scholarly journals Analysis of a Cooperation and Interventional Model in Humanitarian Medicine

2021 ◽  
Vol 9 ◽  
Author(s):  
Stefano M. Marianeschi ◽  
Nicola Uricchio ◽  
Gianandrea Bern Cerri ◽  
Simone Ghiselli ◽  
Cristina Carro ◽  
...  
Keyword(s):  
Developing Countries ◽  
Cardiac Surgery ◽  
Health Sector ◽  
Humanitarian Mission ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Medical Teams ◽  
The Individual ◽  
The Cost ◽  
The Impact

Background: Every year, around 15 million children, in developing countries, die or develop life-long disabilities because of congenital cardiac diseases. In this report we measure the effect of a pediatric cardiac surgery humanitarian project on the health of the individual and on the potential influence this has on the countries economy and its growing health services.Methods: We collected and analyzed data from the Italian NGO, Mission Bambini's database, including all congenital cardiac missions undertaken in Cambodia between 2012 and 2019. DALY's (Disability Adjusted Life Years) saved by the humanitarian mission were estimated and used to reflect on the impact this had on the populations economy. Progression in the local medical teams skills emulated the advancements made in the health sector of the region.Results: Between 2012 and 2019, 128 patients underwent a congenital cardiac operation at Angkor Hospital for Children at Siem Reap, Cambodia. The median age was 6 years. The majority of the pathologies included VSD, TOF, ASD. The mean Aristotle's Complexity Score was 6. Post-operative mortality was 0.8% (1/128). The cost-effectiveness analysis identified 5.360 DALY's saved by surgery. The competency of the local team was progressive with them being able to handle more complex cases on subsequent missions.Conclusion: In developing Countries, performing congenital cardiac surgery cases can be carried out successfully with improvement in both the economy and the health system of the country by increasing the years and the quality of life of the working population and developing the expertise of the regional team.

Assessing antiretroviral therapy success in HIV/AIDS morbidity and mortality trends in Brazil, 1990–2017: an interrupted time series study

2020 ◽  
pp. 095646242095298
Author(s):  
Augusto Cesar Lara de Sousa ◽  
Tatiana de Araujo Eleuterio ◽  
José Victor Afonso Coutinho ◽  
Raphael Mendonça Guimarães
Keyword(s):  
Time Series ◽  
Antiretroviral Therapy ◽  
Burden Of Disease ◽  
Interrupted Time Series ◽  
People Living With Hiv ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Impact ◽  
Hiv Aids

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.

Investing in Health Wisely: The Role of Needs-based Technology Assessment

1995 ◽  
Vol 11 (4) ◽  
pp. 673-684 ◽  
Author(s):  
Dean T. Jamison ◽  
Helen Saxenian ◽  
Yves Bergevin
Keyword(s):  
Public Health ◽  
Technology Assessment ◽  
Universal Access ◽  
Policy Formulation ◽  
Disability Adjusted Life ◽  
Life Years ◽  
National Public Health ◽  
The Cost ◽  
Improve Health

AbstractCountries worldwide spend huge sums on health—about $1,700 billion a year, or roughly 8% of global income. But the World Development Report 1993: Investing in Health shows that these monies could be spent much more wisely, in the process doing a great deal to help the world's 1 billion poor. Essential national public health and clinical packages are proposed based on assessment of the burden of disease (measured in disability adjusted life years) and the cost-effectiveness of interventions. Governments can play a central role in improving the health of their citizens: they can foster an environment that enables households to improve health and they can also improve their own spending on health, targeting it to support universal access to essential national public health and clinical packages based on the above methods. This is a good example of the concept of needs-based technology assessment, combining the disciplines of epidemiology, economics, and policy formulation. When applied, it should lead to improved effectiveness, efficiency, and equity.

scholarly journals The Impact of RSV-Associated Respiratory Disease on Children in Asia

2018 ◽  
Vol 14 (03) ◽  
pp. 079-088
Author(s):  
Maduja Divarathne ◽  
Rukshan Ahamed ◽  
Faseeha Noordeen
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Disease Burden ◽  
Heart Diseases ◽  
Epidemiological Studies ◽  
Morbidity And Mortality ◽  
Life Years ◽  
Rsv Infection ◽  
Tract Infections ◽  
The Impact

