scholarly journals Affordability Assessment from a Static to Dynamic Concept: A Scenario-Based Assessment of Cardiovascular Medicines

2020 ◽  
Vol 17 (5) ◽  
pp. 1710
Author(s):  
Leila Zarei ◽  
Iman Karimzadeh ◽  
Najmeh Moradi ◽  
Payam Peymani ◽  
Sara Asadi ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Financial Burden ◽  
Insurance Coverage ◽  
World Health ◽  
Medical Conditions ◽  
Medicine Price ◽  
Medication Therapy ◽  
Therapeutic Groups ◽  
Out Of Pocket Payments ◽  
Health Organization

The out-of-pocket payments for prescription medications can impose a financial burden on patients from low- and middle- incomes and who suffer from chronic diseases. The present study aims at evaluating the affordability of cardiovascular disease (CVD) medication in Iran. This includes measuring affordability through World Health Organization/Health Action International (WHO/HAI) methodology. In this method, affordability is characterized as the number of days’ wages of the lowest-paid unskilled government worker. The different medication therapy scenarios are defined in mono-and combination therapy approaches. This method adds on to WHO/HAI methodology to discover new approaches to affordability assessments. The results show the differences in the medicines affordability when different approaches are used in mono-and combination therapy between 6 main sub-therapeutic groups of CVD. It indicates the medicine affordability is not a static concept and it changes dynamically between CVD therapeutic subgroups when it used alone or in combination with other medicines regarding patients’ characteristics and medical conditions. Hypertension and anti-arrhythmia therapeutic groups had the most non-affordability and hyperlipidemia had the most affordable medicines. Therefore, affordability can be considered as a dynamic concept, which not only affected by the medicine price but significantly affected by a patient’s characteristics, the number of medical conditions, and insurance coverage.

scholarly journals Continued low efficacy of artemether-lumefantrine in Angola, 2019

2020 ◽  
Author(s):  
Pedro Rafael Dimbu ◽  
Roberta Horth ◽  
Ana Luisa M. Cândido ◽  
Carolina Miguel Ferreira ◽  
Felismina Caquece ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Confidence Interval ◽  
Microsatellite Markers ◽  
Therapeutic Efficacy ◽  
World Health ◽  
The Third ◽  
Kaplan Meier ◽  
Late Failure ◽  
Health Organization ◽  
Parasitological Response

Background: Biennial therapeutic efficacy monitoring is a crucial activity for ensuring efficacy of currently used artemisinin-based combination therapy in Angola. Methods: Children with acute uncomplicated P. falciparum infection in sentinel sites in Benguela, Zaire, and Lunda Sul Provinces were treated with artemether-lumefantrine (AL) or artesunate amodiaquine (ASAQ) and followed for 28 days to assess clinical and parasitological response. Molecular correction was performed using seven microsatellite markers. Samples from treatment failures were genotyped for the pfk13, pfcrt, and pfmdr1 genes. Results: Day 3 clearance rates were ≥95% in all arms. Uncorrected Day-28 Kaplan-Meier efficacy estimates ranged from 84.2 to 90.1% for the AL arms, and 84.7 to 100% for the ASAQ arms. Corrected Day-28 estimates were 87.6% (95% Confidence interval [CI]: 81–95%) for the AL arm in Lunda Sul, 92.2% (95%CI: 87-98%) for AL in Zaire, 95.6% (95%CI: 91-100%) for ASAQ in Zaire, 98.4% (95%CI: 96-100%) for AL in Benguela, and 100% for ASAQ in Benguela and Lunda Sul. All 103 analyzed samples had wildtype pfk13 sequences. The 76T pfcrt allele was found in most (92%, 11/12) ASAQ late failure samples but only 16% (4/25) of AL failure samples. The N86 pfmdr1 allele was found in 97% (34/35) of treatment failures. Conclusion: AL efficacy in Lunda Sul was below the 90% World Health Organization threshold, the third time in four rounds that this threshold was crossed for an AL arm in Angola. In contrast, observed ASAQ efficacy has not been below 95% to date in Angola, including this latest round.

scholarly journals Update on field use of the available drugs for the chemotherapy of human African trypanosomiasis

Parasitology ◽  
2012 ◽  
Vol 139 (7) ◽  
pp. 842-846 ◽  
Author(s):  
P. P. SIMARRO ◽  
J. FRANCO ◽  
A. DIARRA ◽  
J. A. RUIZ POSTIGO ◽  
J. JANNIN
Keyword(s):  
Human African Trypanosomiasis ◽  
Treatment Time ◽  
Financial Burden ◽  
World Health ◽  
African Trypanosomiasis ◽  
Patient Cost ◽  
Drug Of Choice ◽  
Control Programmes ◽  
Health Organization ◽  
The Cost

