ORCID Profile
0000-0003-2445-2952
Current Organisations
University of Adelaide
,
Women's and Children's Hospital
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Publisher: Informa UK Limited
Date: 11-01-2021
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.VACCINE.2014.02.054
Abstract: To assess knowledge of invasive meningococcal disease (IMD) and concern about the disease in the South Australian Community including adolescents, adults, parents and non-parents. This cross-sectional study was conducted by face to face interviews in South Australia in 2012. Participants were scored on their knowledge and concern about IMD. Univariate and multivariate regression analyses were performed with the survey data weighted by age and gender in accordance with 2011 Census data. Of 5200 households randomly selected and stratified by metropolitan or rural location, 3055 participants were interviewed with a response rate of 60.3%. The majority were Australian born (74.2%, n=2267) with 31.8% (n=972) of those interviewed being parents, and 15.9% (n=487) adolescents (15-24 years). Almost a quarter of participants (23.5%, n=717) do not know what meningococcal disease is, with 9.1% (n=278) believing incorrectly that IMD is a viral infection. 36.6% (n=1114) had low overall knowledge of IMD. Adolescents (p<0.050), non-Australian born (p<0.001), low educational attainment (p=0.019), low household income (p=0.011), low/medium socio-economic status (p<0.050) or living in a metropolitan area (p=0.006) were more likely to have lower overall knowledge of IMD. Participants who were not parents (p<0.001), male gender (p<0.001), single (p<0.001), highly educated (p=0.022) or had high household income (p=0.015), had lower concern about IMD. Large community knowledge gaps for IMD were observed, particularly amongst adolescents and adults with low educational attainment and low socio-economic status. Improving community knowledge of IMD could help ensure optimal uptake of a new meningococcal vaccine. Our study results can help guide development of community tailored immunisation education programs.
Publisher: Springer Science and Business Media LLC
Date: 09-06-2018
DOI: 10.1007/S40273-018-0679-5
Abstract: Invasive meningococcal disease remains a public health concern because of its rapid onset and significant risk of death and long-term disability. New meningococcal serogroup B and combination serogroup ACWY vaccines are being considered for publicly funded immunization programs in many countries. Contemporary costing data associated with invasive meningococcal disease are required to inform cost-effectiveness analyses. The objective of this study was to estimate costs and resource utilization associated with acute infection and the long-term care of invasive meningococcal disease. PubMed, EMBASE, The Cochrane Library, health economic databases, and electronically available conference abstracts were searched. Studies reporting any costs associated with acute infection and long-term sequelae of invasive meningococcal disease in English were included. All costs were converted into purchasing power parity-adjusted estimates [international dollars (I$)] using the C bell and Cochrane Economics Methods Group and the Evidence for Policy and Practice Information and Coordinating Centre cost converter. Fourteen studies met our eligibility criteria and were included. The mean costs of acute admission ranged from I$1629 to I$50,796, with an incremental cost of I$16,378. The mean length of hospital stay was reported to be 6-18 days in multiple studies. The average costs reported for readmissions ranged from I$7905 to I$15,908. Key variables such as the presence of sequelae were associated with higher hospitalization costs and longer inpatient stay. No studies estimated direct non-healthcare costs and productivity loss. Ten studies reported only unadjusted mean values without using appropriate statistical methods for adjustment. Invasive meningococcal disease can result in substantial costs to healthcare systems. However, costing data on long-term follow-up and indirect costs used to populate health economic models are lacking.
