scholarly journals Market penetration of Xpert MTB/RIF in high tuberculosis burden countries: A trend analysis from 2014 - 2016

2018 ◽  
Vol 2 ◽  
pp. 35 ◽  
Author(s):  
Danielle Cazabon ◽  
Tripti Pande ◽  
Sandra Kik ◽  
Wayne Van Gemert ◽  
Hojoon Sohn ◽  
...  
Keyword(s):  
Public Sector ◽  
World Health ◽  
Sputum Smear ◽  
Positive Trend ◽  
Market Penetration ◽  
The Public ◽  
Control Programs ◽  
Health Organization ◽  
Roll Out ◽  
Structured Questionnaire

Background: Xpert® MTB/RIF, a rapid tuberculosis (TB) molecular test, was endorsed by the World Health Organization in 2010. Since then, 34.4 million cartridges have been procured under concessional pricing. Although the roll out of this diagnostic is promising, previous studies showed low market penetration. Methods: To assess 3-year trends of market penetration of Xpert MTB/RIF in the public sector, smear and Xpert MTB/RIF volumes for the year 2016 were evaluated and policies from 2014-2016 within 22 high-burden countries (HBCs) were studied. A structured questionnaire was sent to representatives of 22 HBCs. The questionnaires assessed the total smear and Xpert MTB/RIF volumes, number of modules and days of operation of GeneXpert machines in National TB Programs (NTPs). Data regarding the use of NTP GeneXpert machines for other diseases and GeneXpert procurement by other disease control programs were collected. Market penetration was estimated by the ratio of total sputum smear volume for initial diagnosis divided by the number of Xpert MTB/RIF tests procured in the public sector. Results: The survey response rate was 21/22 (95%). Smear/Xpert ratios decreased in 17/21 countries and increased in four countries, since 2014. The median ratio decreased from 32.6 (IQR: 44.6) in 2014 to 6.0 (IQR: 15.4) in 2016. In 2016, the median GeneXpert utilization was 20%, however seven countries (7/19; 37%) were running tests for other diseases on their NTP-procured GeneXpert systems in 2017, such as HIV, hepatitis-C virus (HCV), Chlamydia trachomatis, and Neisseria gonorrhoeae. Five (5/15; 33%) countries reported GeneXpert procurement by HIV or HCV programs in 2016 and/or 2017. Conclusions: Our results show a positive trend for Xpert MTB/RIF market penetration in 21 HBC public sectors. However, GeneXpert machines were under-utilized for TB, and inadequately exploited as a multi disease technology.

scholarly journals Market penetration of Xpert MTB/RIF in high tuberculosis burden countries: A trend analysis from 2014 - 2016

2018 ◽  
Vol 2 ◽  
pp. 35 ◽  
Author(s):  
Danielle Cazabon ◽  
Tripti Pande ◽  
Sandra Kik ◽  
Wayne Van Gemert ◽  
Hojoon Sohn ◽  
...  
Keyword(s):  
Public Sector ◽  
World Health ◽  
Sputum Smear ◽  
Positive Trend ◽  
Market Penetration ◽  
The Public ◽  
Control Programs ◽  
Full Capacity ◽  
Health Organization ◽  
Roll Out

