151
|
Odd D, Stoianova S, Williams T, Odd D, Kurinczuk JJ, Wolfe I, Luyt K. What is the relationship between deprivation, modifiable factors and childhood deaths: a cohort study using the English National Child MortalityDatabase. BMJ Open 2022; 12:e066214. [PMID: 36600341 PMCID: PMC9743372 DOI: 10.1136/bmjopen-2022-066214] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES The aim of this analysis is to identify the patterns of social deprivation and childhood mortality; and identify potential points where public health, social and education interventions, or health policy may be best targeted. DESIGN Decile of deprivation and underlying population distribution was derived using Office for National Statistics data. The risk of death was then derived using a Poisson regression model, calculating the increasing risk of death for each increasing deprivation decile. SETTING England. PARTICIPANTS 2688 deaths before 18 years of age reviewed between April 2019 and March 2020. MAIN OUTCOME MEASURES The relationship between deprivation and risk of death; for deaths with, and without modifiable factors. RESULTS There was evidence of increasing mortality risk with increase in deprivation decile, with children in the least deprived areas having a mortality of 13.25 (11.78-14.86) per 100 000 person-years, compared with 31.14 (29.13-33.25) in the most deprived decile (RR 1.08 (95% CI 1.07 to 1.10)); with the gradient of risk stronger in children who died with modifiable factors than those without (RR 1.12 (95% CI 1.09 to 1.15)) vs (RR 1.07 (95% CI 1.05 to 1.08)). Deprivation subdomains of employment, adult education, barriers to housing and services, and indoor living environments appeared to be the most important predictors of child mortality CONCLUSIONS: There is a clear gradient of increasing child mortality across England as measures of deprivation increase; with a striking finding that this varied little by area, age or other demographic factor. Over one-fifth of all child deaths may be avoided if the most deprived half of the population had the same mortality as the least deprived. Children dying in more deprived areas may have a greater proportion of avoidable deaths. Adult employment, and improvements to housing, may be the most efficient place to target resources to reduce these inequalities.
Collapse
Affiliation(s)
- David Odd
- Division of Population Medicine, Cardiff University, Cardiff, UK
- National Child Mortality Database, University of Bristol, Bristol, UK
| | - Sylvia Stoianova
- National Child Mortality Database, University of Bristol, Bristol, UK
| | - Tom Williams
- National Child Mortality Database, University of Bristol, Bristol, UK
| | - Dawn Odd
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | | | - Ingrid Wolfe
- Department of Women's and Children's Health, King's College London, London, UK
| | - Karen Luyt
- National Child Mortality Database, University of Bristol, Bristol, UK
| |
Collapse
|
152
|
Xie J, Wang M, Long Z, Ning H, Li J, Cao Y, Liao Y, Liu G, Wang F, Pan A. Global burden of type 2 diabetes in adolescents and young adults, 1990-2019: systematic analysis of the Global Burden of Disease Study 2019. BMJ 2022; 379:e072385. [PMID: 36740855 PMCID: PMC9727920 DOI: 10.1136/bmj-2022-072385] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To estimate the global burden of type 2 diabetes in adolescents and young adults (aged 15-39 years) from 1990 to 2019. DESIGN Systematic analysis. DATA SOURCE Global Burden of Disease Study 2019. Participants aged 15-39 years from 204 countries and territories, 1990-2019. MAIN OUTCOMES MEASURES Age standardised incidence rate, age standardised disability adjusted life years (DALY) rate, and age standardised mortality rate for type 2 diabetes in people aged 15-39 years from 1990 to 2019, and proportional DALY attributable to different risk factors. RESULTS From 1990 to 2019, significant increases in age standardised incidence rate and age standardised DALY rate were found for type 2 diabetes in adolescents and young adults globally (P<0.001). Age standardised incidence rate (per 100 000 population) increased from 117.22 (95% confidence interval 117.07 to 117.36) in 1990 to 183.36 (183.21 to 183.51) in 2019, and age standardised DALY rate (per 100 000 population) increased from 106.34 (106.20 to 106.48) in 1990 to 149.61 (149.47 to 149.75) in 2019. The age standardised mortality rate (per 100 000 population) was modestly increased from 0.74 (0.72 to 0.75) in 1990 to 0.77 (0.76 to 0.78) in 2019. When grouped by countries with different sociodemographic indexes, countries with a low-middle and middle sociodemographic index had the highest age standardised incidence rate and age standardised DALY rate in 2019, whereas countries with a low sociodemographic index had the lowest age standardised incidence rate but the highest age standardised mortality rate. Women generally had higher mortality and DALY rates than men at ages <30 years, but differences between the sexes were reversed in those aged >30 years except in countries with a low sociodemographic index. The main attributable risk factor for DALY for early onset type 2 diabetes was high body mass index in all regions by sociodemographic index. The proportional contribution of other risk factors varied across regions, however, with higher proportions of ambient particulate air pollution and smoking in countries with a high sociodemographic index and higher proportions of household air pollution from solid fuels and diet low in fruit in countries with a low sociodemographic index. CONCLUSIONS Early onset type 2 diabetes is a growing global health problem in adolescents and young adults, especially in countries with a low-middle and middle sociodemographic index. A greater disease burden in women aged <30 years was found. Specific measures are needed in countries with different levels of socioeconomic development because of the variable attributable risk factors for type 2 diabetes in adolescents and young adults.
