The Indirect cost of illness in Africa

Background: The current study estimated (a) the indirect costs associated with non-fatal disability and premature death across a wide range of diseases and health conditions in Africa in 2015 and (b) the potential savings that could be accrued if countries were to meet the 3 health targets of the substainable development goal (SDG) compared to the costs under the status quo. Methods: This study used the lost output or human capital approach to quantify the gross domestic product (GDP) losses associated with the disability-adjusted-life-years (DALYs) lost due to all causes by age group as well as by country economic classification (Group 1: 10 high/upper-middle income countries; Group 2: 17 lower-middle income countries; and Group 3: 27 low income countries). Results: The expected indirect cost of the 704,765,879 DALYs lost in Africa in 2015 was Int$ 2,983,187,560,197. Of this amount, 25.17%, 57.84% and 16.99% were incurred by the economies of the countries comprising Group 1, Group 2 and Group 3, respectively. Of the total continental indirect cost, 36.9%, 10.5%, 13.7%, 17.0%, 7.6%, 6.8% and 7.5% were associated with people aged 0-4, 5-14, 15-29, 30-49, 50-59, 60-69 and 70 years or older, respectively. Most of the total indirect cost (56.61%) was attributable to maternal conditions, AIDS, tuberculosis (TB), malaria, neglected tropicald diseases (NTDs), non-communicable diseases and traffic injuries. Approximately half (47%) of this cost could be avoided (or saved) every year if the 3 (health) targets of the SDG were fully met. Conclusion: The study estimated the total indirect cost of illness due to all causes by age group and country economic classification. The annual indirect cost is substantial. The findings contained in this paper suggest that health system strengthening should focus on both rich and poor countries, people of all ages and specific disease categories.

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The Monetary Value of Human Lives Lost to Suicide in the African Continent: Beating the African War Drums

Healthcare ◽

10.3390/healthcare8020084 ◽

2020 ◽

Vol 8 (2) ◽

pp. 84

Author(s):

Joses M. Kirigia ◽

Rosenabi D.K. Muthuri ◽

Newton G. Muthuri

Keyword(s):

Discount Rate ◽

Economic Burden ◽

Years Of Life Lost ◽

African Continent ◽

Middle Income ◽

Middle Income Countries ◽

Monetary Value ◽

Group 3 ◽

Group 2 ◽

Group 1

Background: Suicide is an important public health problem in the African continent whose economic burden remains largely unknown. This study estimated the monetary value of human lives lost due to suicide in the African continent in 2017. Methods: The human capital approach was applied to monetarily value the years of life lost due to premature mortality from suicide deaths (SD) among 54 African countries. A 3% discount rate was used to convert future losses into their present values. The sensitivity of monetary value of human lives lost to changes in discount rate and average life expectancy was tested. Results: The 75,505 human lives lost from suicide had a grand total monetary value of International Dollars (Int$) 6,989,963,325; and an average present value of Int$ 92,576 per SD. About 31.1% of the total monetary value of SD was borne by high-income and upper-middle-income countries (Group 1); 54.4% by lower-middle-income countries (Group 2); and 14.5% by low-income countries (Group 3). The average monetary value per human life lost from SD was Int$ 234,244 for Group 1, Int$ 109,545 for Group 2 and Int$ 32,223 for Group 3. Conclusions: Evidence shows that suicide imposes a substantive economic burden on African economies. The evidence reinforces the case for increased investments to ensure universal coverage of promotive, preventive, curative and rehabilitative mental health services.

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Interventional nephrology and vascular access practice: A perspective from South and Southeast Asia

The Journal of Vascular Access ◽

10.1177/11297298211011375 ◽

2021 ◽

pp. 112972982110113

Author(s):

Raja Ramachandran ◽

Vinant Bhargava ◽

Sanjiv Jasuja ◽

Maurizio Gallieni ◽

Vivekanand Jha ◽

...