Background: Xpert® MTB/RIF, a rapid tuberculosis (TB) molecular test, was endorsed by the World Health Organization in 2010. Since then, 34.4 million cartridges have been procured under concessional pricing. Although the roll out of this diagnostic is promising, previous studies showed low market penetration. Methods: To assess 3-year trends of market penetration of Xpert MTB/RIF in the public sector, smear and Xpert MTB/RIF volumes for the year 2016 were assessed and policies from 2014-2016 within 22 high-burden countries (HBCs) were studied. A structured questionnaire was sent to representatives of 22 HBCs. The questionnaires assessed the total smear and Xpert MTB/RIF volumes, number of modules and days of operation of GeneXpert machines in National TB Programs (NTPs). Data regarding the use of NTP GeneXpert machines for other diseases and GeneXpert procurement by other disease control programs were collected. Market penetration was estimated by the ratio of total sputum smear volume for initial diagnosis divided by the number of Xpert MTB/RIF tests procured in the public sector. Results: The survey response rate was 21/22 (95%). Smear/Xpert ratios decreased in 17/21 countries and increased in four countries, since 2014. The median ratio decreased from 32.6 (Q1:14.3, Q3: 58.9) in 2014 to 6.0 (Q1: 1.6, Q3: 17.0) in 2016. Nineteen countries (19/19; 100%) were not using GeneXpert machines to their full capacity, however seven countries (7/19; 37%) were running tests for other diseases on their NTP-procured GeneXpert systems in 2017, such as HIV, hepatitis-C virus (HCV), Chlamydia trachomatis, and Neisseria gonorrhoeae. Five (5/15; 33%) countries reported GeneXpert procurement by HIV or HCV programs in 2016 and/or 2017. Conclusions: Our results show a positive trend for Xpert MTB/RIF market penetration in 21 HBC public sectors. However, GeneXpert machines were under-utilized for TB, and inadequately exploited as a multi disease technology.

scholarly journals From resistance to persistence: Insights of a mathematical model on the indiscriminate use of insecticide

2020 ◽  
Vol 14 (11) ◽  
pp. e0008862
Author(s):  
Helio Schechtman ◽  
Denise Valle ◽  
Max O. Souza
Keyword(s):  
Theoretical Study ◽  
World Health ◽  
Fitness Costs ◽  
Private Companies ◽  
The Public ◽  
Control Programs ◽  
The World ◽  
Resistant Population ◽  
Domestic Use ◽  
Health Organization

The development of insecticide resistance is becoming a threat to many arboviruses control programs worldwide. While this has been attributed to the indiscriminate use of insecticide, a more theoretical study is apparently not available. Using in-silico experiments, we investigated the effects of two different policies: one used by the Brazilian Ministry of Health (which follows the World Health Organization protocol) and a more permissive one, akin to those employed by various gated communities and private companies. The results show that the public policy does not lead to resistance fixation. On the other hand, permissive application of adulticide, such as intensive domestic use mainly during epidemic periods, might lead to the fixation of a resistant population, even when resistance is associated with moderate fitness costs.

scholarly journals Barreras de acceso geográfico a los servicios de salud oral en el departamento del Tolima, Colombia.

Tequio ◽  
2021 ◽  
Vol 4 (12) ◽  
pp. 5-24
Author(s):  
John Harold Estrada Montoya ◽  
Laura Camila Reyes Cañón
Keyword(s):  
Public Sector ◽  
Public Transport ◽  
World Health ◽  
Dental Services ◽  
Cross Sectional ◽  
The Public ◽  
Geographical Access ◽  
General Dentists ◽  
Health Organization ◽  
Geographical Accessibility

Cross-sectional descriptive mixed study carried out for the 47 municipalities of the department of Tolima, Colombia, neighboring the department of Cundinamarca, where Bogota, the capital of the country, is located. The objective was to analyze the geographical access barriers and the inventory of human talent and dental services in this department. A distance and time measurement system was applied to identify the duration of travel from each municipality to Ibagué (departmental capital) by public transport. The geographical accessibility barrier determinant endorsed by the World Health Organization (W.H.O.) is a trip duration greater than four hours. It was found that the first level of care in the public sector is present in all municipalities, the second level is in six; the third only in Ibague. Displacement by public transport represents a geographical access barrier in six municipalities; the number of dentists in the public sector does not satisfactorily cover the needs of the population, since more than 50% of the municipalities have a deficit of more than four general dentists and there is a low presence of specialists. In the department of Tolima there are geographical accessibility barriers to health and, specifically, to oral health.

scholarly journals Availability, affordability and stock-outs of commodities for the treatment of snakebite in Kenya