Collapse
Affiliation(s)
- Jinchi Xie
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Maoqing Wang
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Zhiping Long
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Hua Ning
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Jingkuo Li
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yukun Cao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yunfei Liao
- Department of Endocrinology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Fan Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| |
Collapse
|
153
|
Haakenstad A, Yearwood JA, Fullman N, Bintz C, Bienhoff K, Weaver MR, Nandakumar V, LeGrand KE, Knight M, Abbafati C, Abbasi-Kangevari M, Abdoli A, Abeldaño Zuñiga RA, Adedeji IA, Adekanmbi V, Adetokunboh OO, Afzal MS, Afzal S, Agudelo-Botero M, Ahinkorah BO, Ahmad S, Ahmadi A, Ahmadi S, Ahmed A, Ahmed Rashid T, Aji B, Akande-Sholabi W, Alam K, Al Hamad H, Alhassan RK, Ali L, Alipour V, Aljunid SM, Ameyaw EK, Amin TT, Amu H, Amugsi DA, Ancuceanu R, Andrade PP, Anjum A, Arabloo J, Arab-Zozani M, Ariffin H, Arulappan J, Aryan Z, Ashraf T, Atnafu DD, Atreya A, Ausloos M, Avila-Burgos L, Ayano G, Ayanore MA, Azari S, Badiye AD, Baig AA, Bairwa M, Bakkannavar SM, Baliga S, Banik PC, Bärnighausen TW, Barra F, Barrow A, Basu S, Bayati M, Belete R, Bell AW, Bhagat DS, Bhagavathula AS, Bhardwaj P, Bhardwaj N, Bhaskar S, Bhattacharyya K, Bhurtyal A, Bhutta ZA, Bibi S, Bijani A, Bikbov B, Biondi A, Bolarinwa OA, Bonny A, Brenner H, Buonsenso D, Burkart K, Busse R, Butt ZA, Butt NS, Caetano dos Santos FL, Cahuana-Hurtado L, Cámera LA, Cárdenas R, Carneiro VLA, Catalá-López F, Chandan JS, Charan J, Chavan PP, Chen S, Chen S, Choudhari SG, Chowdhury EK, Chowdhury MAK, Cirillo M, Corso B, Dadras O, Dahlawi SMA, Dai X, Dandona L, Dandona R, Dangel WJ, Dávila-Cervantes CA, Davletov K, Deuba K, Dhimal M, Dhimal ML, Djalalinia S, Do HP, Doshmangir L, Duncan BB, Effiong A, Ehsani-Chimeh E, Elgendy IY, Elhadi M, El Sayed I, El Tantawi M, Erku DA, Eskandarieh S, Fares J, Farzadfar F, Ferrero S, Ferro Desideri L, Fischer F, Foigt NA, Foroutan M, Fukumoto T, Gaal PA, Gaihre S, Gardner WM, Garg T, Getachew Obsa A, Ghafourifard M, Ghashghaee A, Ghith N, Gilani SA, Gill PS, Goharinezhad S, Golechha M, Guadamuz JS, Guo Y, Gupta RD, Gupta R, Gupta VK, Gupta VB, Hamiduzzaman M, Hanif A, Haro JM, Hasaballah AI, Hasan MM, Hasan MT, Hashi A, Hay SI, Hayat K, Heidari M, Heidari G, Henry NJ, Herteliu C, Holla R, Hossain S, Hossain SJ, Hossain MBH, Hosseinzadeh M, Hostiuc S, Hoveidamanesh S, Hsieh VCR, Hu G, Huang J, Huda MM, Ifeagwu SC, Ikuta KS, Ilesanmi OS, Irvani SSN, Islam RM, Islam SMS, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Jahani MA, Jahanmehr N, Jain R, Jakovljevic M, Janodia MD, Jayapal SK, Jayaram S, Jha RP, Jonas JB, Joo T, Joseph N, Jürisson M, Kabir A, Kalankesh LR, Kalhor R, Kamath AM, Kamenov K, Kandel H, Kantar RS, Kapoor N, Karanikolos M, Katikireddi SV, Kavetskyy T, Kawakami N, Kayode GA, Keikavoosi-Arani L, Keykhaei M, Khader YS, Khajuria H, Khalilov R, Khammarnia M, Khan MN, Khan MAB, Khan M, Khezeli M, Kim MS, Kim YJ, Kisa S, Kisa A, Klymchuk V, Koly KN, Korzh O, Kosen S, Koul PA, Kuate Defo B, Kumar GA, Kusuma D, Kyu HH, Larsson AO, Lasrado S, Lee WC, Lee YH, Lee CB, Li S, Lucchetti G, Mahajan PB, Majeed A, Makki A, Malekzadeh R, Malik AA, Malta DC, Mansournia MA, Mantovani LG, Martinez-Valle A, Martins-Melo FR, Masoumi SZ, Mathur MR, Maude RJ, Maulik PK, McKee M, Mendoza W, Menezes RG, Mensah GA, Meretoja A, Meretoja TJ, Mestrovic T, Michalek IM, Mirrakhimov EM, Misganaw A, Misra S, Moazen B, Mohammadi M, Mohammed S, Moitra M, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moradi G, Moreira RS, Mosser JF, Mostafavi E, Mouodi S, Nagarajan AJ, Nagata C, Naghavi M, Nangia V, Narasimha Swamy S, Narayana AI, Nascimento BR, Nassereldine H, Nayak BP, Nazari J, Negoi I, Nepal S, Neupane Kandel S, Ngunjiri JW, Nguyen HLT, Nguyen CT, Ningrum DNA, Noubiap JJ, Oancea B, Oghenetega OB, Oh IH, Olagunju AT, Olakunde BO, Omar Bali A, Omer E, Onwujekwe OE, Otoiu A, Padubidri JR, Palladino R, Pana A, Panda-Jonas S, Pandi-Perumal SR, Pardhan S, Pasupula DK, Pathak PK, Patton GC, Pawar S, Pereira J, Pilania M, Piroozi B, Podder V, Pokhrel KN, Postma MJ, Prada SI, Quazi Syed Z, Rabiee N, Radhakrishnan RA, Rahman MM, Rahman M, Rahman M, Rahman MHU, Rahmani AM, Ranabhat CL, Rao CR, Rao SJ, Rasella D, Rawaf S, Rawaf DL, Rawal L, Renzaho AM, Reshmi B, Resnikoff S, Rezapour A, Riahi SM, Ripon RK, Sacco S, Sadeghi M, Saeed U, Sahebkar A, Sahiledengle B, Sahoo H, Sahu M, Salama JS, Salamati P, Samy AM, Sanabria J, Santric-Milicevic MM, Sathian B, Sawhney M, Schmidt MI, Seidu AA, Sepanlou SG, Seylani A, Shaikh MA, Sheikh A, Shetty A, Shigematsu M, Shiri R, Shivakumar KM, Shokri A, Singh JA, Sinha DN, Skryabin VY, Skryabina AA, Sofi-Mahmudi A, Sousa RARC, Stephens JH, Sun J, Szócska M, Tabarés-Seisdedos R, Tadbiri H, Tamiru AT, Thankappan KR, Topor-Madry R, Tovani-Palone MR, Tran MTN, Tran BX, Tripathi N, Tripathy JP, Troeger CE, Uezono DR, Ullah S, Ullah A, Unnikrishnan B, Vacante M, Valadan Tahbaz S, Valdez PR, Vasic M, Veroux M, Vervoort D, Violante FS, Vladimirov SK, Vlassov V, Vo B, Waheed Y, Wamai RG, Wang YP, Wang Y, Ward P, Wiangkham T, Yadav L, Yahyazadeh Jabbari SH, Yamagishi K, Yaya S, Yazdi-Feyzabadi V, Yi S, Yiğit V, Yonemoto N, Younis MZ, Yu C, Yunusa I, Zaman SB, Zastrozhin MS, Zhang ZJ, Zhong C, Zuniga YMH, Lim SS, Murray CJL, Lozano R. Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Glob Health 2022; 10:e1715-e1743. [PMID: 36209761 PMCID: PMC9666426 DOI: 10.1016/s2214-109x(22)00429-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/13/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. METHODS We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. FINDINGS Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9-21·3), as well as among the young (22·5, 19·9-24·7), working (17·2, 15·2-19·1), and post-working (15·1, 13·2-17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6-33·0) on average in low-SDI countries to 83·4 (82·4-84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4-89·0), working (33·8-82·8), and post-working (30·4-79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. INTERPRETATION Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
