We identified three primary mechanisms of spillovers : reduced disease transmission , social proximity and substitution of re sources within households .
We found the strongest evidence for spillovers through reduced disease transmission , particularly vaccines and mass drug administration .
In general , the proportion of a population receiving an intervention was associated with improved health .
We found evidence of publication bias for certain spillover estimates but not for total or direct effects .
Conclusions We found the strongest evidence for spillovers from vaccines and mass drug administration to control infectious disease .
There was little high quality evidence of spillovers for other interventions
Background Many interventions delivered to improve health may benefit not only direct recipients but also people in close physical or social proximity .
Our objective was to review all published literature about the spillover effects of interventions on health outcomes in low-middle income countries and to identify methods used in estimating these effects .
Impact of pediatric vaccination with pneumococcal conjugate vaccine on the risk of bacteremic pneumococcal pneumonia in adults.
Invasive pneumococcal disease in adults may be declining , reflecting a form of herd protection from a new pediatric pneumococcal conjugate vaccine . Our aim was to determine whether vaccination of children protects adults in the same home from bacteremic pneumococcal pneumonia . We conducted a case-control study with 43 participating hospitals across a five-county region in Pennsylvania . Eligible cases were adults with bacteremic pneumococcal pneumonia identified by the microbiology laboratories at participating hospitals . Controls were healthy adults from the region identified through r and om digit dialing . Cases and controls were interviewed by telephone . We analyzed vaccine protection in those adults who reported living in homes with at least one child < or = 6 years of age . From April 2002 through June 2004 , there was a significant decline in the proportion of adult pneumococcal bacteremia due to any of the seven serotypes in the conjugate vaccine ( p=0.006 ) . Within this time period , 17 % of cases and controls reported living in homes with at least one child < or = 6 years of age . In adjusted analysis , vaccination of the youngest child in the home was associated with an 80 % reduction in the odds of bacteremic pneumococcal pneumonia among adults with children in the home ( OR=0.2 , 95 % CI 0.1 - 0.8 ) . We conclude that introduction of a pneumococcal conjugate vaccine for children has reduced the population rate of adult pneumococcal bacteremia due to vaccine serotypes and is associated with a reduced risk of bacteremic pneumococcal pneumonia for adults with children in the home
We identified three primary mechanisms of spillovers : reduced disease transmission , social proximity and substitution of re sources within households .
We found the strongest evidence for spillovers through reduced disease transmission , particularly vaccines and mass drug administration .
In general , the proportion of a population receiving an intervention was associated with improved health .
We found evidence of publication bias for certain spillover estimates but not for total or direct effects .
Conclusions We found the strongest evidence for spillovers from vaccines and mass drug administration to control infectious disease .
There was little high quality evidence of spillovers for other interventions
Background Many interventions delivered to improve health may benefit not only direct recipients but also people in close physical or social proximity .
Our objective was to review all published literature about the spillover effects of interventions on health outcomes in low-middle income countries and to identify methods used in estimating these effects .