HPV type, gender, and age. Catalytic models were developed to explore potential effects of antibody waning over time and changing risk of infection by age-cohort. Results: Seroprevalence for HPV 6, 11, 16, and 18 was 16.4%, 5.7%, 14.7%, and 6.3%, respectively, among females and 7.6%, 2.2%, 5.0%, and 2.0%, respectively, among males. Seroprevalence in females was significantly higher than males (P < 0.001 for all types) and showed a decline in older ages that was not seen in males. There was no evidence of declining antibody titers with increasing age. Model results suggest that cohort effects mediated through changes in sexual behavior better explain the observed trend in seroprevalence than waning antibodies over time. Conclusions: Preimmunization HPV seroprevalence in England shows similar trends to reports from other developed countries. We find the lower seroprevalence in older females probably reflects changes in sexual behavior over the last few decades. This study provides baseline data to monitor the impact of the immunization programme.Response to comment on article by Jit et al. "The cost effectiveness of rotavirus vaccination : Comparative analyses for five European countries and transferability in Europe"
AbstractJit, M., Bilcke, J., Mangen, M. J., Salo, H., Melliez, H., Edmunds, W. J., Yazdanpanah, Y., & Beutels, P. (n.d.).Publication year
2011Journal title
VaccineVolume
29Issue
21Page(s)
3732-3733Abstract~The cost-effectiveness of rotavirus vaccination in Armenia
AbstractJit, M., Yuzbashyan, R., Sahakyan, G., Avagyan, T., & Mosina, L. (n.d.).Publication year
2011Journal title
VaccineVolume
29Issue
48Page(s)
9104-9111AbstractThe cost-effectiveness of introducing infant rotavirus vaccination in Armenia in 2012 using Rotarix(R) was evaluated using a multiple birth cohort model. The model considered the cost and health implications of hospitalisations, primary health care consultations and episodes not leading to medical care in children under five years old. Rotavirus vaccination is expected to cost the Ministry of Health $220,000 in 2012, rising to $830,000 in 2016 following termination of GAVI co-financing, then declining to $260,000 in 2025 due to vaccine price maturity. It may reduce health care costs by $34,000 in the first year, rising to $180,000 by 2019. By 2025, vaccination may be close to cost saving to the Ministry of Health if the vaccine purchase price declines as expected. Once coverage has reached high levels, vaccination may prevent 25,000 cases, 3000 primary care consultations, 1000 hospitalisations and 8 deaths per birth cohort vaccinated. The cost per disability-adjusted life year (DALY) saved is estimated to be about $650 from the perspective of the Ministry of Health, $850 including costs accrued to both the Ministry and to GAVI, $820 from a societal perspective excluding indirect costs and $44 from a societal perspective including indirect costs. Since the gross domestic product per capita of Armenia in 2008 was $3800, rotavirus vaccination is likely to be regarded as " very cost-effective" from a WHO standpoint. Vaccination may still be " very cost-effective" if less favourable assumptions are used regarding vaccine price and disease incidence, as long as DALYs are not age-weighted.The impact of genital warts : Loss of quality of life and cost of treatment in eight sexual health clinics in the UK
AbstractJit, M., Woodhall, S. C., Jit, M., Soldan, K., Kinghorn, G., Gilson, R., Nathan, M., Ross, J. D., & Lacey, C. J. (n.d.).Publication year
2011Journal title
Sexually transmitted infectionsVolume
87Issue
6Page(s)
458-463AbstractObjectives: To estimate the loss of quality of life and cost of treatment associated with genital warts seen in sexual health clinics. Methods: A cross-sectional questionnaire study and case note review of individuals with genital warts, carried out in eight sexual health clinics in England and Northern Ireland. Individuals with genital warts attending the participating clinics were invited to take part in the questionnaire study. 895 participants were recruited. A separate sample of 370 participants who had attended a participating clinic with a first visit for a first or recurrent episode of genital warts between April and June 2007 was included in the case note review. Quality of life was measured using the EQ-5D questionnaire and the cost of an episode of care was derived from the case note review. Results: The weighted mean EQ-5D index score was 0.87 (95% CI 0.85 to 0.89). The weighted mean disutility was 0.056 (95% CI 0.038 to 0.074). The estimated mean loss of quality-adjusted life-years associated with an episode of genital warts was 0.018 (95% CI 0.0079 to 0.031), equivalent to 6.6 days of healthy life lost per episode. The weighted mean cost per episode of care was £94 (95% CI £84 to £104), not including the cost of a sexually transmitted infection screen. Conclusions: Genital warts have a substantial impact on the health service and the individual. This information can be utilised for economic evaluation of human papillomavirus vaccination.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. A., & 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