154
|
Smolić Š, Čipin I, Međimurec P. Access to healthcare for people aged 50+ in Europe during the COVID-19 outbreak. Eur J Ageing 2022; 19:793-809. [PMID: 34149338 PMCID: PMC8195455 DOI: 10.1007/s10433-021-00631-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 01/26/2023] Open
Abstract
This paper combines SHARE Corona Survey and SHARE Wave 7 data for 25 European countries and Israel (N = 40,919) with institutional and epidemic-related country characteristics to investigate healthcare access for Europeans aged 50+ during the outbreak of COVID-19. We use a micro-macro approach to examine whether and to what extent barriers to accessing healthcare measured by reported unmet healthcare needs vary within and between countries. We consider various aspects of barriers and distinguish among: (1) respondents who forewent medical treatment because they were afraid of becoming infected with the Coronavirus; (2) respondents who had pre-scheduled medical appointments postponed by health providers due to the outbreak; and (3) respondents who tried to arrange a medical appointment but were denied one. Limited access to healthcare during the initial outbreak was more common for the occupationally active, women, the more educated and those living in urban areas. A bad economic situation, poor overall health and higher healthcare utilisation were robust predictors of unmet healthcare. People aged 50+ in countries of 'Old' Europe, countries with higher universal health coverage and stricter containment and closure policies were more likely to have medical services postponed. Policymakers should address the healthcare needs of older people with chronic health conditions and a poor socio-economic status who were made more vulnerable by this pandemic. In the aftermath of the health crisis, public health systems might experience a great revival in healthcare demand, a challenge that should be mitigated by careful planning and provision of healthcare services.
Collapse
Affiliation(s)
- Šime Smolić
- Faculty of Economics & Business, Department of Macroeconomics and Economic Development, University of Zagreb, Zagreb, Croatia
| | - Ivan Čipin
- Faculty of Economics & Business, Department of Demography, University of Zagreb, Zagreb, Croatia
| | - Petra Međimurec
- Faculty of Economics & Business, Department of Demography, University of Zagreb, Zagreb, Croatia
| |
Collapse
|
155
|
Zhang D, Liu S, Li Z, Wang R. Global, regional and national burden of gastroesophageal reflux disease, 1990-2019: update from the GBD 2019 study. Ann Med 2022; 54:1372-1384. [PMID: 35579516 PMCID: PMC9122392 DOI: 10.1080/07853890.2022.2074535] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Because trends in the epidemiology and burden of gastroesophageal reflux disease (GERD) are changing, reinvestigating the geographical differences and trend changes is essential. Here we evaluated the latest epidemiologic patterns and trends for GERD, using data from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS Annual case numbers, age-standardized rates of prevalence, incidence, and years of life lived with disability (YLDs), and their estimated annual percentage changes (EAPCs) for GERD between 1990 and 2019 were derived from the GBD 2019 study. Association between GERD burden and socio-demographic index (SDI) was also investigated. RESULTS In 2019, there were 783.95 million cases of GERD globally. Between 1990 and 2019, the total number of prevalent cases, incident cases, and YLDs increased by 77.53%, 74.79%, and 77.19%, respectively. The global age-standardized incidence rate (ASIR) and age-standardized YLD rate (ASYR) increased during this period (EAPC = 0.06 and 0.05, respectively). Tropical Latin America and East Asia had the highest and lowest age-standardiZed prevalence rate (ASPR), ASIR, and ASYR in 2019, respectively. From 1990 to 2019, prevalent cases, incident cases, YLDs, and their corresponding age-standardized rates of GERD were higher in females than males in all years. Higher SDI was associated with lower ASPR, ASIR, and ASYR of GERD in 2019. CONCLUSIONS GERD will continue to be a major public health burden due to increasing numbers of prevalent cases, incident cases, and YLDs. In order to tackle this troublesome disease, it is crucial to understand the changes in both global and regional trends in epidemiology and the burden for policymakers and other stakeholders. Key messagesThis is the most updated estimate on GERD epidemiology globally, including 204 countries, some of which were not assessed before.The overall burden of GERD continued to worsen with the prevalent cases increasing by 77.53% from 441.57 million in 1990 to 783.95 million in 2019.GERD is likely to remain a common reason for consultation in primary care, and our data may allow for health service provision planning.