SUMMARYDespite the fact that eflornithine was considered as the safer drug to treat human African trypanosomiasis (HAT) and has been freely available since 2001, the difficulties in logistics and cost burden associated with this drug meant that the toxic melarsoprol remained the drug of choice. The World Health Organization responded to the situation by designing a medical kit containing all the materials needed to use eflornithine, and by implementing a training and drugs distribution programme which has allowed a transition to this much safer treatment. The introduction of the combination of nifurtimox and eflornithine (NECT) has accelerated the shift from melarsoprol to the best treatment available, due to reduced dosage and treatment time for eflornithine that has significantly lessened the cost and improved the burden of logistics encountered during treatment and distribution. The decrease in the use of more dangerous but cheaper melarsoprol has meant a rise in the per patient cost of treating HAT. Although NECT is cheaper than eflornithine monotherapy, an unexpected consequence has been a continuing rise in the per patient cost of treating HAT. The ethical decision of shifting to the best available treatment imposes a financial burden on HAT control programmes that might render long-term application unsustainable. These factors call for continuing research to provide new safer and more effective drugs that are simple to administer and cheaper when compared to current drugs.

scholarly journals Two Hyperparasitaemic Plasmodium Falciparum Cases Successfully Treated with Artemisinin-based Combination Therapy

2020 ◽  
Author(s):  
Benudhar Mukhi ◽  
Anupkumar R. Anvikar ◽  
Bina Srivast ◽  
Himanshu Gupta ◽  
Susanta Kumar Ghosh
Keyword(s):  
Plasmodium Falciparum ◽  
Combination Therapy ◽  
Malaria Diagnosis ◽  
World Health ◽  
Host Responses ◽  
Reference Ranges ◽  
Female Ratio ◽  
Health Organization ◽  
Complications And Mortality ◽  
Male To Female

Abstract BackgroundHyperparasitaemia is an important event in a cascade of Plasmodium falciparum severe malaria (SM) but requires host responses to cause cerebral malaria (CM) leading to death, if left untreated. Here, we report two hyperparasitaemic patients with no CM.MethodsMalaria diagnosis was performed based on thick and thin smears examination, and immunochromatographic-based rapid diagnostic test assay. Parasitaemia was calculated following World Health Organization (WHO) protocol. Haematological and biochemical investigations were also performed. ResultsThe first patient had 42% parasitaemia (100% asexual parasites). The second one had 9.5% parasitaemia comprising 46% asexual, and 54% sexual stages with 1:1 male to female ratio. On the day of admission, both had presented abnormal haematological and biochemical parameters compared to the reference ranges. Remarkably, both the patients recovered successfully with oral artemisinin-based combination therapy (ACT) and a single dose of primaquine.ConclusionThe presence of hypergametocytaemia may hinder the elimination efforts, if not treated immediately. This report also signifies the need of accurately estimating the parasitaemia in malaria patients and their timely management to prevent complications and mortality.

scholarly journals TREATMENT OF DIABETES, EDUCATION ON THE COMPLICATIONS FROM THE DISEASE AND IMPORTANCE OF THE HYGIENE-DYTHETIC REGIME

2018 ◽  
Vol 28 (2) ◽  
pp. 581-589
Author(s):  
Gordana Panova ◽  
Georgi Shumanov ◽  
Danijel Trajanovski
Keyword(s):  
Diabetes Education ◽  
Tolerance Test ◽  
World Health ◽  
Oral Glucose ◽  
World Population ◽  
Dietary Regimen ◽  
Medication Therapy ◽  
Republic Of Macedonia ◽  
The Republic ◽  
Health Organization

Introduction: Diabetes is a metabolic disease that has a chronic and aggressive nature, characterized by a disorder of carbohydrate metabolism due to decreased secretion of insulin from the pancreas, thereby increasing the blood sugar level - hyperglycemia. Symptoms that characterize this disease are: polyuria, polydipsia and polyphagia.The World Health Organization defines diabetes as an elevated blood glucose level followed by symptoms, increased values during two measurements:Fast plasma glucose ≥ 7.0 mmol / L (126 mg / dL) orPlasma Glucose ≥ 11.1 mmol / L (200 mg / dL), which is determined by an oral glucose tolerance test, which is measured two hours after the patient receives 75 g of glucose solution. (HbA1c) ≥6.5%Objectives: The goals of the work are to show the characteristics of the disease with an emphasis on the treatment of it, the importance of education and explanation for possible complications and hygiene dietary regimen with statistics of patients in the Republic of Macedonia in 2017Materials and Methods: Data from the Public Health Institute of the Republic of Macedonia for newly diagnosed diseased in 2017 have been used, explaining the importance of diabetes education to patients with diabetes.Results: The survey showed that, statistically, the number of cases increases after the fifth decade. Lifestyle and genetics play an important role.Conclusion: The disease itself is very specific and if it is not controlled it can contribute to several acute and chronic complications that further complicate the process of treatment of the same. With the educative approach of healthcare professionals towards all the people who deal with diabetes, with love, empathy and dedication, the problem that affects a large group of the entire world population will become a solved puzzle.The proper use of medication and non-medication therapy also plays a major role in the treatment of the disease. Proper physical activity, knowledge of the bread units and proper use of them, in line with good medication therapy, using the innovative methods in medicine, the disease can be controlled very easily.

