scholarly journals A systematic review and meta-analysis of the catastrophic costs incurred by tuberculosis patients

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Ramy Mohamed Ghazy ◽  
Haider M. El Saeh ◽  
Shaimaa Abdulaziz ◽  
Esraa Abdellatif Hammouda ◽  
Amira Mohamed Elzorkany ◽  
...  

AbstractOne of the strategies of the World Health Organization End Tuberculosis (TB) was to reduce the catastrophic costs incurred by TB-affected families to 0% by 2020.Catastrophic cost is defined by the total cost related to TB management exceeding 20% of the annual pre-TB household income. This study aimed to estimate the pooled proportion of TB affected households who incurred catastrophic costs. We searched PubMed, SciELO, Scopus, Embase, Google Scholar, ProQuest, SAGE, and Web of Science databases according to Preferred Reporting Items of the Systematic Reviews and Meta-Analysis (PRISMA) guidelines till November 20, 2020. Eligible studies were identified and data on catastrophic costs due to TB were extracted. We performed a meta-analysis to generate the pooled proportion of patients with TB facing catastrophic costs. From 5114 studies identified, 29 articles were included in the final analysis. The pooled proportion of patients faced catastrophic costs was (43%, 95% CI [34–51]). Meta-regression revealed that country, drug sensitivity, and Human immune-deficiency Virus (HIV) co-infection were the main predictors of such costs. Catastrophic costs incurred by drug sensitive, drug resistant, and HIV co-infection were 32%, 81%, and 81%, respectively. The catastrophic costs incurred were lower among active than passive case findings (12% vs. 30%). Half (50%) of TB-affected households faced catastrophic health expenditure at 10% cut-off point. The financial burden of patients seeking TB diagnosis and treatment continues to be a worldwide impediment. Therefore, the End TB approach should rely on socioeconomic support and cost-cutting initiatives.PROSPERO registration: CRD42020221283.

2021 ◽  
Author(s):  
Ramy Mohamed Ghazy ◽  
Haider M. El Saeh ◽  
Shaimaa Abdulaziz ◽  
Esraa Abdellatif Hammouda ◽  
Amira Elzorkany ◽  
...  

Abstract Background: One of the World Health Organization End Tuberculosis (TB) Strategy is to reduce the proportion of TB affected families facing catastrophic costs (CC) to 0% by 2020. CC is defined if total cost related to TB management exceeded 20% of annual pre-TB household income. This study aimed to estimate the pooled proportion (PP) of TB affected households who suffered from CC. Method: A search of the online database through September 2020 was performed. Of 5114 articles, 29 articles were included in meta-analysis. We used R software to estimate the PP at 95% confidence intervals (CIs) using the fixed/random-effect models. Result: The PP of patients faced CC was 43%. Meta-regression revealed that country, drug sensitivity and HIV co-infection were the main predictors. CC incurred by drug sensitive, drug resistant and HIV coinfection patients were 32%, 80%, and 81% respectively. Lower CC incurred by active than passive case finding; 12% versus 42%. Direct cost represented 55% (95% CI 43-66) of the total cost. About 45% of TB-affected household faced catastrophic health expenditure at cut-off point of 10%. Conclusion: There is still a significant proportion of TB patients facing CC, which represent a main obstacle against TB control.PROSPERO registration: CRD42020221283


2021 ◽  
Author(s):  
Ramy Mohamed Ghazy ◽  
Haider M. El Saeh ◽  
Shaimaa Abdulaziz ◽  
Esraa Abdellatif Hammouda ◽  
Amira Elzorkany ◽  
...  