Collapse
Affiliation(s)
- Decai Zhang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha, China
| | - Shaojun Liu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha, China
| | - Zhaoqi Li
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha, China
| | - Rui Wang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha, China
| |
Collapse
|
156
|
Zhou Y, Li C, Wang M, Xu S, Wang L, Hu J, Ding L, Wang W. Universal health coverage in China: a serial national cross-sectional study of surveys from 2003 to 2018. THE LANCET PUBLIC HEALTH 2022; 7:e1051-e1063. [DOI: 10.1016/s2468-2667(22)00251-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/26/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
|
157
|
Piñeros M, Ginsburg O, Bendahhou K, Eser S, Shelpai WA, Fouad H, Znaor A. Staging practices and breast cancer stage among population-based registries in the MENA region. Cancer Epidemiol 2022; 81:102250. [PMID: 36115143 PMCID: PMC9693698 DOI: 10.1016/j.canep.2022.102250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/25/2022] [Accepted: 09/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Availability of stage information by population-based cancer registries (PBCR) remains scarce for diverse reasons. Nevertheless, stage is critical cancer control information particularly for cancers amenable to early detection. In the framework of the Global Initiative for Cancer Registry Development (GICR), we present the status of stage data collection and dissemination among registries in the Middle East and Northern Africa (MENA) region as well as the stage distribution of breast cancer patients. METHODS A web-based survey exploring staging practices and breast cancer stage was developed and sent to 30 PBCR in 18 countries of the MENA region. RESULTS Among 23 respondent PBCR, 21 collected stage data, the majority (80%) for all cancers. Fourteen registries used a single classification (9 TNM and 5 SEER), 7 used both staging systems in parallel. Out of 12,888 breast cancer patients (seven registries) 27.7% had unknown TNM stage (11.1% in Oman, 46% in Annaba). When considering only cases with known stage, 65.3% were early cancers (TNM I+II), ranging from 57.9% in Oman to 83.3% in Batna (Algeria), and 9.9% were stage IV cancers. Among the nine registries providing SEER Summary stage for breast cancer cases, stage was unknown in 19% of the cases, (0 in Bahrain, 39% in Kuwait). Stage data were largely absent from the published registry reports. CONCLUSION Despite wide stage data collection by cancer registries, missing information and low dissemination clearly limit informing efforts on early detection. The use of two classification systems in parallel implies additional workload and might undermine completeness. The favourable results of early cancer (TNM I+II) in two thirds of breast cancer patients needs to be interpreted with caution and followed up in time. Although efforts to improve quality of stage data are needed, our findings are particularly relevant to the WHO Global Breast Cancer Initiative.
Collapse
Affiliation(s)
- Marion Piñeros
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | - Ophira Ginsburg
- Center for Global Health, US National Cancer Institute, MD, USA
| | | | - Sultan Eser
- Balıkesir University, Faculty of Medicine, Balikesir, Turkey
| | | | - Heba Fouad
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Ariana Znaor
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| |
Collapse
|
158
|
Hooley B, Mtenga S, Tediosi F. Informal Support Networks of Tanzanians With Chronic Diseases: Predictors of Support Provision and Treatment Adherence. Int J Public Health 2022; 67:1605366. [PMID: 36506711 PMCID: PMC9726723 DOI: 10.3389/ijph.2022.1605366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives: To examine the role of NCD patients' social ties as informal caregivers and whether receiving their support is associated with engagement in care. Methods: NCD outpatients (N2 = 100) in rural Tanzania completed a cross-sectional questionnaire to characterize the support role of their social ties (N1 = 304). Bivariate analyses explored predictors of social support and whether social support is associated with engagement in care. Results: This study found that 87% of participants had health insurance, yet 25% received financial support for financing healthcare. Patient gender, age and marital status were found to be important predictors of social support, with NCD-related disability and disease severity being predictive to a lesser degree. Monthly receipt of both material and non-material support were associated with increased odds of adherence to prescribed medications. Conclusion: These findings indicate that patients' social ties play an important role in filling the gaps in formal social health protection and incur substantial costs by doing so. The instrumental role of even non-material social support in promoting engagement in care deserves greater attention when developing policies for improving this population's engagement in care.
Collapse
Affiliation(s)
- Brady Hooley
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- University of Basel, Basel, Switzerland
| |
Collapse
|
159
|
Allen LN. The philosophical foundations of 'health for all' and Universal Health Coverage. Int J Equity Health 2022; 21:155. [PMID: 36335332 PMCID: PMC9636790 DOI: 10.1186/s12939-022-01780-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/07/2022] [Indexed: 11/08/2022] Open
Abstract
The WHO constitution calls for 'health for all' and Universal Health Coverage has been called "the ultimate expression of fairness", however it is not always clear how health systems can move towards equity. Should we prioritise the needs of the worst off? And if so, should we direct resources to these marginalised groups or marginalised individuals? This article provides an overview of the philosophical underpinnings of health equity and proportionate universalism, highlighting the trade-offs involved in operationalising a core tenant of global health practice.
Collapse
Affiliation(s)
- Luke N Allen
- London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
| |
Collapse
|
160
|
Feng XL, Zhang Y, Hu X, Ronsmans C. Tracking progress towards universal health coverage for essential health services in China, 2008-2018. BMJ Glob Health 2022; 7:e010552. [PMID: 36446446 PMCID: PMC9710350 DOI: 10.1136/bmjgh-2022-010552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION We comprehensively evaluate whether the Chinese Government's goal of ensuring Universal Health Coverage for essential health services has been achieved. METHODS We used data from the 2008, 2013 and 2018 National Health Services Survey to report on the coverage of a range of Sustainable Development Goals (SDG) indicator 3.8.1. We created per capita household income deciles for urban and rural samples separately. We report time trends in coverage and the slope index (SII) and relative index (RII). RESULTS Despite much lower levels of income and education, rural populations made as much progress as their urban counterparts for most interventions. Coverage of maternal and child health interventions increased substantially in urban and rural areas, with decreasing rich-poor inequalities except for antenatal care. In rural China, one-fifth women could not access 5 or more antenatal visits. Coverage of 8 or more visits were 34% and 68%, respectively in decile D1 (the poorest) and decile D10 (the richest) (SII 35% (95% CI 22% to 48%)). More than 90% households had access to clean water, but basic sanitation was poor for rural households and the urban poorest, presenting bottom inequality. Effective coverage for non-communicable diseases was low. Medication for hypertension and diabetes were relatively high (>70%). But adequate management, counting in preventive interventions, were much lower and decreased overtime, although inequalities were small in size. Screening of cervical and breast cancer was low in both urban and rural areas, seeing no progress overtime. Cervical cancer screening was only 29% (urban) and 24% (rural) in 2018, presenting persisted top inequalities (SII 25% urban, 14% rural). CONCLUSION China has made commendable progress in protecting the poorest for basic care. However, the 'leaving no one behind' agenda needs a strategy targeting the entire population rather than only the poorest. Blunt investing in primary healthcare facilities seems neither effective nor efficient.