scholarly journals A qualitative study of old patients’ experiences of the quality of the health services in hospital and 30 days after hospitalization

2019 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland
Keyword(s):  
Older People ◽  
World Health Organization ◽  
Everyday Life ◽  
Financial Burden ◽  
Healthcare Quality ◽  
World Health ◽  
Old Patients ◽  
The World ◽  
Health Organization ◽  
The Impact

Abstract Background: The number of people aged 80 years and above is projected to triple over the next 30 years. People in this age group normally have at least two chronic conditions. The impact of multimorbidity is often significantly greater than expected from the sum of the effects of each condition. The World Health Organization has indicated that healthcare systems must prepare for a change in the focus of clinical care for older people. The World Health Organization (WHO) defines healthcare quality as care that is effective, efficient, integrated, patient centered, equitable and safe. The degree to which healthcare quality can be defined as acceptable is determined by services’ ability to meet the needs of users and adapt to patients’ expectations and perceptions.Method: We took a phenomenological perspective to explore older patients’ subjective experiences and conducted semistructured individual interviews. Eighteen patients (aged from 82 to 100 years) were interviewed twice after discharge from hospital. The interview transcriptions were analyzed thematically.Results: The patients found their meetings with the health service to be complex and demanding. They reported attempting to restore a sense of security and meaning in everyday life, balancing their own needs against external requirements. Five overarching themes emerged from the interviews: hospital stay and the person behind the diagnosis, poor communication and coordination, life after discharge, relationship with their next of kin, and organizational and systemic determinants.Conclusion: According to the WHO, to deliver quality healthcare, services must include all six of the dimensions listed above. Our findings show that they do not. Healthcare focused on measurable values and biomedical inquiries. Few opportunities for participation, scant information and suboptimal care coordination left the patients with a feeling of being in limbo, where they struggled to find balance in their everyday life. Further work must be done to ensure that integrated services are provided without a financial burden, centered on the needs and rights of older people.

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 ◽  
...  
Keyword(s):  
Financial Burden ◽  
Meta Analysis ◽  
Final Analysis ◽  
Catastrophic Health Expenditure ◽  
World Health ◽  
Human Immune Deficiency Virus ◽  
Tuberculosis Patients ◽  
Cost Cutting ◽  
Human Immune ◽  
Health Organization

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.

Following the directives of World Health Organization: A Hobsons Choice

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Shaima S. Ali Miraj
Keyword(s):  
World Health Organization ◽  
Large Scale ◽  
Financial Burden ◽  
International Health ◽  
Health Agency ◽  
Developed Countries ◽  
World Health ◽  
Effective Control ◽  
The World ◽  
Health Organization

Introduction: Of late several articles in prestigious scientific platforms have shown that, 'COVID-19 has questioned the global health expertise of some developed countries like the USA UK and other European nations as well as the international health agency, the World Health Organization, highlighting that they faltered in managing the crisis during the pandemic. The objective of this article is to highlight the fact that as there was no specific vaccine or treatment at hand, the portfolio available with these nations under the directions of the WHO to counter the measures against COVID19, was limited. There was no other alternative in this time of world’s most unprecedented emergency, and whatever immediate steps were taken to contain the virus spread by the WHO were justified. Methods: Using the available literature on the internet and library sources, a survey of published articles in leading journals of the world have been made to analyse the various articles describing the position of the WHO and its future strategies in dealing with the worlds most unprecedented pandemic. Results and Conclusion: The present communication suggests that a large scale fund allocation in a fixed percentage for Health for All, from every member country’s defence budget can be separately made for substantially replenishing the already depleting funding of the WHO. This will enable an effective control of the global pandemic crisis with significant international cooperation, allowing sharing of the financial burden. The specially created fund can be used under international monitoring for such unprecedented calamities in future. More focus can thus be given to special training of manpower, advancements in the protective equipment, development of vaccines, critical care hospitals and centres on a global basis.