AbstractBackgroundAs one of the World Health Organization (WHO) End Tuberculosis (TB) Strategy is to reduce the proportion of TB affected families that face catastrophic costs to 0% by 2020. This systematic review and meta-analysis aimed to estimate the pooled proportion of TB affected households who face catastrophic cost.MethodA search of the online database through September 2020 was performed. A total of 5114 articles were found, of which 29 articles got included in quantitative synthesis. Catastrophic cost is defined if total cost related to TB exceeded 20% of annual pre-TB household income. R software was used to estimate the pooled proportion at 95% confidence intervals (CIs) using the fixed/random-effect models.ResultThe proportion of patients faced catastrophic cost was 43% (95% CI 34-52, I2 = 99%); 32% (95% CI 29 – 35, I2 = 70%) among drug sensitive, and 80% (95% CI 74-85, I2 = 54%) among drug resistant, and 81% (95%CI 78-84%, I2 = 0%) among HIV patients. Regarding active versus passive case finding the pooled proportion of catastrophic cost was 12% (95% CI 9-16, I2 = 95%) versus 42% (95% CI 35-50, I2 = 94%). The pooled proportion of direct cost to the total cost was 45% (95% CI 39-51, I2 = 91%). The pooled proportion of patients facing catastrophic health expenditure (CHE) at cut of point of 10% of their yearly income was 45% (95% CI 35-56, I2 = 93%) while at 40% of their capacity to pay was 63% (95% CI 40-80, I2 = 96%).ConclusionDespite the ongoing efforts, there is a significant proportion of patients facing catastrophic cost, which represent a main obstacle against TB control.PROSPERO registrationCRD42020221283


Author(s):  
Adel Alizadeh ◽  
Reza Negarandeh ◽  
Fahimehe Bagheri Amiri ◽  
Zahra Yazdani

Abstract Objectives This systematic and meta-analysis review was conducted to determine the status of Iranian children and adolescents’ physical activity. Content All the related articles which were published in the major databases, including Pubmed, Scopus, Web of Science, Embase, Magiran, SID from the beginning of 2010 to the end of 2019, were reviewed by researchers. The Newcastle-Ottawa scale was also used to evaluate the quality of articles. Moreover, I 2 index and chi-square were used to assess the heterogeneity between the results. Summary 490 articles were found as a result of the search in the selected international and local databases, where finally, 10 articles were included into the meta-analysis after the elimination of the duplicated articles and applying inclusion and exclusion criteria. The results indicated that 29.5% of the girls were considered active according to WHO criteria (16.1–42.8: 95% CI) and also 20.5% of the boys (7.3–33.7: 95% CI). Outlook Overall, this study’s findings showed that a large percentage of Iranian children and adolescents do not achieve the level of physical activity recommended by the World Health Organization. This can lead to undesirable consequences for this group of population that is considered as the human capital of any country; consequently, it seems necessary to take basic measures at the micro and macro levels in order to reduce such problems in the society.


BMJ ◽  
2021 ◽  
pp. n526
Author(s):  
François Lamontagne ◽  
Thomas Agoritsas ◽  
Reed Siemieniuk ◽  
Bram Rochwerg ◽  
Jessica Bartoszko ◽  
...  

Abstract Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Understanding the new recommendation The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline. Readers note This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.


Author(s):  
Hasan Ghodsi ◽  
Sanaz Sohrabizadeh ◽  
Reaza Khani Jazani ◽  
Amir Kavousi

ABSTRACT Objective: Volunteers need considerable resiliency to cope with formidable challenges during their operations in disaster scenes. The present study was conducted to identify factors affecting the different aspects of resiliency among volunteers in disasters. Material and Methods: The databases of Web of Science, Scopus, PubMed, ProQuest, Google Scholar, World Health Organization Library, International Committee of the Red Cross (ICRC) Library, PsycArticles, and SafetyLit were searched until September 29, 2018. The main search terms were resiliency, disaster, humanitarian aid worker, and volunteer. Results: A total of 548 documents were obtained and screened based on the inclusion and exclusion criteria. A number of 8 documents was selected for the final analysis. The main factors contributing to the resilience of volunteers at the 3 stages of pre-, during, and post-disasters were classified into 3 groups of individual, environmental, and organizational. Important factors affecting resilience of volunteers in disasters included previous disaster response experience and disaster-related training. Conclusion: Resiliency should be deemed integral to relief operations. Considering the main factors affecting volunteers’ resiliency, it is highly suggested that organizations active in humanitarian endeavors explore the factors impacting on resilience among their volunteers via various research methods and seek to select those with higher degrees of resilience in order to avert untoward consequences in their missions.