Collapse
Affiliation(s)
- Xing Lin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Yaoguang Zhang
- Division of Health Statistics, Centre for Health Statistics and Information, National Health Commission of China, Beijing, China
| | - Xuhuai Hu
- Research Department II of Shenzhen Health Development Research and Data Management Center, Shenzhen, China
| | - Carine Ronsmans
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
161
|
Liang R, Feng X, Shi D, Yang M, Yu L, Liu W, Zhou M, Wang X, Qiu W, Fan L, Wang B, Chen W. The global burden of disease attributable to high fasting plasma glucose in 204 countries and territories, 1990-2019: An updated analysis for the Global Burden of Disease Study 2019. Diabetes Metab Res Rev 2022; 38:e3572. [PMID: 36001650 DOI: 10.1002/dmrr.3572] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/30/2022] [Accepted: 07/16/2022] [Indexed: 11/11/2022]
Abstract
AIMS High fasting plasma glucose (HFPG) is an independent risk factor for several adverse health outcomes and has become a serious public health problem. We aimed to evaluate the spatial pattern and temporal trend of disease burden attributed to HFPG from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. MATERIALS AND METHODS Using data from GBD 2019, we estimated the numbers and age-standardized rates of deaths and disability-adjusted life years (DALYs) attributed to HFPG by calendar year, age, gender, country, region, Socio-demographic Index (SDI), and specific causes. The joinpoint regression analysis was used to assess the temporal trends of deaths and DALYs from 1990 to 2019. RESULTS In 2019, globally, the numbers of deaths and DALYs attributable to HFPG were approximately 6.50 million and 172.07 million, respectively, with age-standardized rates of 83.00 per 100,000 people and 2104.26 per 100,000 people, respectively. From 1990 to 2019, the global numbers of deaths and DALYs attributed to HFPG have over doubled. The age-standardized rate of DALYs showed an increasing trend, particularly in males and in regions with middle SDI or below. The leading causes of the global disease burden attributable to HFPG in 2019 were diabetes mellitus, ischaemic heart disease, stroke, and chronic kidney disease. CONCLUSIONS HFPG is an important contributor to increasing the global and regional disease burden. Necessary measures should be taken to curb the growing burden attributed to HFPG, particularly in males and in regions with middle SDI or below.
Collapse
Affiliation(s)
- Ruyi Liang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaobing Feng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Da Shi
- Food and Human Nutritional Science, Faculty of Agriculture and Food Science, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Meng Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Health Care Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Linling Yu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Min Zhou
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xing Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weihong Qiu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lieyang Fan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bin Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
162
|
Children's Hip Predictive (CHiP) Score: A Triage Tool for Hip Dislocation in Children Referred With Suspected Hip Dysplasia. J Pediatr Orthop 2022; 42:552-557. [PMID: 35993600 DOI: 10.1097/bpo.0000000000002239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND A fundamental tenent of treating developmental dysplasia of the hip is to identify patients with dislocated hips early so as to avoid the long-term sequelae of late diagnosis. The aim of this study was to develop a readily useable triage tool for patients with suspected hip dislocation, based on the clinical history and examination findings of the referring practitioner. METHODS All primary care referrals (n=934) over a 3-year period for suspected developmental dysplasia of the hip to a tertiary pediatric center were evaluated. Defined parameters with respect to history and clinical examination were evaluated. Multivariable logistic regression was used to establish predictors of hip dislocation, and from this a predictive model was derived which incorporated significant predictors of dislocation. An illustrative nomogram translated this predictive model into a usable numerical scoring system called the Children's Hip Prediction score, which estimates probability of hip dislocation. RESULTS There were 97 dislocated hips in 85 patients. The final predictive model included age, sex, family history, breech, gait concerns, decreased abduction, leg length discrepancy, and medical/neurological syndrome. The area under receiver operating curve for the model is 0.761. A Children's Hip Prediction score of≥5 corresponds to a sensitivity of 76.3% and a score of≥15 has a specificity of 97.8%, corresponding to an odds ratio of 27.3 for increased risk of dislocation. CONCLUSION We found that a novel clinical prediction score, based on readily available history and examination parameters strongly predicted risk of dislocations in hip dysplasia referral. It is hoped that this tool could be utilized to optimize resource allocation and may be of particular benefit in less well-resourced health care systems. LEVEL OF EVIDENCE Level II.
Collapse
|
163
|
Ferrara P, Dallagiacoma G, Alberti F, Gentile L, Bertuccio P, Odone A. Prevention, diagnosis and treatment of cervical cancer: A systematic review of the impact of COVID-19 on patient care. Prev Med 2022; 164:107264. [PMID: 36150446 PMCID: PMC9487163 DOI: 10.1016/j.ypmed.2022.107264] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/07/2022] [Accepted: 09/17/2022] [Indexed: 11/30/2022]
Abstract
Worldwide, the COVID-19 pandemic disrupted healthcare services, including cervical cancer management, and an increased burden for this condition is expected. This systematic review synthetizes the available evidence on the impact of the pandemic on prevention, diagnosis and treatment of cervical cancer. Searches were performed on PubMed, Embase, and Scopus for relevant studies on these topics with the purpose of comparing service access and care delivery before and during COVID-19 pandemic. Due to the methodological heterogeneity among the studies, findings were narratively discussed. Of the 715 screened titles and abstracts, 33 articles were included, corresponding to 42 reports that covered the outcomes of interest: vaccination against human papillomavirus (HPV) (6 reports), cancer screening (19), diagnosis (8), and treatment (8). Seven studies observed reductions in HPV vaccination uptake and coverage during COVID-19. Reports on cervical screening and cancer diagnosis activities showed a substantial impact of the pandemic on access to screening services and diagnostic procedures. All but one study that investigated cervical cancer treatment reported changes in the number of women with cervical lesions who received treatments, as well as treatment delay and interruption. With a major impact during the first wave in 2020, COVID-19 and restriction measures resulted in a substantial disruption in cervical cancer prevention and management, with declines in screening and delays in treatment. Taken together, findings from this systematic review calls for urgent policy interventions for recovering cervical cancer prevention and care.