Keyword(s):

Southeast Asia ◽

Vascular Access ◽

Central Catheter ◽

Middle Income ◽

Middle Income Countries ◽

South And Southeast Asia ◽

Group 2 ◽

Venous Fistula ◽

Economic Constraints ◽

Group 1

South and Southeast Asia is the most populated, heterogeneous part of the world. The Association of Vascular Access and InTerventionAl Renal physicians (AVATAR Foundation), India, gathered trends on epidemiology and Interventional Nephrology (IN) for this region. The countries were divided as upper-middle- and higher-income countries as Group-1 and lower and lower-middle-income countries as Group-2. Forty-three percent and 70% patients in the Group 1 and 2 countries had unplanned hemodialysis (HD) initiation. Among the incident HD patients, the dominant Vascular Access (VA) was non-tunneled central catheter (non-TCC) in 70% of Group 2 and tunneled central catheter (TCC) in 32.5% in Group 1 countries. Arterio-Venous Fistula (AVF) in the incident HD patients was observed in 24.5% and 35% of patients in Group-2 and Group-1, respectively. Eight percent and 68.7% of the prevalent HD patients in Group-2 and Group-1 received HD through an AVF respectively. Nephrologists performing any IN procedure were 90% and 60% in Group-2 and Group 1, respectively. The common procedures performed by nephrologists include renal biopsy (93.3%), peritoneal dialysis (PD) catheter insertion (80%), TCC (66.7%) and non-TCC (100%). Constraints for IN include lack of time (73.3%), lack of back-up (40%), lack of training (73.3%), economic issues (33.3%), medico-legal problems (46.6%), no incentive (20%), other interests (46.6%) and institution not supportive (26%). Routine VA surveillance is performed in 12.5% and 83.3% of Group-2 and Group-1, respectively. To conclude, non-TCC and TCC are the most common vascular access in incident HD patients in Group-2 and Group-1, respectively. Lack of training, back-up support and economic constraints were main constraints for IN growth in Group-2 countries.

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Neonatal Neurobehavior in the First 48 Hours of Life: Effect of the Administration of Meperidine With and Without Naloxone in the Mother

PEDIATRICS ◽

10.1542/peds.62.3.294 ◽

1978 ◽

Vol 62 (3) ◽

pp. 294-298 ◽

Cited By ~ 1

Author(s):

Robert Hodgkinson ◽

M. Bhatt ◽

G. Grewal ◽

G. F. Marx

Keyword(s):

Age Group ◽

Naloxone Hydrochloride ◽

Group 3 ◽

Group 2 ◽

Group 1

The early neonatal neurobehavioral scale ‘was administered to three groups of newborns at 2, 4, and 24 hours of age. Group 1 consisted of 28 babies whose mothers had received no narcotics during labor, group 2 of 33 babies whose mothers had received meperidine hydrochloride alone during labor, and group 3 of 40 babies whose mothers had received meperidine followed by 0.4 mg of naloxone hydrochloride intravenously approximately 15 minutes before delivery. Babies who were not exposed to meperidine showed a statistically significantly greater percentage of high scores than those exposed to meperidine alone for all items on the neurobehavioral scale at 2 and 4 hours and for all items except tone and Moro response at 24 hours. Similarly, babies whose mothers had received meperidine and naloxone showed a significantly greater percentage of high scores than those whose mothers had received meperidine alone at 2 hours of age. At 4 hours a difference was found for tone and rooting and at 24 hours for overall score, placing, and total decrement score. It is concluded that naloxone given intravenously to the mother reverses the effect of meperidine on neonatal neurobehavior for approximately two hours after birth. At 4 and 24 hours, however, the neurobehavior of neonates exposed to meperidine and naloxone is depressed almost as much as that of babies exposed to meperidine alone.

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Interaction Between Age and Change in Velocity During a Baseball Training Program

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120927939 ◽

2020 ◽

Vol 8 (6) ◽

pp. 232596712092793

Author(s):

Christopher Antonacci ◽

Thomas R. Atlee ◽

Peter N. Chalmers ◽

Christopher Hadley ◽

Meghan E. Bishop ◽

...