Publisher: Oxford University Press (OUP)
Date: 15-02-2021
DOI: 10.1093/CID/CIAA1636
Abstract: From 2017, a statewide cluster randomized trial was conducted in South Australia to assess the impact of the meningococcal B vaccine 4CMenB on pharyngeal Neisseria meningitidis carriage in adolescents. Senior schools were randomized to receive the vaccine in 2017 (intervention) or 2018 (control). In this study we report the vaccine impact of 4CMenB on serogroup B invasive meningococcal disease (IMD) in 16- to 19-year-old adolescents in South Australia. This observational time series analysis of serogroup B IMD cases compares the 14 years prior to the commencement of the trial (2003–2016) with the 2 years following 4CMenB vaccination of the 2017 adolescent cohort. Approximately 62% of year 10 and 11 students (15–16 years old) in South Australia enrolled in the trial. A total of 30 522 year 10–12 students received at least 1 dose of 4CMenB. The number of serogroup B IMD cases in 16- to 19-year old adolescents in South Australia increased on average by 10% per year from 2003 to 2016 (95% confidence interval [CI], 6%–15%, P & .001), peaking with 10 cases in 2015. Serogroup B IMD cases reduced to 5 in 2017–2018 and 1 in 2018–2019, below the expected numbers of 9.9 (95% prediction interval [PI], 3.9–17.5) and 10.9 (95% PI, 4.4–19.1), respectively. This translated to an overall reduction in the number of serogroup B IMD cases of 71% (95% CI, 15%–90%, P = .02). There were no serogroup B IMD cases in vaccinated adolescents. Vaccinating adolescents with 4CMenB was associated with a reduction in group B meningococcal disease in South Australia. NCT03089086.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2016
Publisher: Informa UK Limited
Date: 08-06-2022
Publisher: Elsevier BV
Date: 08-2020
Publisher: Public Library of Science (PLoS)
Date: 26-07-2017
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.VACCINE.2019.04.020
Abstract: Invasive meningococcal disease (IMD) is uncommon but still causes considerable public health burden due to its high mortality and morbidity. This review aims to quantitatively synthesise all published evidence pertinent to mortality caused by IMD and assess the effect of age and serogroup on case fatality rates (CFRs). The PubMed and Embase databases, and the Cochrane Library were searched. Articles reporting national CFRs and published in English between January 2000 and May 2018 were eligible. The studies reporting mortality resulting from a specific symptom of IMD (e.g. meningococcal meningitis) were excluded. Mixed-effects logistic regression with a restricted cubic spline was used to analyse CFRs as a function of age. Random-effects meta-analyses were performed to estimate an overall CFR and CFRs by serogroup. Among 48 eligible studies reporting national CFRs, 40 studies were included in meta-analyses representing 163,758 IMD patients. CFRs ranged from 4.1% to 20.0% with the pooled overall CFR of 8.3% (95% confidence interval (CI): 7.5-9.1%). Serogroup B was associated with a lower pooled CFR (6.9% (95%CI: 6.0-7.8%)) than other serogroups (W: 12.8% (95%CI: 10.7-15.0%) C: 12.0% (95%CI: 10.5-13.5%) Y: 10.8% (95%CI: 8.2-13.4%)). The meta-analysis was not performed for serogroup A (MenA) cases due to a small number of MenA patients who were enrolled in eligible studies. For laboratory confirmed IMD cases, the predicted CFR was 9.0% in infants, gradually decreased to 7.0% in 7-year olds, subsequently increased to 15.0% in young adults aged 28 years, stabilised between 15 and 20% in mid-aged adults and reached a high in elderly people. Our findings can provide useful information for better understanding the mortality risks, and quantifying the burden associated with IMD mortality.