Analysis of Current COVID-19 Situations in Dental Practice among Karachi Population

2020 ◽  
Author(s):  
Naseer Ahmed
Keyword(s):  
World Health Organization ◽  
Financial Burden ◽  
World Health ◽  
Dental Practice ◽  
Emergency Procedures ◽  
First Case ◽  
Dental Practitioners ◽  
The World ◽  
Dental Practices ◽  
Health Organization

Background: December 2019, marked the beginning of novel Coronavirus (COVID-19) from China (Wuhan), which hit the general population and healthcare systems, worldwide, as a pandemic. Karachi reported the first case of COVID-19 on February 26 2020 in a student returning from Iran. Currently, World Health Organization has put forward specific guidelines for dental practitioners. The primary objective of the study was to determine the practices of dental practitioners in Karachi in following the standard guidelines set by the World Health Organization. Methods: In this, cross sectional questionnaire-based study, we have collected data from 111 dental practices through random sampling for analysis across Karachi, Pakistan. Structured questionnaire was designed comprising questions regarding knowledge, equipment, financial burden and procedures performed. Using SPSS version 25, descriptive analysis was executed on these variables. A multiple regression test was used to detect any relationship between them. Results: Majority (55.3%) of the dentists were found aware of the standard guidelines regarding dental practices and treatment of patients during COVID-19 outbreak but implementation in practice has been a major dilemma. Shortage of equipments as well as financial crisis was the main causative factors. Non-emergency procedures (5%) are being performed as well as inadequate protective measures are being adapted. Conclusion: According to the world standards, dental practices in Karachi should follow the standard guidelines put forward by world-renowned health organizations. Majority (p=0.44) of the dentists are aware of the standard guidelines, but lack of resources and financial instability are the primary factors affecting their dental practice.

Artemether and imatinib combination therapy against malaria infection

2021 ◽  
Vol 19 (1) ◽  
pp. 139-143
Author(s):  
A.V. Kondrashin ◽  
◽  
E.V. Stepanova ◽  
L.F. Morozova ◽  
V.P. Sergiev ◽  
...  
Keyword(s):  
Combination Therapy ◽  
World Health ◽  
In Vivo Studies ◽  
Telomerase Inhibitors ◽  
Combined Use ◽  
The World ◽  
Oncological Diseases ◽  
Health Organization ◽  
Key Words Malaria

Artemisinin-based combination therapy (ACT) is recommended by the World Health Organization (WHO) as the first and second line of treatment for uncomplicated malaria caused by P. falciparum, as well as for chloroquine-resistant P. vivax malaria. Despite the large number of antimalarial drugs, there is no any ideal drug, since each individual combination of drugs or monotherapy have their own limitations, ranging from their triple (activity) in relation to certain forms of the development of Plasmodium in the human body, side effects, toxicity and resistance. During the course of the study carried out, the most promising compound-candidate was selected – imatinib, which is currently used as targeted therapy for a number of oncological diseases. The objective of this work is to evaluate the efficacy of the combined use of imatinib and artemether in vivo studies on the human malarial model – the rodent malaria parasites Plasmodium berghei. Dut to the optimally selected treatment scheme, it was possible to reduce the dosage of imatinib twice – to 0,25 mg/kg, and that of artemether three times – to 33 mg/kg. The use of this scheme made it possible to considerably reduce the toxic effect of these drugs due to the potentiation of antimalarial effect. Key words: malaria, drug resistance, telomerase inhibitors, imatinib, chemotherapy of malaria

scholarly journals Determination of Ambulance Abuse Level

2019 ◽  
Author(s):  
Turgut Şahinöz ◽  
Kadir Çavuş ◽  
Saime Şahinöz ◽  
Melikşah Turan
Keyword(s):  
Health Services ◽  
Financial Burden ◽  
High Rate ◽  
Urgent Care ◽  
World Health ◽  
Automation System ◽  
The Public ◽  
Emergency Ambulance ◽  
Health Directorate ◽  
Health Organization

Emergency Health Services refers to the urgent care. Ambulance abuse threaten the provision of proper health services and at the same time it affects the country's economy negatively. It was aimed to determine ambulance abuse level. This was a retrospective cohort research. In order to carry out our study, we analyzed 12,207 cases who called to the 112 Emergency Ambulance Services between 01.01.2016 and 31.12.2016. The data of the study has been obtained from the Emergency Health Automation System of the Provincial Health Directorate. According to preliminary diagnoses, traumatic cases were found to be 19.4% and cardiovascular cases were 12%. According to the World Health Organization 32 Critical Code List 59.6% of the cases who called to the 112 Emergency Ambulance Services in 2016 were inappropriate. Ambulance abuse rate was 59.6%. The high rate of misuse of 112 emergency ambulances affects the service flow and motivation of the staff negatively and causes extra financial burden. Thereof, awareness trainings should be given to the public and task and duties of the paramedics and emergency medical technicians who work at emergency ambulances should be expanded so that the transfer of unnecessary cases should be prevented.

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