scholarly journals ESTIMATING BURDEN OF DISEASE DUE TO CONTINUOUS PROPAGATION OF HIV INFECTION AMONG INJECTING DRUG USERS

2020 ◽  
Vol 12 (1) ◽  
pp. 97-104
Author(s):  
A. N. Barinova ◽  
A. A. Lebedeva ◽  
N. N. Ladnaya ◽  
E. E. Zaytseva ◽  
S. L. Plavinskii

Despite long period of propagation of HIV infection among injecting drug users (IDU) in Russian Federation there is still capacity for appearance of new cases. Based on results of integrated bio-behavioral study conducted in six cities of Russian Federation burden of HIV infection was estimated. Several approaches to calculate disability-adjusted life years (DALY) were used. Estimates of DALY depend mostly on mortality associated with HIV infection. It was shown, that estimates also change depending on changing age-dependent productivity and discount rate. Average loss was estimated at 15,1 DALY per one case of infection. Extrapolating these results on Russian Federation as a whole show that due to continuation of HIV spread among IDU every year 595 thousand DALYs are lost. Summary measures of public health should be used to prioritize investment in prevention.

Author(s):  
Anna N. Barinova

Purpose of the study. To evaluate the efficiency of the prevention programs aimed at the prevention of the spread of HIV infection, represent the it in disabled adjusted life years (DALY) and compare the efficiency with the prevention and treatment costs. Material and methods. Results of the panel study executed in 2006-2013 in 10 regions of Russian Federation in HIV infection risk groups (4 waves). The total number of include participants accounted of 9891. The study protocol included the detailed survey for the risk behavior and HIV testing. The obtained results of the study were used to calibrate the dynamic (Markov) model of the effect of the prevention on the length of the quality-adjusted life and treatment cost. The cost of the prevention was estimated on the base of reporting documents of prevention programs. Results. Programs of the comprehensive prevention of HIV-infection, among injecting drug users give rise in the significant decrease in the HIV incidence. The evaluation of the effect of prevention in frameworks of a multidimensional model shows odds ratio to be of 0.56 (95% CI = 0.40-0.78). This relative reduction of the incidence corresponds to the absolute incidence decrease from 3.98 per 100 person-years, among those not participating in prevention programs (95% CI: 3.37-4.69) to 2.22 per 100 person-years (95% CI: 1.89-2.62) among participants. This effect of the prevention leads to averting losses of 0.75-1.1 DALY per person, with most savings from the diminishing of the disability. In most plausible scenario this results in cost saving with return on the investment of 40 kopeks per rouble invested in prevention. Conclusion. Comprehensive programs of HIV prevention in Russian Federation possess of the significant effectiveness and under plausible assumptions are cost-saving. When discussing financing preventive measures they should be evaluated on real effectiveness and cost.


Author(s):  
Scott Burris ◽  
Micah L. Berman ◽  
Matthew Penn, and ◽  
Tara Ramanathan Holiday

Chapter 5 discusses the use of epidemiology to identify the source of public health problems and inform policymaking. It uses a case study to illustrate how researchers, policymakers, and practitioners detect diseases, identify their sources, determine the extent of an outbreak, and prevent new infections. The chapter also defines key measures in epidemiology that can indicate public health priorities, including morbidity and mortality, years of potential life lost, and measures of lifetime impacts, including disability-adjusted life years and quality-adjusted life years. Finally, the chapter reviews epidemiological study designs, differentiating between experimental and observational studies, to show how to interpret data and identify limitations.


Biomedicines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 111
Author(s):  
Aida Muntsant ◽  
Francesc Jiménez-Altayó ◽  
Lidia Puertas-Umbert ◽  
Elena Jiménez-Xarrie ◽  
Elisabet Vila ◽  
...  

Life expectancy decreases with aging, with cardiovascular, mental health, and neurodegenerative disorders strongly contributing to the total disability-adjusted life years. Interestingly, the morbidity/mortality paradox points to females having a worse healthy life expectancy. Since bidirectional interactions between cardiovascular and Alzheimer’s diseases (AD) have been reported, the study of this emerging field is promising. In the present work, we further explored the cardiovascular–brain interactions in mice survivors of two cohorts of non-transgenic and 3xTg-AD mice, including both sexes, to investigate the frailty/survival through their life span. Survival, monitored from birth, showed exceptionally worse mortality rates in females than males, independently of the genotype. This mortality selection provided a “survivors” cohort that could unveil brain–cardiovascular interaction mechanisms relevant for normal and neurodegenerative aging processes restricted to long-lived animals. The results show sex-dependent distinct physical (worse in 3xTg-AD males), neuropsychiatric-like and cognitive phenotypes (worse in 3xTg-AD females), and hypothalamic–pituitary–adrenal (HPA) axis activation (higher in females), with higher cerebral blood flow and improved cardiovascular phenotype in 3xTg-AD female mice survivors. The present study provides an experimental scenario to study the suggested potential compensatory hemodynamic mechanisms in end-of-life dementia, which is sex-dependent and can be a target for pharmacological and non-pharmacological interventions.