AbstractAcute respiratory tract infections (ARTIs) are leading contributors to the global infectious disease burden, which is estimated to be 112,900,000 disability adjusted life years. Viruses contribute to the etiology of ARTIs in a big way compared with other microorganisms. Since the discovery of respiratory syncytial virus (RSV) 61 years ago, the virus has been recognized as a major cause of ARTI and hospitalization in children. The morbidity and mortality attributable to RSV infection appear to be higher in infants < 3 months and in those with known risk factors such as prematurity, chronic lung, and congenital heart diseases. Crowded living conditions, exposure to tobacco smoke, and industrial or other types of air pollution also increase the risk of RSV-associated ARTI. Many epidemiological studies have been conducted in developed countries to understand the seasonal patterns and risk factors associated with RSV infections. Dearth of information on RSV-associated morbidity and mortality in Asian and developing countries indicates the need for regional reviews to evaluate RSV-associated disease burden in these countries. Epidemiological studies including surveillance is the key to track the disease burden including risk factors, seasonality, morbidity, and mortality associated with RSV infection in these countries. These data will contribute to improve the clinical diagnosis and plan preventive strategies in resource-limited developing countries.

Evaluating the effect of climate variation on the cost efficiency of a crop permit policy in Southern Sweden

2013 ◽  
Vol 4 (2) ◽  
pp. 110-117
Author(s):  
Dennis Collentine ◽  
Holger Johnsson
Keyword(s):  
Cost Efficiency ◽  
Agricultural Sector ◽  
Policy Design ◽  
Correlation Coefficients ◽  
Nitrogen Loads ◽  
Weather Variation ◽  
The Baltic ◽  
The Individual ◽  
The Cost ◽  
The Impact

Current international agreements call for a significant reduction of nitrogen loads to the Baltic Sea. New measures to reduce nitrogen loads from the agricultural sector and an increased focus on cost efficiency will be needed to meet reduction targets. For policy design and evaluation it is important to understand the impact of weather on the efficiency of abatement measures. One new proposed policy is the use of crop permits based on weather normalized average leaching. This paper describes the use of the Spearman method to determine the efficiency of this policy with annual weather variation. The conclusion is that the values of the Spearman correlation coefficients in the study indicate that using average leaching for the individual crops on specific soil types for calculating crop permit requirements is an efficient policy. The Spearman method is demonstrated to be a simple useful tool for evaluating the impact of weather and is recommended for use in new studies.

scholarly journals Disability-adjusted Life Years for respiratory syncytial virus in children under 2 years

2020 ◽  
Author(s):  
jefferson buendia ◽  
Fernando Polack ◽  
Juana Patricia Sanchez Villamil
Keyword(s):  
Respiratory Syncytial Virus ◽  
Statistical Parameter ◽  
Epidemiological Surveillance ◽  
Years Of Life Lost ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
The Impact

Abstract BACKGROUND: Respiratory syncytial virus infection is the leading cause of bronchiolitis in Colombia. There is growing evidence about the impact of Respiratory syncytial virus on society in terms of years of life lost due to this condition. The objective of the present study is to determine the Disability-Adjusted Life Years for respiratory syncytial virus in children under 2 years in ColombiaMETHODS: Data from the national epidemiological surveillance system were used to estimate DALYs, calculated from the sum of years of life lost and years lived with disability due to RSV infection in Colombia. A bootstrapped method with 10000 iterations was used to estimate each statistical parameter using the package DALY calculator in R. RESULTS: In 2019, 260 873 years of life (CI95% 208 180- 347 023) were lost due to RSV bronchiolitis in Colombian children under 2 years. The estimated rate was 20 DALYs / 1000 person-year (95% CI 16 – 27).CONCLUSION: This is the first report estimating the impact of RSV bronchiolitis morbidity and mortality in Colombia. The findings of the present study suggest that the actual burden and cost of bronchiolitis due to RSV is high. Prevention strategies, such as RSV vaccination, to reduce morbidity associated with RSV infection should be encouraged in our country.

Abstract P116: The Impact of Diet Low in Fruits and Vegetables on Cardiovascular Disease Burden Across 195 Countries in 2015

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Patrick J Sur ◽  
Ashkan Afshin
Keyword(s):  
Cardiovascular Disease ◽  
Fruits And Vegetables ◽  
Population Level ◽  
Optimal Level ◽  
Protective Effects ◽  
Disability Adjusted Life Years ◽  
Country Level ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Impact