Keyword(s):

Training Program ◽

Age Groups ◽

Maximum Velocity ◽

Age Group ◽

Significant Difference ◽

Group 3 ◽

Baseball Pitchers ◽

Group 2 ◽

The Relationship ◽

Group 1

Background: Pitching velocity is one of the most important metrics used to evaluate a baseball pitcher’s effectiveness. The relationship between age and pitching velocity after a lighter ball baseball training program has not been determined. Purpose/Hypothesis: The purpose of this study was to examine the relationship between age and pitching velocity after a lighter ball baseball training program. We hypothesized that pitching velocity would significantly increase in all adolescent age groups after a lighter baseball training program, without a significant difference in magnitude of increase based on age. Study Design: Cohort study; Level of evidence, 2. Methods: Baseball pitchers aged 10 to 17 years who completed a 15-week training program focused on pitching mechanics and velocity improvement were included in this study. Pitchers were split into 3 groups based on age (group 1, 10-12 years; group 2, 13-14 years; group 3, 15-17 years), and each group trained independently. Pitch velocity was assessed at 4 time points (sessions 3, 10, 17, and 25). Mean, maximum, and mean change in pitch velocity between sessions were compared by age group. Results: A total of 32 male baseball pitchers were included in the analysis. Mean/maximum velocity increased in all 3 age groups: 3.4/4.8 mph in group 1, 5.3/5.5 mph in group 2, and 5.3/5.2 mph in group 3. While mean percentage change in pitch velocity increased in all 3 age groups (group 1, 6.5%; group 2, 8.3%; group 3, 7.6%), the magnitude of change was not significantly different among age groups. Program session number had a significant effect on mean and maximum velocity, with higher mean and maximum velocity seen at later sessions in the training program ( P = .018). There was no interaction between age and program session within either mean or maximum velocity ( P = .316 and .572, respectively). Conclusion: Age had no significant effect on the magnitude of increase in maximum or mean baseball pitch velocity during a velocity and mechanics training program in adolescent males.

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Tositumomab and Iodine I 131 Tositumomab (the BEXXAR® Therapeutic Regimen) Shows Efficacy in Elderly Patients (pts) with Relapsed/Refractory Low-Grade (LG), Follicular, and Transformed Non-Hodgkin’s Lymphoma (NHL).

Blood ◽

10.1182/blood.v104.11.2630.2630 ◽

2004 ◽

Vol 104 (11) ◽

pp. 2630-2630

Author(s):

Stephanie A. Gregory ◽

Andrew Zelenetz ◽

Susan J. Knox ◽

Julie Vose ◽

John P. Leonard ◽

...

Keyword(s):