Collapse
Affiliation(s)
- Pietro Ferrara
- Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy; IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Giulia Dallagiacoma
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Federica Alberti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Leandro Gentile
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Paola Bertuccio
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy.
| |
Collapse
|
164
|
Kim S, Tadesse E, Jin Y, Cha S. Association between Development Assistance for Health and Disease Burden: A Longitudinal Analysis on Official Development Assistance for HIV/AIDS, Tuberculosis, and Malaria in 2005-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14091. [PMID: 36360980 PMCID: PMC9656851 DOI: 10.3390/ijerph192114091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
From the early stage of the millennium development goals campaign, HIV/AIDS, tuberculosis and malaria have received huge aid funds. With the datasets published by the Institute for Health Metrics and Evaluation, Organization for Economic Cooperation and Developments, and World Health Organization from 2005 to 2017, we analyzed the association between the total DAH or DAH per capita and the disease burden. We measured the total DAH or DAH per capita as the dependent variable, with six independent variables of disease burden for Disability Adjusted Life Year (DALY), number of infected people, number of deaths, prevalence, incidence, and mortality rate. For the trend in ODA targeting, the likelihood ratio test of the fixed effects models was used to assess any existence of slope changes in linear regression across the years. The total amount of DAH and DAH per capita was found positively related with every aspect of disease burden, with the regression coefficients increasing during 2005-2017. For instance, the slope of association between the DAH per capita and the disease burden of malaria became steeper over time (likelihood ratio, χ2 = 26.14, p < 0.001). Although the selection criteria for the recipient country have been controversial, ODA targeting has been performed based on disease burden in this research.
Collapse
Affiliation(s)
- Sumin Kim
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554, Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Korea
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06355, Korea
| | - Ermias Tadesse
- Department of Human Ecology and Technology, Graduate School of Advanced Convergence, Handong Global University, Pohang 37554, Korea
| | - Yan Jin
- Department of Microbiology, Dongguk University College of Medicine, Gyeongju 38066, Korea
| | - Seungman Cha
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554, Korea
| |
Collapse
|
165
|
Leo A, Tallarico M, Sciaccaluga M, Citraro R, Costa C. Epilepsy and Alzheimer's Disease: Current Concepts and Treatment Perspective on Two Closely Related Pathologies. Curr Neuropharmacol 2022; 20:2029-2033. [PMID: 35524669 PMCID: PMC9886839 DOI: 10.2174/1570159x20666220507020635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/13/2022] [Accepted: 02/19/2022] [Indexed: 11/22/2022] Open
Abstract
The literature on epileptic seizures in Alzheimer's disease has significantly increased over the past decades. Remarkably, several studies suggest a bi-directional link between these two common neurological diseases, with either condition carrying a nearly 2-fold risk of contracting the other in comparison to healthy subjects. In this respect, evidence from both clinical and preclinical studies indicates that epileptogenesis and neurodegeneration possibly share common underlying mechanisms. However, the precise association between epileptogenesis and neurodegeneration still needs to be fully elucidated. Targeted intervention to reduce abnormal network hyperexcitability might constitute a therapeutic strategy to postpone the onset of later neurodegenerative changes and consequent cognitive decline by many years in patients. By virtue of this, an early diagnosis and treatment of seizures in patients with Alzheimer's disease should be pursued. To date, no guidelines are available for treating epileptic activity in this context, largely due to the paucity of studies sufficient to answer the related questions. Accordingly, clinical trials are mandatory, not only to inform clinicians about symptomatic management of seizures in Alzheimer's disease patients but also to detect if treatment with antiseizure medications could have disease-modifying effects. Moreover, it will be fundamental to expand the application of animal models of Alzheimer's disease to comorbid conditions, such as epilepsy both to reveal the mechanisms underlying seizure onset and to better define their role in cognitive decline. Such models could also be useful to identify pharmacological compounds having therapeutically effectiveness as well as reliable early biomarkers for seizures in Alzheimer's disease.
Collapse
Affiliation(s)
- Antonio Leo
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy;
| | - Martina Tallarico
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy;
| | - Miriam Sciaccaluga
- Neurology Clinic, Department of Medicine and Surgery, University of Perugia, Santa Maria Della Misericordia Hospital, Perugia, Italy
| | - Rita Citraro
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy; ,Address correspondence to this author at the Department of Science of Health, School of Medicine and Surgery, University of Catanzaro, Viale Europa – Germaneto 88100 Catanzaro, Italy; Tel: +39 0961 3694191; Fax: +39 0961 3694192; E-mail:
| | - Cinzia Costa
- Neurology Clinic, Department of Medicine and Surgery, University of Perugia, Santa Maria Della Misericordia Hospital, Perugia, Italy
| |
Collapse
|
166
|
Paschall MJ, Ringwalt CL, Fisher DA, Grube JW, Achoki T, Miller TR. Screening and brief intervention for alcohol use disorder risk in three middle-income countries. BMC Public Health 2022; 22:1967. [PMID: 36289538 PMCID: PMC9609268 DOI: 10.1186/s12889-022-14358-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/09/2022] [Accepted: 10/14/2022] [Indexed: 11/11/2022] Open
Abstract
Background This study examined the prevalence of screening and brief intervention (SBI) for alcohol use disorder (AUD) risk in samples of adult drinkers in three middle-income countries (Brazil, China, South Africa), and the extent to which meeting criteria for AUD risk was associated with SBI. Methods Cross-sectional survey data were collected from adult samples in two cities in each country in 2018. Survey measures included past-year alcohol use, the CAGE assessment for AUD risk, talking to a health care professional in the past year, alcohol use screening by a health care professional, receiving advice about drinking from a health care professional, and sociodemographic characteristics. The prevalence of SBI was determined for past-year drinkers in each country and for drinkers who had talked to a health care professional. Logistic regression analyses were conducted to examine whether meeting criteria for AUD risk was associated with SBI when adjusting for sociodemographic characteristics. Results Among drinkers at risk for AUD, alcohol use screening rates ranged from 6.7% in South Africa to 14.3% in Brazil, and brief intervention rates ranged from 4.6% in South Africa to 8.2% in China. SBI rates were higher among drinkers who talked to a health care professional in the past year. In regression analyses, AUD risk was positively associated with SBI in China and South Africa, and with brief intervention in Brazil. Conclusion Although the prevalence of SBI among drinkers at risk for AUD in Brazil, China, and South Africa appears to be low, it is encouraging that these drinkers were more likely to receive SBI. Supplementary information The online version contains supplementary material available at 10.1186/s12889-022-14358-4.