Introduction: While cardio-protective effects of fruits and vegetables are well-established, the impact of their suboptimal intake on the CVD burden across nations and levels of development has not been evaluated. Objective: To systematically quantify the burden of CVD attributable to low intake of fruits and low intake of vegetables in 195 countries by age, sex, country, and development status in 2015. Methods: We obtained data on consumption of fruits and vegetables from nationally or subnationally representative nutrition surveys and data on their national availability from the UN FAO. Etiologic effect sizes of fruits and vegetables on CVD endpoints were obtained from meta- analyses of prospective cohort studies. The optimal level of intakes for each was determined based on the levels associated with lowest risk of mortality in prospective observational studies. A comparative risk assessment analysis was conducted to quantify the proportion of disability- adjusted life years (DALYs) attributable to low intake of each. The variation of this burden was further evaluated across different levels of our newly developed socio-demographic index (SDI). Results: In 2015, low intake of fruits accounted for 57.3 (95% UI: 37.1- 78.4) million DALYs due to CVD globally (41.5% from IHD and 58.5% from stroke). Low intake of vegetable caused 44.6 (23.6- 68.8) million CVD DALYs (67.3% IHD and 32.7% stroke). The highest burden of CVD attributable to low intake of fruits and vegetables was seen in the middle and low-middle SDI quintiles (17.2 and 14.3% of total DALYs), while the lowest burden for each was seen in high and high-middle SDI quintiles (12.7 and 11.2%). At the country level, the attributable CVD burden ranged from 5.1% of total DALYs (Rwanda) to 23.2% (Bangladesh) for low intake of fruit and from 5.9% (North Korea) to 19.4% (Mongolia) for low intake of vegetable. Conclusion: Our findings suggest that population inventions to increase consumption of fruits and vegetables at population level could save millions of life years globally. Figure. Age-standardized proportion of disability-adjusted life years attributable to low intake of fruits (A) and vegetables (B) from cardiovascular disease among adults (> 25y) in 2015.

scholarly journals A Cost-Effectiveness Analysis of Newborn Screening for Severe Combined Immunodeficiency in the UK

2019 ◽  
Vol 5 (3) ◽  
pp. 28 ◽  
Author(s):  
Alice Bessey ◽  
James Chilcott ◽  
Joanna Leaviss ◽  
Carmen de la Cruz ◽  
Ruth Wong
Keyword(s):  
Cost Effectiveness ◽  
Severe Combined Immunodeficiency ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Combined Immunodeficiency ◽  
Tree Model ◽  
Life Years ◽  
The Uk ◽  
The Cost ◽  
The Impact

Severe combined immunodeficiency (SCID) can be detected through newborn bloodspot screening. In the UK, the National Screening Committee (NSC) requires screening programmes to be cost-effective at standard UK thresholds. To assess the cost-effectiveness of SCID screening for the NSC, a decision-tree model with lifetable estimates of outcomes was built. Model structure and parameterisation were informed by systematic review and expert clinical judgment. A public service perspective was used and lifetime costs and quality-adjusted life years (QALYs) were discounted at 3.5%. Probabilistic, one-way sensitivity analyses and an exploratory disbenefit analysis for the identification of non-SCID patients were conducted. Screening for SCID was estimated to result in an incremental cost-effectiveness ratio (ICER) of £18,222 with a reduction in SCID mortality from 8.1 (5–12) to 1.7 (0.6–4.0) cases per year of screening. Results were sensitive to a number of parameters, including the cost of the screening test, the incidence of SCID and the disbenefit to the healthy at birth and false-positive cases. Screening for SCID is likely to be cost-effective at £20,000 per QALY, key uncertainties relate to the impact on false positives and the impact on the identification of children with non-SCID T Cell lymphopenia.

scholarly journals Cost Effectiveness Analysis Using Disability-Adjusted Life Years for Cataract Surgery

2020 ◽  
Vol 17 (16) ◽  
pp. 6010
Author(s):  
Thinni Nurul Rochmah ◽  
Anggun Wulandari ◽  
Maznah Dahlui ◽  
Ernawaty ◽  
Ratna Dwi Wulandari
Keyword(s):  
Cost Effectiveness ◽  
Cataract Surgery ◽  
Cost Effective ◽  
Disability Adjusted Life Years ◽  
Cost Effectiveness Ratio ◽  
Small Incision Cataract Surgery ◽  
Post Surgery ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Cost