2021 ◽  
Vol 15 (8) ◽  
pp. e0009702
Author(s):  
Gaby Isabelle Ooms ◽  
Janneke van Oirschot ◽  
Dorothy Okemo ◽  
Benjamin Waldmann ◽  
Eugene Erulu ◽  
...  
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
World Health ◽  
Health Coverage ◽  
The Public ◽  
For Profit ◽  
Not For Profit ◽  
Health Action ◽  
Health Organization ◽  
Universal Health

Background Annually, about 2.7 million snakebite envenomings occur globally. Alongside antivenom, patients usually require additional care to treat envenoming symptoms and antivenom side effects. Efforts are underway to improve snakebite care, but evidence from the ground to inform this is scarce. This study, therefore, investigated the availability, affordability, and stock-outs of antivenom and commodities for supportive snakebite care in health facilities across Kenya. Methodology/principal findings This study used an adaptation of the standardised World Health Organization (WHO)/Health Action International methodology. Data on commodity availability, prices and stock-outs were collected in July-August 2020 from public (n = 85), private (n = 36), and private not-for-profit (n = 12) facilities in Kenya. Stock-outs were measured retrospectively for a twelve-month period, enabling a comparison of a pre-COVID-19 period to stock-outs during COVID-19. Affordability was calculated using the wage of a lowest-paid government worker (LPGW) and the impoverishment approach. Accessibility was assessed combining the WHO availability target (≥80%) and LPGW affordability (<1 day’s wage) measures. Overall availability of snakebite commodities was low (43.0%). Antivenom was available at 44.7% of public- and 19.4% of private facilities. Stock-outs of any snakebite commodity were common in the public- (18.6%) and private (11.7%) sectors, and had worsened during COVID-19 (10.6% versus 17.0% public sector, 8.4% versus 11.7% private sector). Affordability was not an issue in the public sector, while in the private sector the median cost of one vial of antivenom was 14.4 days’ wage for an LPGW. Five commodities in the public sector and two in the private sector were deemed accessible. Conclusions Access to snakebite care is problematic in Kenya and seemed to have worsened during COVID-19. To improve access, efforts should focus on ensuring availability at both lower- and higher-level facilities, and improving the supply chain to reduce stock-outs. Including antivenom into Universal Health Coverage benefits packages would further facilitate accessibility.

scholarly journals Availability, prices and affordability of essential medicines in Zhejiang Province, China

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241761
Author(s):  
Zuojun Dong ◽  
Qiucheng Tao ◽  
Bobo Yan ◽  
Guojun Sun
Keyword(s):  
Public Sector ◽  
Zhejiang Province ◽  
Essential Medicines ◽  
World Health ◽  
Price Ratio ◽  
Public And Private ◽  
The Public ◽  
The Mean ◽  
Daily Wage ◽  
Health Organization

Objective To evaluate the availability, prices, and affordability of essential medicines in Zhejiang Province, China. Methods The survey was carried out in Zhejiang Province in 2018 following the methodology of the World Health Organization (WHO) and Health Action International (HAI). This method is an international standard method.Data on 50 medicines were collected from public health facilities and private pharmacies. Medication prices were compared with international reference prices to obtain a median price ratio. The affordability of medicines was measured based on the daily wage of the lowest-paid unskilled government worker. In private pharmacies, the mean availability of Originator Brands (OBs) and Lowest-priced Generics (LPGs) was 36.7% and 40.3%, respectively. Findings The effects of the mean availability of OBs and LPGs were seen in private pharmacies. Correspondingly, the average availability of OBs and LPGs was 41.8% and 35.1% in the public sector, respectively. In the public sector, the median price ratios (MPRs) were 5.21 for generics and 13.49 for OBs. In the private sector, the MPRs were 4.94 for generics and 14.75 for OBs. Treating common diseases with LPGs was generally affordable, while treatment with OBs was less affordable. Conclusions In Zhejiang Province, low availability was observed for medicines surveyed in the public and private sectors. Price differences between originator brands and generics in both sectors are apparent. OBs were more expensive than LPGs in both the public and private sectors. Low availability affects access to essential medicines. Policy measures should be taken to improve the availability of essential medicines.