Collapse
Affiliation(s)
- Mallie J. Paschall
- grid.280247.b0000 0000 9994 4271PIRE Programs NF, Pacific Institute for Research and Evaluation, 2030 Addiston St., Suite 410, 94704 Berkeley, CA United States
| | - Christopher L. Ringwalt
- grid.280247.b0000 0000 9994 4271PIRE Programs NF, Pacific Institute for Research and Evaluation, 2030 Addiston St., Suite 410, 94704 Berkeley, CA United States
| | - Deborah A. Fisher
- grid.280247.b0000 0000 9994 4271PIRE Programs NF, Pacific Institute for Research and Evaluation, 101 Conner Drive, Suite 200, 27514 Chapel Hill, NC United States ,grid.280247.b0000 0000 9994 4271PIRE Programs NF, Pacific Institute for Research and Evaluation, 4061 Powder Mill Road, Suite 350, 20705 Beltsville, MD United States
| | - Joel W. Grube
- grid.280247.b0000 0000 9994 4271PIRE Programs NF, Pacific Institute for Research and Evaluation, 2030 Addiston St., Suite 410, 94704 Berkeley, CA United States
| | - Tom Achoki
- grid.431216.3AB InBev Foundation, 1440 G Street NW, 20005 Washington, DC United States
| | - Ted R. Miller
- grid.280247.b0000 0000 9994 4271PIRE Programs NF, Pacific Institute for Research and Evaluation, 4061 Powder Mill Road, Suite 350, 20705 Beltsville, MD United States ,grid.1032.00000 0004 0375 4078Curtin University School of Public Health, 6845 Perth, WA Australia
| |
Collapse
|
167
|
Yu H, Peng Y, Pu L. Study on the Impact of Government Health Expenditure Equity on Residents' Health Level in the Chengdu-Chongqing Economic Circle of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12758. [PMID: 36232058 PMCID: PMC9566478 DOI: 10.3390/ijerph191912758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND When the global COVID-19 epidemic continues to spread, residents pay more attention to their health. This paper studies the relationship between the equity of government health expenditure and the health level of residents. METHODS The Theil index and a principal component analysis were used to measure the equity of government health expenditure and the health level of residents in the Chengdu-Chongqing economic circle. Then, an empirical study on the relationship between the equity of government health expenditure and the health level of residents in this region was conducted with the System GMM model. RESULTS 1. The Theil index rose from 0.0115 in 2015 to 0.0231 in 2017 and gradually decreased to 0.0106 in 2020. 2. The overall health level of residents showed an upward trend, rising from 1.95 in 2015 to 2.33 in 2017, then remained high and fluctuated slightly. 3. There was a positive correlation between the Theil index and the health level of residents at a significance level of 1% (β = 0.903, p < 0.01). CONCLUSIONS 1. The Theil index was close to 0, indicating that the equity of government health expenditure in the Chengdu-Chongqing economic circle was generally good. 2. The health level of residents in the Chengdu-Chongqing economic circle had improved compared to before. 3. The fairer the government's health expenditure, the higher the residents' health level.
Collapse
Affiliation(s)
- Haidong Yu
- School of Public Health, Chongqing Medical University, Chongqing 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing 400016, China
| | - Yujie Peng
- School of Public Health, Chongqing Medical University, Chongqing 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing 400016, China
| | - Lanfang Pu
- School of Public Health, Chongqing Medical University, Chongqing 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing 400016, China
| |
Collapse
|
168
|
Ren G, Yu K, Xie Z, Wang P, Zhang W, Huang Y, Wang Y, Wu X. Current Applications of Machine Learning in Spine: From Clinical View. Global Spine J 2022; 12:1827-1840. [PMID: 34628966 PMCID: PMC9609532 DOI: 10.1177/21925682211035363] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
STUDY DESIGN Narrative review. OBJECTIVES This review aims to present current applications of machine learning (ML) in spine domain to clinicians. METHODS We conducted a comprehensive PubMed search of peer-reviewed articles that were published between 2006 and 2020 using terms (spine, spinal, lumbar, cervical, thoracic, machine learning) to examine ML in spine. Then exclude research of other domain, case report, review or meta-analysis, and which without available abstract or full text. RESULTS Total 1738 articles were retrieved from database, and 292 studies were finally included. Key findings of current applications were compiled and summarized in this review. Main clinical applications of those techniques including image processing, diagnosis, decision supporting, operative assistance, rehabilitation, surgery outcomes, complications, hospitalization and cost. CONCLUSIONS ML had achieved excellent performance and hold immense potential in spine. ML could help clinical staff to improve medical level, enhance work efficiency, and reduce adverse events. However more randomized controlled trials and improvement of interpretability are essential to clinicians accepting models' assistance in real work.
Collapse
Affiliation(s)
- GuanRui Ren
- Southeast University Medical College,
Nanjing, Jiangsu, China
| | - Kun Yu
- Nanjing Jiangbei Hospital, Nanjing,
Jiangsu, China
| | - ZhiYang Xie
- Department of Spine Surgery, Zhongda
Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - PeiYang Wang
- Southeast University Medical College,
Nanjing, Jiangsu, China
| | - Wei Zhang
- Southeast University Medical College,
Nanjing, Jiangsu, China
| | - Yong Huang
- Southeast University Medical College,
Nanjing, Jiangsu, China
| | - YunTao Wang
- Department of Spine Surgery, Zhongda
Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China,YunTao Wang, Department of Spine Surgery,
Zhongda Hospital, School of Medicine, Southeast University, No. 87, Dingjiaqiao
Road, Nanjing, Jiangsu 210009, China.
| | - XiaoTao Wu
- Department of Spine Surgery, Zhongda
Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China,XiaoTao Wu, Department of Spine Surgery,
Zhongda Hospital, School of Medicine, Southeast University, No. 87, Dingjiaqiao
Road, Nanjing, Jiangsu 210009, China.