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.VACCINE.2019.09.060
Abstract: Invasive meningococcal disease (IMD) is an uncommon but life-threatening infectious disease associated with high sequelae rates in young children and an increased risk of mortality in adolescents and young adults. Funding decisions to reject inclusion of new meningococcal serogroup B vaccines on national immunisation schedules have been criticised by IMD patients, their families, paediatricians and charity organisations. We aim to estimate the lifetime costs of IMD with the best available evidence to inform cost-effectiveness analyses. A Markov model was developed taking healthcare system and societal perspectives. A range of data including age-specific mortality rates, and probabilities of IMD-related sequelae were derived from a systematic review and meta-analysis. All currencies were inflated to year 2017 prices by using consumer price indexes in local countries and converted to US dollars by applying purchasing power parities conversion rates. Expert panels were used to inform the model development process including key structural choices and model validations. The estimated lifetime societal cost is US$319,896.74 per IMD case including the direct healthcare cost of US$65,035.49. Using a discount rate of 5%, the costs are US$54,278.51 and US$13,968.40 respectively. Chronic renal failure and limb utation result in the highest direct healthcare costs per patient. Patients aged < 5 years incur the higher healthcare expenditure compared with other age groups. The costing results are sensitive to the discount rate, disease incidence, acute admission costs, and sequelae rates and costs of brain injuries and epilepsy. IMD can result in substantial costs to the healthcare system and society. Understanding the costs of care can assist decision-making bodies in evaluating cost-effectiveness of new vaccine programs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2022
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1016/J.VACCINE.2014.05.069
Abstract: Invasive meningococcal disease (IMD) remains a serious public health concern due to a sustained high case fatality rate and morbidity in survivors. This study aimed to estimate the hospital service costs associated with IMD and variables associated with the highest costs in Australian children admitted to a tertiary paediatric hospital. Clinical details were obtained from medical records and associated inpatient costs were collected and inflated to 2011 Australian dollars using the medical and hospital services component of the Australian Consumer Price Index. Both unadjusted and adjusted analyses were undertaken. Multivariate regression models were used to adjust for potential covariates and determine independent predictors of high costs and increased length of hospital stay. Of 109 children hospitalised with IMD between May 2000 and April 2011, the majority were caused by serogroup B (70.6%). Presence of sequelae, serogroup B infection, male gender, infants less than one year of age, and previous medical diagnosis were associated with higher inpatient costs and length of stay (LOS) in hospital (p<0.001) during the acute admissions. Children diagnosed with septicaemia had a longer predicted LOS (p=0.033) during the acute admissions compared to those diagnosed with meningitis alone or meningitis with septicaemia. Serogroup B cases incurred a significantly higher risk of IMD related readmissions (IRR: 21.1, p=0.008) for patients with sequelae. Serogroup B infection, male gender, diagnosis of septicaemia, infants less than one year of age, and no previous medical diagnosis were more likely to have higher inpatient costs and LOS during the IMD related readmissions for patients with sequelae (p<0.05). Although IMD is uncommon, the disease severity and associated long-term sequelae result in high health care costs, which should be considered in meningococcal B vaccine funding considerations.
Publisher: MDPI AG
Date: 19-01-2023
Abstract: Real-world data on the effectiveness of COVID-19 vaccines against the Omicron variant (B.1.1.529) is limited. This systematic review aimed to investigate the real-world effectiveness and durability of protection conferred by primary course and booster vaccines against confirmed Omicron infection, and severe outcomes. We systematically searched literature up to 1 August 2022. Meta-analysis was performed with the DerSimonian-Laird random-effects model to estimate the pooled vaccine effectiveness (VE). Overall, 28 studies were included representing 11 million in iduals. The pooled VE against Omicron infection was 20.4% (95%CI: 12.1–28.7%) and 23.4% (95%CI: 13.5–33.3%) against symptomatic infection with variation based on vaccine type and age groups. VE sharply declined from 28.1% (95%CI: 19.1–37.1%) at three months to 3.9% (95%CI: −24.8–32.7%) at six months. Similar trends were observed for symptomatic Omicron infection. A booster dose restored protection against Omicron infection up to 51.1% (95%CI: 43.8–58.3%) and 57.3% (95%CI: 54.0–60.5%) against symptomatic infection within three months however, this waned to 32.8% (95%CI: 16.8–48.7%) within six months. VE against severe Omicron infection following the primary course was 63.6% (95%CI: 57.5–69.7%) at three months, decreased to 49% (95%CI: 35.7–63.4%) within six months, and increased to 86% after the first or second booster dose.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2014
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.VACCINE.2016.09.040
Abstract: There is limited knowledge of adolescent views and attitudes towards immunisation. Our study investigated adolescent attitudes to immunisation and compared differences in vaccination attitudes between adolescents and adults. This study was a cross-sectional, national online survey. Recruitment was stratified by state and gender to ensure findings were nationally representative. Regression analyses were performed to assess and compare adolescent and adult views on vaccine benefits, community protection, risks, side effects, sources of information, and decision-making preference. In 2013, 502 adolescents and 2003 adults completed the online survey. Lower levels of vaccine confidence were observed in adolescents with adolescents less likely to believe vaccines are beneficial and/or safe compared to adults (p=0.043). Compared to females, males were less confident of vaccine benefits (p<0.05) but less concern about vaccine side effects (p<0.05). Adolescents were more concerned about vaccine side effects than adults for pain (p<0.001), redness or swelling (p<0.001), and fever (p=0.006). Adolescents were less likely than adults to consider health professionals (p<0.001) and the media (e.g. internet) (p=0.010) as important sources of information, and were more likely to seek information from social networks (p<0.001) including families and schools. Although 62.0% of adolescents agreed that parents should make the decision about vaccination for them, adolescents were more likely to prefer a joint decision with parents (p<0.001) or by themselves (p=0.007) compared with adults. Adolescents have a lesser understanding of vaccine safety and benefits than adults and have higher concerns about potential vaccine reactions. Improving adolescent awareness and knowledge of the benefits and risks of vaccination through school-based educational programs may improve confidence in and uptake of vaccines for adolescents and increase vaccine confidence in the next generation of parents.
