Morro Touray gained an MSc in Development Management (with distinction) from Glasgow Caledonian University in 1999 and an MSc in Health Policy, Planning and Finance specialising in Health Economics from London School of Economics and Political Science in 2005. He also holds a PhD from the University of South Wales. His PhD focused on overweight and obesity and uses health, conventional and behavioural economic theories to explore demand for excess-weight related preventive goods by the UK's adult population.
Morro has worked in several countries and on various research projects. He has extensive working experiences in The Gambia, West Africa where he was a member of the Pneumococcal Polysaccharide Conjugate Vaccine Trial (PVT) with the Medical Research Council (UK) Laboratories. He designed and implemented the economic evaluation component of the study. PVT was one of the largest clinical trials in Africa and involved 17,437 participants aged 40–364 days.
With the University of South Wales and Cardiff University, he worked on a number projects including: DECIDE - a diabetes management trial, HELP - obesity intervention trial in pregnant and postpartum women, FRAGMATIC - a lung cancer clinical trial, and CONSTRUCT – a study on the comparison of infliximab and ciclosporin in steroid resistant ulcerative colitis. With University of Surrey, some of his projects include: RICHFIELDS – H2020 project intended to assess introduction of facilities, structures and services for provision of data on food production, preparation and consumption to inform research on health behaviours and PD_Manager – another Horizon 2020 funded project being implemented by a consortium of partners from different EU member countries with the aim of providing appropriate and timely information to support decision making in the care, treatment and management of Persons with Parkinson’s.
Prior to joining the University of Surrey, Morro worked as a Research Fellow for the University of South Wales in the Health Economics and Policy Research Unit. He also held a Research Fellow position at Swansea University in the Swansea Centre for Health Economics.
Affiliations and memberships
2. The International Association for the Study of Obesity (IASO)
3. Welsh Health Economist Study Group (WHEG)
Morro's specific area of interest is in economic evaluations of health related to overweight / obesity and related issues, and the understanding of behavioural dimension of diseases (including cultural and traditional practices) and their influence on healthcare resources. He also has research interest in economic analysis along clinical trials; global health; zoonotic, tropical and infectious diseases; health policy and systems in low income and developing countries; health services and health outcomes research; health technology assessment; and evidence synthesis for decision making in healthcare.
Advanced Topics in Health Economics (ECOM050)
Objectives? To evaluate the cost effectiveness of the use of nine-valent pneumococcal polysaccharide conjugate vaccine in a routine infant immunisation programme based on the Pneumococcal Vaccine Trial (PVT) study in The Gambia.
Methods? This was a clinical trial-based cost-effectiveness study conducted as part of the PVT study. The PVT was an intention-to-treat double-blind placebo-controlled trial of a nine-valent pneumococcal polysaccharide conjugate vaccine. The trial was conducted in the eastern parts of The Gambia, West Africa and recruited 17 437 children aged 40?364 days. A deterministic static cohort model was developed to evaluate direct benefits and costs of pneumococcal conjugate vaccine in The Gambia's routine immunisation programme. The incremental cost-effectiveness ratio (iCER) is defined as vaccinating infants against pneumococcal disease compared with no vaccination from a public provider's perspective using The Gambia's 2005 projected under-one-year population.
Key findings? The results show the use of the vaccine in The Gambia's routine infant vaccination programme to be cost effective using an assumed price of US$5.00 per vial in single-dose vials. Compared with offering no vaccination, the incremental cost per DALYs averted would be 30 DALYs from the public provider perspective. At least 1569 and 340 invasive childhood pneumococcal illnesses and deaths respectively among the cohort would be prevented. In the absence of the vaccine 16 871 DALYs would be lost while with the use of the vaccine 7804 DALYs would be lost. Given the average treatment cost of pneumococcal illnesses to be US$191 (95% confidence interval 180 to 203) the introduction of the vaccine programme would lead to an additional cost of US$274 279 (about US$8.43/child).
Conclusions? The availability of a cost-effective vaccine that can prevent thousands of pneumococcal illnesses and related deaths is a major development towards improving the disease burden in sub-Saharan African countries. This study supports the introduction of nine-valent pneumococcal vaccine into the infant immunisation programme of The Gambia as it is cost effective and will avert many preventable deaths and illnesses. Despite differences in distribution of serotypes between countries, the static model used in the analysis makes the results applicable to other developing countries, particularly those in sub-Saharan Africa.
The objectives were to investigate the impact of ?time-effect? on the estimation of quality-adjusted life years (QALYs) along prospective clinical trials? outcomes using an assumed fixed time duration versus the actual time durations for each case. The ?time? duration is the length of time in a health state.
Two methods were used in the estimation of QALYs based using EQ-5D 3L scores collected at specific time-point intervals. One method used the actual time durations for each case based on CRF records, and the other used an assumed time duration and globally applied it to all the cases. Using SPSS® software program, we used paired-sample t-tests to assess whether the ?time-effect? can potentially affect trial results using CONSTRUCT trial data as reported in the trial results publications. The trial compared use of Infliximab with Cyclosporine for patients with Ulcerative Colitis and it involved some 270 participants.
The results largely indicate statistically significant differences between the two methods of QALY estimations. QALYs at the respective time-points indicate no statistical difference between the two approaches. However, the difference in terms of total QALYs between the two QALY estimation approaches is statistically significant with considerable impact on costs/QALY.
Considering the possible impact of the time-effect on QALY estimations, the result implies that it can have significant implications for resources allocations decisions. In this respect, researchers have to pay due considerations to the approach they use and where possible, actual time durations must be used in QALY estimations along prospective clinical trials.
symptoms that have a serious adverse effect on quality of life. Management is problematic due to the variable and
fluctuating nature of symptoms, often hourly and daily. The PD_Manager mHealth platform aims to provide a
continuous feed of data on symptoms to improve clinical understanding of the status of any individual patient and
inform care planning. The objectives of this trial are to (1) assess patient (and family carer) perspectives of PD_
Manager regarding comfort, acceptability and ease of use; (2) assess clinician views about the utility of the data
generated by PD_Manager for clinical decision making and the acceptability of the system in clinical practice.
Methods/design: This trial is an unblinded, parallel, two-group, randomised controlled pilot study. A total of 200
persons with Parkinson?s disease (Hoehn and Yahr stage 3, experiencing motor fluctuations at least 2 h per day),
with primary family carers, in three countries (110 Rome, 50 Venice, Italy; 20 each in Ioannina, Greece and Surrey,
England) will be recruited. Following informed consent, baseline information will be gathered, including the
following: age, gender, education, attitudes to technology (patient and carer); time since Parkinson?s diagnosis,
symptom status and comorbidities (patient only). Randomisation will assign participants (1:1 in each country), to
PD_Manager vs control, stratifying by age (1 d 70 : 1 > 70) and gender (60% M: 40% F). The PD_Manager system
captures continuous data on motor symptoms, sleep, activity, speech quality and emotional state using wearable
devices (wristband, insoles) and a smartphone (with apps) for storing and transmitting the information. Control
group participants will be asked to keep a symptom diary covering the same elements as PD_Manager records.
After a minimum of two weeks, each participant will attend a consultation with a specialist doctor for review of the
data gathered (by either means), and changes to management will be initiated as indicated. Patients, carers and
clinicians will be asked for feedback on the acceptability and utility of the data collection methods. The PD_
Manager intervention, compared to a symptom diary, will be evaluated in a cost-consequences framework Discussion: Information gathered will inform further development of the PD_Manager system and a larger
Trial registration: ISRCTN Registry, ISRCTN17396879. Registered on 15 March 2017.