Author(s):  
Rajesh Sharma

Abstract Background This study presents an up-to-date, comprehensive and comparative examination of breast cancer’s temporal patterns in females in Asia in last three decades. Methods The estimates of incidence, mortality, disability-adjusted-life-years and risk factors of breast cancer in females in 49 Asian countries were retrieved from Global Burden of Disease 2019 study. Results In Asia, female breast cancer incidence grew from 245 045[226 259–265 260] in 1990 to 914 878[815 789–1025 502] in 2019 with age-standardized incidence rate rising from 21.2/100 000[19.6–22.9] to 35.9/100 000[32.0–40.2] between 1990 and 2019. The death counts more than doubled from 136 665[126 094–148 380] to 337 822[301 454–375 251]. The age-standardized mortality rate rose marginally between 1990 and 2019 (1990: 12.1[11.0–13.1]; 2019: 13.4[12.0–14.9]). In 2019, age-standardized incidence rate varied from 17.2/100 000[13.95–21.4] in Mongolia to 122.5[92.1–160.7] in Lebanon and the age-standardized mortality rate varied 4-fold from 8.0/100 000 [7.2–8.8] in South Korea to 51.9[39.0–69.8] in Pakistan. High body mass index (5.6%), high fasting plasma glucose (5.6%) and secondhand smoke (3.5%) were the main contributory risk factors to all-age disability-adjusted-life-years due to breast cancer in Asia. Conclusion With growing incidence, escalating dietary and behavioural risk factors and lower survival rates due to late-disease presentation in low- and medium-income countries of Asia, breast cancer has become a significant public health threat. Its rising burden calls for increasing breast cancer awareness, preventive measures, early-stage detection and cost-effective therapeutics in Asia.


2020 ◽  
pp. 095646242095298
Author(s):  
Augusto Cesar Lara de Sousa ◽  
Tatiana de Araujo Eleuterio ◽  
José Victor Afonso Coutinho ◽  
Raphael Mendonça Guimarães

To describe the trends of HIV/AIDS metrics related to the burden of disease for Brazil between 1990 and 2017 we conducted a timeseries analysis for HIV/AIDS indicators by extracting data from the Global Burden of Disease study. We calculated traditional prevalence, incidence and mortality rates, the number of years lost by HIV-related deaths (YLL) and disability (YLD), and disability-adjusted life years (DALY). We estimated time series models and assessed the impact of highly active antiretroviral therapy (HAART) on the same indicators. In the set of disability-adjusted life years (DALY), the highest weight of its magnitude was due to YLL. There was a decline, especially after 1996, of DALY, mortality and YLL for HIV/AIDS. However, YLD, incidence, and prevalence increased over the same period. Also, the analysis of interrupted time series showed that the introduction of HAART into health policy had a significant impact on indicators, especially for DALY and YLL. We need to assess the quality of life of people living with HIV, especially among older adults. In addition, we need to focus on primary prevention, emphasizing methods to avoid infection and public policies should reflect this.


2021 ◽  
pp. 49-51
Author(s):  
Narayanaswamy Venketasubramanian ◽  
Yee Mon Khine ◽  
Ohnmar Ohnmar ◽  
Myat Po Po Kyaw Khin ◽  
Min Thit Win

Myanmar is home to over 51 million people. The age- and sex-standardized mortality rate due to stroke is 165.4/100,000, while the rate of age- and sex-standardized disability-adjusted life years lost due to stroke is 2971.3/100,000. The prevalence of stroke among adults aged 40–99 years is 1.5%. Stroke is the leading cause of morbidity and mortality and comprises 20% of the neurological workload. There are only 10 stroke units in the whole country. Doctors are aware of the importance of hypertension in stroke prevention and the need for physiotherapy after stroke, but, until recently and in rural areas, they also tend to use steroids and neuroprotectants, and lower blood pressure aggressively acutely after stroke; antiplatelets are not widely used. Thrombolysis service is available at some tertiary centers but mechanical thrombectomy is not yet available.


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