Publisher: Elsevier BV
Date: 07-2022
Publisher: MDPI AG
Date: 11-12-2021
Abstract: The COVID-19 vaccine rollout is crucial to lifting community and economic restrictions. This cross-sectional study aimed to assess: (a) COVID-19 vaccine uptake and associated factors (b) COVID-19 vaccine intentions and associated factors (c) community support for COVID-19 vaccination strategies and associated factors. The survey was conducted between May and July 2021 in Australia. Of 3003 participants, 30% reported they were already vaccinated and 39% indicated they would get vaccinated. Low socioeconomic and education levels, non-English speaking backgrounds and being parents were associated with decreased vaccine willingness and/or vaccination rates. High levels of support for vaccination strategies were demonstrated with mandatory vaccination being less preferable. Respondents from non-English speaking backgrounds were more likely to support a mandatory vaccination policy. Respondents with the highest socioeconomic level were more likely to support vaccination requirements for international travel, visiting nursing homes and working in healthcare settings. Respondents who were aged ≥70 years were more likely to support all proposed vaccination strategies. Targeted c aigns should be implemented for parents and those who live in socioeconomic disadvantaged areas and have lower educational attainment. Concise and clear vaccine information should be provided in lay and multiple languages to improve vaccine confidence. Vaccine enforcement policies should be considered and implemented with caution.
Publisher: Elsevier BV
Date: 08-2023
Publisher: BMJ
Date: 12-2019
DOI: 10.1136/BMJOPEN-2019-032583
Abstract: Invasive meningococcal disease (IMD) primarily causes disease in young children and adolescents and can cause long-term disability. Many countries are considering implementation of meningococcal B and/or meningococcal ACWY vaccines to control meningococcal disease. Estimating the cost-effectiveness of meningococcal vaccine programme is h ered due to a lack of good quality costing and burden of disease data. This study aims to address this evidence gap by assessing the clinical, physical, neurocognitive, economic and societal impact of IMD on adolescents and young adults. A case–control study of 64 participants with confirmed IMD (15–24 years 11 months at time of disease) and 64 control participants (17–34 years 11 months) will be conducted in Australia from 2016 to 2020. All participants will undergo a neurocognitive assessment, full medical examination, pure tone audiometry assessment and complete quality of life and behavioural questionnaires. Meningococcal cases will be assessed 2–10 years posthospitalisation and a subset of cases will be interviewed to explore in depth their experiences of IMD and its impact on their life. Primary outcome measures include general intellectual functioning from the Wechsler Adult Intelligence Scale and overall quality of life from the Health Utilities Index. Secondary outcome measures include academic achievement, executive functioning, behaviour, hearing, psychological and physical functioning. Outcome measures will be compared between cases and controls using independent t-tests or ORs, or if any significant confounders are identified, adjusted analyses (analysis of covariance or adjusted ORs) will be conducted. Thematic analysis will be used to analyse transcribed interviews and a costing model will be used to project lifetime costs. The Adolescent MENingococcal Disease (AMEND) study has been approved by the Human Research Ethics Committee of the Women’s and Children’s Health Network (HREC/14/WCHN/024). The results will be disseminated via peer-reviewed publications, conference presentations, study participants, and meningococcal and meningitis foundations. NCT03798574 .
No related grants have been discovered for Bing Wang.