Cataracts are the second most prioritized eye disease in the world. Cataracts are an expensive treatment because surgery is the only method that can treat the disease. This study aims to analyze the cost effectiveness of each operating procedure. Specifically, phacoemulsification and Small Incision Cataract Surgery (SICS) with Disability-Adjusted Life Years (DALYs) as the effectiveness indicator is used. This study is an observational analytic study with a prospective framework. The sample size is 130 patients who have undergone phacoemulsification and 25 patients who have undergone SICS. The DALY for phacoemulsification at Day-7 (D-7) is 0.3204, and at Day-21 (D-21), it is 0.3204, while the DALY for SICS at D-7 is 0.3060, and at D-21, it is 0.3158. The incremental cost effectiveness ratio (ICER) for cataract surgery at D-7 is USD $1872.49, and at D-21, it is USD $5861.71, whereas the Indonesian Gross Domestic Product (GDP) is USD $4174.90. In conclusion, the phacoemulsification technique is more cost effective than the SICS technique. The ICER value is very cost effective at D-7 post-surgery compared to at D-21 post-surgery because the ICER is less than 1 GDP per capita per DALY.

Economic Development and Non-Communicable Chronic Diseases

2012 ◽  
Vol 12 (4) ◽  
pp. 1850274 ◽  
Author(s):  
David A. Mayer-Foulkes ◽  
Claudia Pescetto-Villouta
Keyword(s):  
Chronic Diseases ◽  
Health Sector ◽  
Two Dimensions ◽  
Data Availability ◽  
Health Policies ◽  
Comprehensive Data ◽  
Lack Of Exercise ◽  
The Individual ◽  
Research Initiatives ◽  
The Impact

This article outlines the economics of non communicable chronic diseases (NCDs), necessary for designing evidence-based health policies to reduce the prevalence of NCDs. The main risk factors of NCDs are manmade: abuse of alcohol, tobacco, junk food, and lack of exercise. Hence we define an economic category of analysis, unwholesome goods. The analysis tackles the two dimensions of NCDs: individual and collective. The first one linked to how much NCDs are a result of consumer’s choice and the second one, the recognition that NCDs are result of a complex interrelated environment at the society level, evidencing the need for a multisectoral approach. An economic analysis includes the study of 1) NCD in the context of intergenerational life cycle dynamics; 2) demand, supply, externalities, and political economy of NCD factors; 3) the incidence of lifestyle risks according to socioeconomic status, and changes under the impact of economic growth and the demographic transition. Where do the different countries lie on the development pathway? How much of the burden lies on the individual and on the collective dimensions of NCDs? What are the most effective policies for immediate application tackling both, the individual and collective dimensions? To what extent are households affected by financial catastrophe and impoverishment due to NCDs? What are the essential requirements for the health systems to respond with efficiency and efficacy to the NCDs phenomenon? Policy and research initiatives include health sector capability for NCDs, prevention of NCD factors, promotion of multisectoral approaches, and a comprehensive data initiative. Conclusions point to the need to simultaneously implement health policy and construct the necessary evidence bases. A comprehensive data initiative is proposed as needed in addition to expanding data availability in tandem with policy implementation. Finally an initiative is proposed to formulate sufficiently effective multisectoral policies and to establish the necessary links between the health sector and other sectors involved.

scholarly journals The Impact of COVID-19 on the Dietary Habits of Middle-Class Population in Mulund, Mumbai, India

2020 ◽  
Author(s):  
Vidhi Mehta
Keyword(s):  
Dietary Habits ◽  
Preventive Measures ◽  
Negative Impact ◽  
Health Sector ◽  
Eating Patterns ◽  
Early Implementation ◽  
The Usa ◽  
The Individual ◽  
The Impact

In India, the SARS-CoV-2 COVID-19 pandemic has grown to 112,359 cases and 3,435 deaths as per 21st May, 2020. The severe acute respiratory syndrome (SARS) affected the world with 4,893,186 cases and 323,256 deaths as of 21st May, 2020. The WHO declared the outbreak as a public health emergency of international concern on 30th January, 2020 and it was declared as a pandemic in March 2020. Clinical studies conducted on hospitalized cases show that the onset of COVID-19 is associated with symptoms commonly associated with viral pneumonia, most commonly fever, cough/sore throat and myalgia/fatigue. COVID-19 world pandemic imposed a new set of challenges for the individual to maintain a healthy diet. When compared to the USA, India is currently facing lesser cases of the pandemic because of early implementation of the preventive measures such as a lockdown. Because of the lockdown imposed, India has and is facing a downfall in every aspect, such as the economy, the agriculture, the health sector, the IT and management sectors and also tourism. This in turn, will have a negative impact on the quality of life and economy in India. The present paper aims to find out the impact of COVID-19 pandemic on the health sector and is based on the results obtained from a survey about the eating patterns of participants from Mulund, Mumbai, India. It was seen that the mental stress caused due to the pandemic had an effect on the dietary behaviors of the participants.

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