Summary of cost of typhoid illness studies.

Typhoid remains a public health concern across many low- and middle-income countries. This scoping review summarized and mapped evidence from epidemiological models and economic analyses of typhoid conjugate vaccine (TCV). We included studies on the cost of illness of typhoid, the cost of vaccination, cost-effectiveness, and public health impact of TCV. A search was conducted across five databases and followed the Arksey and O’Malley’s methodological framework. We extracted data on the study design, population, outcomes, model parameters, and cost-effectiveness. All reported costs were converted to 2024 United States Dollars (USD) to allow for comparisons across studies. Findings were summarized by key outcomes. The 26 studies included in the review covered Sub-Saharan Africa, South and East Asia, the Pacific, Latin America, the Middle East, and Europe. A total of ten studies reported the cost of treating a typhoid patient, with costs varying based on the hospital setting, geographic location and severity of the disease. Five studies examined the cost of TCV vaccination and delivery reported higher costs for campaigns than routine immunization, with economic costs consistently higher than financial costs. The two public health impact studies predicted case reductions from 2% to 94% and mortality reductions up to 36% or 100%, depending on the vaccine strategy employed. The nine economic evaluations included in the review reported lower incremental cost effectiveness ratios in high-incidence urban settings, with some strategies termed as cost-saving. Cost-effectiveness depends on incidence, perspective, and vaccine strategy, emphasizing the need for context-specific evaluations. Literature shows that the value of TCV is influenced by the disease burden, vaccination costs, and health outcomes, which are context specific. Future research should employ more comprehensive models to better capture TCV’s economic and public health value and leverage on local data to give more contextual evidence for policymakers.伤寒仍是众多中低收入国家面临的公共卫生问题。本范围综述（scoping review）对伤寒结合疫苗（Typhoid Conjugate Vaccine, TCV）的流行病学模型与经济学分析相关证据进行了汇总与证据图谱绘制。本综述纳入了关于伤寒疾病经济负担、疫苗接种成本、成本效益以及TCV公共卫生影响的相关研究。研究团队通过五个数据库开展文献检索，并遵循Arksey与O’Malley的方法学框架完成范围综述流程。研究人员提取了纳入研究的试验设计、研究人群、结局指标、模型参数及成本效益相关数据。所有报告的成本均统一换算为2024年美元（United States Dollars, USD），以确保不同研究间的可比性。研究团队基于关键结局指标对结果进行了汇总分析。本综述纳入的26项研究覆盖了撒哈拉以南非洲、南亚与东亚、太平洋地区、拉丁美洲、中东及欧洲。共计10项研究报告了伤寒患者的治疗成本，其费用因医疗机构等级、地理位置及疾病严重程度而存在差异。5项研究评估了TCV接种与接种服务的成本，结果显示群体性接种活动的成本高于常规免疫接种，且经济学成本始终高于财务成本。两项公共卫生影响研究预测，根据所采用的疫苗接种策略，伤寒病例数可减少2%至94%，死亡率最多可降低36%乃至100%。综述纳入的9项经济学评估研究显示，在伤寒高发的城市地区，增量成本效益比更低，部分接种策略被归类为成本节约型策略。成本效益水平受疾病发病率、研究视角及疫苗接种策略的影响，这凸显了开展针对具体场景的评估的必要性。现有文献表明，TCV的价值受疾病负担、接种成本及健康结局的影响，而上述因素均具有场景特异性。未来研究应采用更全面的模型，以更精准地评估TCV的经济学与公共卫生价值，并结合本地数据为政策制定者提供更具场景针对性的证据。