2021 ◽  
Vol 38 (2) ◽  
pp. 115-120
Author(s):  
Ayşe İKİNCİ KELEŞ ◽  
Gökhan KELEŞ

Coronavirus disease 2019 (COVID-19), which causes severe airway problems, first emerged in the Chinese city of Wuhan. The virus led to a pandemic that affected the entire world. COVID-19 affects not only health, but also economic and social life. The emergence of this pandemic has led to health systems across the world being questioned. The aim of this study was to assess the adequacy of world health systems in the face of this pandemic. Twelve countries were selected and analyzed in the study. The choice of these countries was determined by the number of COVID-19 cases and deaths. Information concerning health systems and COVID-19 was obtained from Organization for Economic Co-operation and Development 2018, World Health Organization 2020 and Deep Knowledge Group data and was subjected to statistical analysis. According to the analysis, the country with the highest investment in health expenditures is the United States (10586 US dollars/capita), and Germany stands out as the best in health services. Another finding is the first and second wave of COVID-19 was identified as the USA with the highest case and death rate (First wave cases 1.942.363 and deaths 110.514; second wave cases at 7.419.230 and deaths 2.09.450). As a result of the meta-analysis, it is revealed that only socio-economic power is not enough, countries with good health systems are more successful in the pandemic. In addition, the analysis once again reveal how important health systems are in the face of such a pandemic.


Author(s):  
Afsaneh Noormandi ◽  
Mohammad Fathalipour ◽  
Reza Daryabeygi-Khotbehsara ◽  
Soheil Hassanipour

Background and objective: COVID-19 has since been declared a global pandemic by the World Health Organization (WHO), infecting millions worldwide. The use of Interferon (INF) subtypes previously examined in the treatment of SARS and MERS is also being initiated in some clinical trials. Although different clinical trials were evaluated IFNs in the treatment of COVID-19, their efficacy and safety remain unknown. Therefore, this study aims to systematically assess IFNs efficacy and safety in treating patients with COVID-19. Methods: The protocol has been registered in the PROSPERO International Prospective Register (CRD42020200643) on 24 July 2020. This protocol has been arranged according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) 2015 checklist. Discussion: Due to lack of approved medication for the covid-19 treatment and also various mutations of this virus, evaluated the efficacy and safety of medications by various studies could help for finding treatments with high effectiveness. IFNs are one of the medications that have been administered in covid-19 infection.  Moreover, the best time of administration and dose of this medication was unknown. Although meta-analysis is a potent source for assessing the accuracy of subjects, heterogeneity of articles is a potent limitation of our work.


Author(s):  
Gagan Chooramani ◽  
Pooja Singh

The World Health Organization has declared that the spread of tuberculosis is a global emergency. Despite the implementation of strong tuberculosis-control initiatives by WHO, this highly infectious disease continues to affect all vulnerable populations, including the elderly population. Adverse social factors and poor living conditions also affect the elderly much more than the young. The clinical characteristics of tuberculosis in older adults can be unusual and may be confused with age-related illnesses. Various factors related to old age can also cause complications in the diagnosis, treatment, and disease outcomes for tuberculosis patients. The contributory factors may be poor memory, deafness, mental confusion, or impairment of speech. In addition, therapy for tuberculosis in elderly individuals is challenging because of the increased incidence of adverse drug reactions. Hence, understanding the impact of these substantial aspects will help to overcome the problem of tuberculosis in the elderly population.


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