Novel Coronavirus 2019 Outbreak: A Global Epidemic

2020 ◽  
Vol 17 (12) ◽  
pp. 1458-1464
Author(s):  
Sweta Kamboj ◽  
Rohit Kamboj ◽  
Shikha Kamboj ◽  
Kumar Guarve ◽  
Rohit Dutt
Keyword(s):  
World Health ◽  
Upper Respiratory Tract ◽  
Global Epidemic ◽  
The Public ◽  
The Government ◽  
Tract Disease ◽  
The 1960S ◽  
Novel Coronavirus ◽  
Health Organization ◽  
The Impact

Background: In the 1960s, the human coronavirus was designated, which is responsible for the upper respiratory tract disease in children. Back in 2003, mainly 5 new coronaviruses were recognized. This study directly pursues to govern knowledge, attitude and practice of viral and droplet infection isolation safeguard among the researchers during the outbreak of the COVID-19. Introduction: Coronavirus is a proteinaceous and infectious pathogen. It is an etiological agent of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). Coronavirus, appeared in China from the seafood and poultry market last year, which has spread in various countries, and has caused several deaths. Methods: The literature data has been taken from different search platforms like PubMed, Science Direct, Embase, Web of Science, who.int portal and complied. Results: Corona virology study will be more advanced and outstanding in recent years. COVID-19 epidemic is a threatening reminder not solely for one country but all over the universe. Conclusion: In this review article, we encapsulated the pathogenesis, geographical spread of coronavirus worldwide, also discussed the perspective of diagnosis, effective treatment, and primary recommendations by the World Health Organization, and guidelines of the government to slow down the impact of the virus are also optimistic, efficacious and obliging for the public health. However, it will take a prolonged time in the future to overcome this epidemic.

scholarly journals How Loud and Clear Rung the Alarm Bell: The Communication Efforts of WHO on the Beginning of COVID-19 Outbreak

2021 ◽  
pp. 002073142110249
Author(s):  
Huriye Toker
Keyword(s):  
Risk Communication ◽  
International Development ◽  
International Health ◽  
Well Being ◽  
World Health ◽  
The Public ◽  
News Releases ◽  
The Media ◽  
Credible Information ◽  
Health Organization

As seen clearly from the coronavirus disease 2019 (COVID-19) pandemic, health is an important foreign policy and diplomatic issue connected with security, economic well-being, and international development. According to risk communication researchers, effective, transparent, and timely information sharing is the most important tool after vaccines for responding to pandemics. This study aims to start a scholarly discussion on the risk communication efforts of the World Health Organization (WHO) during the COVID-19 outbreak. We analyzed WHO’s communication efforts during the first 3 months of the COVID-19 pandemic. As the leading international health organization, WHO was responsible for providing rapid, up-to-date, and credible information for the public and the media. The selected research items were 42 news releases and statements provided by WHO between December 31, 2019, and March 30, 2020. These were subjected to qualitative and quantitative content analyses using the NVivo 12 qualitative analysis software program for coding. The data were coded under 6 variables (date of publication, topics, frequency, wording of the COVID-19 outbreak, sourcing, and themes of the releases). While 54.7% of WHO's communications were devoted to the COVID-19 outbreak, more than half were not issued until March. That is, instead of early risk communication and clear warnings about the outbreak, WHO acted overcautiously, preferring messages related to solidarity and cooperation during the most devastating pandemic of the 21st century.

scholarly journals Building evidence on what works (and what does not): practical guidance from the World Health Organization on post-project evaluation of adolescent sexual and reproductive health projects