3-4Page(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., Melliez, H., Yazdanpanah, Y., Bilcke, J., Salo, H., Edmunds, W. J., & Beutels, P. (n.d.).Publication year
2010Journal title
VaccineVolume
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.Proceedings of the Modeling Evidence in HPV Pre-Conference Workshop in Malmö, Sweden, May 9-10, 2009
AbstractCraig, B. M., Brisson, M., Chesson, H., Giuliano, A. R., & Jit, M. (n.d.).Publication year
2010Journal title
Clinical TherapeuticsVolume
32Issue
8Page(s)
1546-1564AbstractBackground: Prominent published and active human papillomavirus (HPV) modelers from around the world were invited to participate in the inaugural Modeling Evidence in HPV (MEHPV) Pre-Conference Workshop on May 9-10, 2009, in Malmö, Sweden. The workshop took place directly before the 25th International Papillomavirus Conference.Objectives: The aim of the workshop was to develop an international network of investigators engaged in HPV modeling and to facilitate open discussion about the structure and parameterization of models, as well as other methodologic concerns.Methods: Thirty-four participants from more than a dozen countries and a variety of settings, representing the authors or coauthors of 82% of the HPV modeling literature, exchanged ideas on fundamental questions in the field. These proceedings, based on the 217-page transcript, were assembled by the Scientific Committee to summarize the ideas of workshop participants in a deidentified, readable fashion. They represent the work and recorded opinions of session participants and do not constitute the official positions of participants as a whole or individually, the Scientific Committee, or any sponsoring organization or entity.Results: In charting a path forward, 3 topics emerged as most pressing: best practices for HPV modeling, comparative modeling, and modeling in developing countries.Conclusion: This summary of the proceedings of the preconference workshop on HPV modeling characterizes many of the prominent contemporary issues in the field.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. A. (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., 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., 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
AbstractJit, M., Woodhall, 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, pMathematical modelling of cervical cancer vaccination in the UK
AbstractChoi, Y. H., & Jit, M. (n.d.). (S.-D. Yoo, Ed.).Publication year
2008Page(s)
405-412AbstractHuman papillomaviruses (HPV) are responsible for causing cervical cancer and anogenital warts. The UK considered a national vaccine program introducing one of two licensed vaccines, Gardasil™ and Cervarix™. The impact of vaccination is, however, 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 HPV transmission, based upon about thousands of scenarios incorporating uncertainty in these processes, were developed to describe the infection spread and development of cervical neoplasia, cervical cancer (squamous cell and adenocarci-noma) and anogenital warts. Each scenario was then fitted to epidemiological data to estimate transmission probabilities and the best-fitting scenarios used to predict the impact of twelve different vaccination strategies. Our analysis provides relatively robust estimates of the impact of HPV vaccination, as multiple sources of uncertainty are explicitly included. The most influential remaining source of uncertainty is the duration of vaccine-induced protection.Prevalence of human papillomavirus antibodies in young female subjects in England (British Journal of Cancer (2007) 97, (989-991) DOI: 10.1038/sj.bjc.6603955)
AbstractJit, M., Jit, M., Vyse, A., Borrow, R., Pebody, R., Soldan, K., & Miller, E. (n.d.).Publication year
2008Journal title
British Journal of CancerVolume
98Issue
9Page(s)
1595Abstract~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
AbstractJit, M., Gallivan, 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.