Bone Marrow Involvement ◽

Response Rates ◽

Hematologic Toxicity ◽

Low Grade ◽

Age Group ◽

Prognostic Features ◽

Prior Therapy ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Objective: Pts are first diagnosed with NHL at a median age of 60 yrs. There is increasing support for the idea that physicians should evaluate older pts for cancer treatment on the basis of their health status and cognitive function rather than on chronologic age. Five core clinical trials and an expanded-access program included 995 pts with relapsed/refractory LG follicular or transformed NHL treated with BEXXAR. Data were analyzed to establish the efficacy and safety of BEXXAR as a function of age. Safety data have been presented previously (Gregory et al. Blood. 2003;102. Abstract 1485). Overall toxicity and acute hematologic toxicity associated with BEXXAR in older pts is similar to that observed in pts ≤60 yrs. Methods: BEXXAR efficacy was analyzed by age: group 1 pts, ≤60 yrs (n=586); group 2 pts, >60–≤70 yrs (n=250); group 3 pts, >70 yrs (n=159). Median age at time of BEXXAR was 58 yrs (range, 21–88 yrs). Inclusion criteria included KPS ≥60, platelet count ≥100,000/mm3, ANC ≥1,500 cells/mm3, bone marrow involvement ≤25%, and no impaired renal, hepatic, or cardiac function. Results: All 3 pt groups had received multiple therapies for NHL before receiving BEXXAR (1–3 prior treatments, 63%–65%; ≥4 prior treatments, 34%–37%). In addition to the known poorer prognosis with older age, pts in groups 2 and 3 more frequently had other poor prognostic features, ie, transformed histology and prior radiotherapy (P <.001). Complete response rates (CR+CCR) to the most recent pre-BEXXAR therapy decreased with increasing age (group 1, 21%; group 2, 12%; group 3, 7%), and progressive disease as the initial “response” to prior therapy increased with age (group 1, 20%; group 2, 29%; group 3, 33%). Table 1 shows response rates and CR post- BEXXAR for the 3 groups. Post-BEXXAR CR+CCR rates were higher for pts in every age group compared with CR rates to prior therapy. These rates were nearly doubled for pts >60–≤70 yrs (23% vs 12%) and tripled for pts >70 yrs (23% vs 7%). Conclusions: Of all previously treated pts >60 yrs, ≥50% achieved a response post-BEXXAR. Nearly 25% of pts >60 yrs achieved a CR, with a median duration of CR of 32.3 mos. Response rates and durations of response are somewhat better in younger pts than in pts >60 yrs, but pts >60 yrs presented with poorer prognostic features (as above). Overall toxicity and acute hematologic toxicity associated with BEXXAR in older pts is similar to that observed in pts ≤60 yrs (Gregory et al. Blood. 2003;102. Abstract 1485). BEXXAR can be administered safely and effectively to older pts with low-grade follicular or transformed NHL. Table 1 Response results to BEXXAR by age, N = 995 Age groups Overall response, % CR, % Median CR duration, mos ≤ 60 66 37 59.1 (n=586) 95% CI = 45.8, NR) 60 to ≤70 N = 250 50 23 21.8 (n=250) (95% CI = 15.7, 69.1) >70 54 23 36.4 (n=159) (95% CI = 22.6, NR)

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The Utility of the Callosal/Supratentorial-Supracallosal Area Ratio to Evaluate Corpus Callosum Morphometry in Children

Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy ◽

10.5222/bmj.2020.35220 ◽

2020 ◽

Author(s):

Mehmet Öztürk ◽

Emine Uysal ◽

Halil İbrahim Duran ◽

Zuhal İnce Bayramoğlu ◽

Abidin Kılınçer

Keyword(s):

Corpus Callosum ◽

Sagittal Plane ◽

Pediatric Population ◽

Age Group ◽

Age And Gender ◽

Mean Values ◽

Group 3 ◽

Group 2 ◽

And Gender ◽

Group 1

Objective: To perform morphometric analysis of corpus callosum (CC) by using callosal area (CA), supratentorial-supracallosal area (SSA) and CA/SSA parameters in a healthy pediatric population and to investigate changes according to age and gender. Method: Method: This retrospective study included a total of 313 children (154 boys, 159 girls) aged between 3-17 years. The cases were divided into three groups according to age: 3-6 years (Group 1) (pre-school), 7-12 years (Group 2) (preadolescent) and 13-17 years (Group 3) (adolescent). CA and SSA were measured on the mid-sagittal plane on T1-weighted images. CA/ SSA index was calculated. Differences in age, CA, SSA, and ratio parameters among the gender groups were compared using the Mann-Whitney U or the t-test. Results: Median values of CA (p= 0.002), mean values of SSA (p=0.001) and CA/SSA ratios (p= 0.04) were significantly higher in boys compared to girls. The median CA and mean CA/SSA ratios in Group 3 were significantly higher than Groups 1 and 2 (p= 0.001). Mean CA/SSA ratio values of boys and girls in Age Group 3 were significantly higher than Group 1 (p= 0.001) and significantly higher than Age Group 2 in girls. There were highly significant positive correlations of age with CA (p=0.001, r=0.47), SSA (p=0.028, r=0.12) and CA/SSA ratio (p=0.001, r=042). There was a highly significant and positive correlation between CA and SSA (p=0.001, r=0.25) and CA/SSA ratio (p=0.001, r=0.87). Conclusion: CA, SSA, and CA/ SSA ratio values in children are affected by age and gender. These parameters can be used as reference values for the diagnosis of congenital and acquired pathologies affecting the corpus callosum.

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Socio-economic variations in the clinical presentation, etiology and outcome of infective endocarditis in the ESC-EORP EURO-ENDO (European Infective Endocarditis) registry: a prospective cohort study

European Heart Journal ◽

10.1093/eurheartj/ehab724.1710 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

S Sengupta ◽

B Prendergast ◽

S Furnaz ◽

R Ronderos ◽

A Almaghraby ◽

...