2021 ◽  
Author(s):  
Susan Igras ◽  
Marina Plesons ◽  
Venkatraman Chandra-Mouli
Keyword(s):  
Reproductive Health ◽  
World Health Organization ◽  
Sexual And Reproductive Health ◽  
Project Evaluation ◽  
World Health ◽  
The Public ◽  
What Works ◽  
The World ◽  
Practical Guidance ◽  
Health Organization

Abstract Over the past 25 years, there has been significant progress in increasing the recognition of, resources for, and action on adolescent health, and adolescent sexual and reproductive health (ASRH) in particular. As with numerous other health areas, however, many of the projects that aim to improve ASRH are implemented without well-thought-out plans for evaluation. As a result, the lessons that projects learn as they encounter and address policy and programmatic challenges are often not extracted and placed in the public arena. In such cases, post-project evaluation (PPE) offers the possibility to generate learnings about what works (and does not work), to complement prospective studies of new or follow-on projects. To fill the gap in the literature and guidance on PPE, the World Health Organization developed The project has ended, but we can still learn from it! Practical guidance for conducting post-project evaluations of adolescent sexual and reproductive health projects. This article provides an overview of the guidance by outlining key methodological and contextual challenges in conducting PPE, as well as illustrative solutions for responding to them.

Triage Management, Survival, and the Law in the Age of Ebola

2014 ◽  
Vol 9 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Frederick M Burkle ◽  
Christopher M Burkle
Keyword(s):  
Public Health ◽  
International Health ◽  
Epidemiological Data ◽  
Population Based ◽  
World Health ◽  
Economic Stability ◽  
Budget Cuts ◽  
The Public ◽  
Level 3 ◽  
Health Organization

AbstractLiberia, Sierra Leone, and Guinea lack the public health infrastructure, economic stability, and overall governance to stem the spread of Ebola. Even with robust outside assistance, the epidemiological data have not improved. Vital resource management is haphazard and left to the discretion of individual Ebola treatment units. Only recently has the International Health Regulations (IHR) and World Health Organization (WHO) declared Ebola a Public Health Emergency of International Concern, making this crisis their fifth ongoing level 3 emergency. In particular, the WHO has been severely compromised by post-2003 severe acute respiratory syndrome (SARS) staffing, budget cuts, a weakened IHR treaty, and no unambiguous legal mandate. Population-based triage management under a central authority is indicated to control the transmission and ensure fair and decisive resource allocation across all triage categories. The shared responsibilities critical to global health solutions must be realized and the rightful attention, sustained resources, and properly placed legal authority be assured within the WHO, the IHR, and the vulnerable nations. (Disaster Med Public Health Preparedness. 2014;0:1-6)

scholarly journals Deafening silence on a vital issue: The World Health Organization has ignored the sexuality of persons with disabilities

2018 ◽  
Vol 7 ◽  
Author(s):  
Christine Peta
Keyword(s):  
World Health Organization ◽  
Well Being ◽  
World Health ◽  
Human Beings ◽  
Persons With Disabilities ◽  
The Public ◽  
National Priority ◽  
Social Welfare System ◽  
The World ◽  
Health Organization

In 2016, the World Health Organization, through the Global Cooperation on Assistive Technology Initiative, issued the Priority Assistive Products List which is meant to be a guide to member states of the 50 assistive products needed for a basic health care and/or social welfare system; it is also a model from which nations can develop their national priority assistive products lists. The aim of this opinion paper is to share my views about the Priority Assistive Products List on the grounds that it makes no distinct mention of sexual assistive devices, yet research has indicated that sexuality is an area of great concern for persons with disabilities. In any case, sexuality forms a core part of being human, and it impacts on both the physical and mental well-being of all human beings. I conclude in part that, in its present format, the list perpetuates the myth that persons with disabilities are asexual beings who are innocent of sexual thoughts, feelings and experiences. The list also propagates the stereotype that sexuality is a sacred, private, bedroom matter that should be kept out of the public domain, to the detriment of the health and well-being of persons with disabilities.

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