Keyword(s):

Infective Endocarditis ◽

Clinical Presentation ◽

Income Group ◽

Economic Factors ◽

Middle Income ◽

Middle Income Group ◽

Group 3 ◽

Group 2 ◽

Socio Economic Factors ◽

Group 1

Abstract Background Infective endocarditis (IE) is a life threatening disease associated with high mortality and morbidity worldwide. We sought to determine how socio-economic factors may influence variations in epidemiology, clinical presentation, investigation and management (and their consequence upon clinical outcomes) in a large international multi-centre registry. Methods The ESC-EORPEURO-ENDO registry comprises a prospective cohort of 3116 adult patients admitted to 156 hospitals in 40 countries with IE between January 2016 and March 2018. We analysed the complete dataset to assess potentially important determinants of variation according to World Bank economic stratification (high income (Group 1) [73.8%]; upper-middle income (Group 2) [17.1%]; lower-middle income (Group 3)[9.1%]). Results Patients in Group 3 were younger (median age [IQR]: Group 1 - 66 [54–75] years; Group 2 - 57 [40–68] years; Group 3 - 33 [26–43] years; p<0.001) with a higher prevalence of smoking, intravenous drug use and human immunodeficiency virus (HIV) infection (all p<0.001). Group 3 patients with IE presented later (median [IQR) days since symptom onset: Group 1 - 12 [3–35]; Group 2 - 20 [6–51]; Group 3 - 31 [12–62]; p<0.001) and were more likely to develop congestive heart failure (13.6%; 11.3%; and 22.6%, respectively; p<0.001), septic shock (8.3%; 11.1%; 13.4%; p=0.007), and persistent fever for greater than 7 days (9.6%; 14.4%; 27.9%; p<0.001) following hospital admission. Surgery was performed less frequently in Group 3 (75.4%, 76.8% and 51.3% in Groups 1, 2 and 3, respectively; p<0.001) and mortality was highest in the poorest countries (14.6%; 23.6% and 23.7%, respectively; p<0.001). Conclusion Socio-economic factors influence the clinical profile of patients presenting with IE across the world. Despite being younger, patients from the poorest countries presented with more frequent complications and higher mortality associated with delayed diagnosis and less frequent use of surgery. FUNDunding Acknowledgement Type of funding sources: None.

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A symmetric hypocorrection of myopia by FemtoLASIK in patients with presbyopia

Russian Ophthalmological Journal ◽

10.21516/2072-0076-2018-11-4-43-48 ◽

2018 ◽

Vol 11 (4) ◽

pp. 43-48 ◽

Cited By ~ 1

Author(s):

N. V. Khodzhabekyan ◽

A. T. Khandzhyan ◽

E. P. Tarutta

Keyword(s):

Age Groups ◽

Control Group ◽

Age Group ◽

Corneal Hydration ◽

Flap Thickness ◽

Group 3 ◽

Group 2 ◽

Possible Cause ◽

Group 1

Purpose: to evaluate the results of symmetric binocular hypocorrection of myopia with FemtoLasik surgery in patients with presbyopia of various age groups.Material and methods. 33 patients (66 eyes) with myopic refraction, aged 36 to 50, were operated by FemtoLasik. The intended Femto Flap thickness was 100 μm. The patients were divided into three groups depending on age; group 1 included 16 patients (32 eyes) aged 39–44, group 2 had 12 patients (24 eyes) aged 45–50, and group 3 (controls) was composed of 5 patients (10 eyes) of pre-presbyopic age (36–38 years).Results. The symmetric binocular hypocorrection proved efficient in 35 % of cases in the group 1 and 50 % of cases in group 2. In the control group the intended and obtained values coincided in all 100 % of cases.Conclusion. A possible cause of the discrepancy between the intended and the obtained hypocorrection effect may be a reduced corneal hydration of patients older than 39 years.

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Analysis of lateral teleroentgenograms in pediatric patients with grade III vertical disocclusion of the dentition

Российский стоматологический журнал ◽

10.17816/1728-2802-2020-24-5-297-300 ◽

2020 ◽

Vol 24 (5) ◽

pp. 297-300

Author(s):

A. E. Ali ◽

V. M. Vodolatsky ◽

E. G. Grigorian

Keyword(s):

Pediatric Patients ◽

Age Group ◽

Lower Jaw ◽

Group 12 ◽

Skull Growth ◽

Group 3 ◽

Group 2 ◽

Base Of The Skull ◽

Grade Iii ◽

Group 1

Aim of the study was to study lateral TRG in 43 patients with grade III vertical disocclusion of the dentition at the age of 7 to 18 years. Material and methods. Lateral telerentgenogram were used to study the angle indices SN-NL, SN-ML, NL-ML, showing the ratio of the upper and lower jaw relative to the base of the skull and relative to each other. The highest values of the SN-NL angle were observed in children of 1 group at the age of 18 years 9.0, in 2 group at the age of 18 years 9.3, in 3 group at the age of 17 years 8.9. The lowest values of the SN-NL angle were observed in children of group 1 at the age of 7, 8, 10 years 7.5, in group 2 at the age of 7 years 8.5, in group 3 at the age of 7 years 8.4. The highest values of the SN-ML angle were observed in children of group 1 at the age of 15, 16, 17, 18 years 33, in group 2 at the age of 18 years 37, in group 3 at the age of 17, 18 years 36. The lowest indices of the angle SN-ML was the children 1 age group 12 years 31 in group 2 at the age of 11 33, group 3, ages 11, 12, and 13 34. The highest values of NL-ML 34 angle were observed in children aged 17 years from group 1, in group 2 at age 17, 18 years 33, in group 3 at age 13, 14 and 18 years 30. In children of group 1 aged 7, 8, 11, 2 groups at the age of 9, 10 and 3 groups at the age of 8 years identified the least parameters of an angle NL-ML 28, 28, 27, respectively. Results. As a result of the study, it was noted that in children with vertical dysocclusion of the dentition of the third degree, the angles SN-NL, SN-ML, NL-ML have high indicators, which characterizes the vertical type of skull growth.

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ATTITUDES TOWARDS THE NAMES AND THE TASTES OF FOODS IN SONGKHLA PROVINCE, THAILAND

E-Journal of Cultural Studies ◽

10.24843/cs.2019.v12.i01.p01 ◽

2019 ◽

pp. 1

Author(s):

Angsuviriya Angsuviriya ◽

Chanokporn Chanokporn

Keyword(s):

Ethnic Groups ◽

Positive Attitude ◽

Age Groups ◽

Negative Attitude ◽

The Other ◽

Age Group ◽

Buffalo Meat ◽

Group 3 ◽

Group 2 ◽

Group 1

The objective of this article is to study the attitudes of different age and ethnic groups reflected through the names and the taste of food, that is the southern Thais have a positive attitude towards more tasteful or the taste of hot than the other ethnic groups while the Chinese Thais they have a more positive attitude towards insipid taste than the other ethnic groups. For the Malaysian Thais they have a more positive attitude towards the taste of sweet than the other two ethnic groups. As for main course dish, the most popular main course dishes in all the 3 groups are “Kangsom” (sour soup made of tamarind paste) and “KangTaipla” or “KangPhungpla”. As for dessert, the most favorite desserts in all the 3 groups are “Klauybuatchee” or Klauybuat (banana in coconut milk) and “Lotchong” or “Singaporean Lotchong”. In addition, it is found that the Chinese Thais and the southern Thais have a negative attitude towards beef, eels, buffalo meat etc, while the Malaysian Thais have a negative attitude towards pork because they are Muslim. When age groups have been taken into account, age group 1 (15-25) does not like spicy foods, compared with the other age group. While age group 2 (35-45) has similarities in the food names of those in age group 1 and age group 3; therefore, there are more food names in age group 2 than those in the other groups. In addition, for age group 3 (55 or more) more local names of foods are found. Keywords: Attitudes, the names and the tastes of foods, the ethnic

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