| |
Collapse
|
169
|
Murray CJL. The Global Burden of Disease Study at 30 years. Nat Med 2022; 28:2019-2026. [DOI: 10.1038/s41591-022-01990-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/03/2022] [Indexed: 11/07/2022]
|
170
|
Kawakatsu Y, Adolph C, Mosser JF, Baffoe P, Cheshi F, Aiga H, Watkins D, Sherr KH. Factors consistently associated with utilisation of essential maternal and child health services in Nigeria: analysis of the five Nigerian national household surveys (2003-2018). BMJ Open 2022; 12:e061747. [PMID: 36115678 PMCID: PMC9486329 DOI: 10.1136/bmjopen-2022-061747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/24/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE This study aims to identify the individual and contextual factors consistently associated with utilisation of essential maternal and child health services in Nigeria across time and household geolocation. DESIGN, SETTING AND PARTICIPANTS Secondary data from five nationally representative household surveys conducted in Nigeria from 2003 to 2018 were used in this study. The study participants are women and children depending on essential maternal and child health (MCH) services. OUTCOME MEASURES The outcome measures were indicators of whether participants used each of the following essential MCH services: antenatal care, facility-based delivery, modern contraceptive use, childhood immunisations (BCG, diphtheria, tetanus, pertussis/Pentavalent and measles) and treatments of childhood illnesses (fever, cough and diarrhoea). METHODS We estimated generalised additive models with logit links and smoothing terms for households' geolocation and survey years. RESULTS Higher maternal education and households' wealth were significantly associated with utilisation of all types of essential MCH services (p<0.05). On the other hand, households with more children under 5 years of age and in poor communities were significantly less likely to use essential MCH services (p<0.05). Except for childhood immunisations, greater access to transport was positively associated with utilisation (p<0.05). Households with longer travel times to the most accessible health facility were less likely to use all types of essential MCH services (p<0.05), except modern contraceptive use and treatment of childhood fever and/or cough. CONCLUSION This study adds to the evidence that maternal education and household wealth status are consistently associated with utilisation of essential MCH services across time and space. To increase utilisation of essential MCH services across different geolocations, interventions targeting poor communities and households with more children under 5 years of age should be appropriately designed. Moreover, additional interventions should prioritise to reduce inequities of essential MCH service utilisation between the wealth quantiles and between education status.
Collapse
Affiliation(s)
- Yoshito Kawakatsu
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Community-based Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Christopher Adolph
- Department of Political Science, University of Washington, Seattle, Washington, USA
- Center for Statistics and the Social Sciences, University of Washington, Seattle, Washington, USA
| | - Jonathan F Mosser
- Department of Health Metrics Sciences, University of Washington, Seattle, Washington, USA
| | | | | | - Hirotsugu Aiga
- Department of Health System Development, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - David Watkins
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Kenneth H Sherr
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Industrial & Systems Engineering, University of Washington, Seattle, Washington, USA
| |
Collapse
|
171
|
Kim S, Cha S, Jin Y. Association between Official Development Assistance for Water and Sanitation and Countries' Needs from 2002 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11134. [PMID: 36078845 PMCID: PMC9518171 DOI: 10.3390/ijerph191711134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/22/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
Although an enormous amount of aid has been invested in water and sanitation, few studies have analyzed the criteria used by the international community to select recipient countries and allocate official development assistance (ODA). We examined whether ODA has been allocated in proportion to water and sanitation needs and whether this has improved over the past 18 years. For water, 141 low- and middle-income countries (LMICs) and least-developed countries (LDCs) were selected, whereas 104 LMICs and LDCs were chosen for sanitation due to a lack of data. For aid disbursement, we used ODA data from the Organization for Economic Cooperation and Developments (OECD) Creditor Reporting System (CRS) from 2002 to 2019. OECD CRS data on water and sanitation are available from 2002 onward. For water and sanitation coverage, we collected data from the WHO/UNICEF Joint Monitoring Program from 2002 to 2019. We examined annual ODA trends and performed linear regression analysis adjusted for GNI per capita using log-transformed dependent variables. Neither total ODA nor ODA per capita was found to be associated with countries' needs for water and sanitation. For instance, no significant association was detected between at least basic water and sanitation coverage and total ODA per capita in 2019 (log coefficient: 0.002, p = 0.52). The global community needs to determine the reasons for and means of addressing this discrepancy.
Collapse
Affiliation(s)
- Sumin Kim
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554, Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Korea
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Seungman Cha
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554, Korea
| | - Yan Jin
- Department of Microbiology, Dongguk University College of Medicine, Gyeongju 38066, Korea
| |
Collapse
|
172
|
Batbold O, Banzragch T, Davaajargal D, Pu C. Crowding-Out Effect of Out-of-Pocket Health Expenditures on Consumption Among Households in Mongolia. Int J Health Policy Manag 2022; 11:1874-1882. [PMID: 34634880 PMCID: PMC9808239 DOI: 10.34172/ijhpm.2021.91] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/19/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND High out-of-pocket (OOP) health expenditures are a common problem in developing countries. Studies rarely investigate the crowding-out effect of OOP health expenditures on other areas of household consumption. OOP health costs are a colossal burden on families and can lead to adjustments in other areas of consumption to cope with these costs. METHODS This cross-sectional study used self-reported household consumption data from the nationally representative Household Socioeconomic Survey (HSES), collected in 2018 by the National Statistical Office of Mongolia. We estimated a quadratic conditional Engel curves system to determine intrahousehold resource allocation among 12 consumption variables. The 3-stage least squared method was used to deal with heteroscedasticity and endogeneity problems to estimate the causal crowding-out effect of OOP. RESULTS The mean monthly OOP health expenditure per household was ₮64 673 (standard deviation [SD]=259 604), representing approximately 6.9% of total household expenditures. OOP health expenditures were associated with crowding out durables, communication, transportation, and rent, and with crowding in education and heating for all households. The crowding-out effect of ₮10 000 in OOP health expenditures was the largest for food (₮5149, 95% CI=-8582; -1695) and crowding-in effect was largest in heating (₮2691, 95% CI=737; 4649) in the lowest-income households. The effect of heating was more than 10 times greater than that in highest-income households (₮261, 95% CI=66; 454); in the highest-income households, food had a crowding-in effect (₮179, 95% CI=-445; 802) in absolute amounts. In terms of absolute amount, the crowding-out effect for food was up to 5 times greater in households without social health insurance (SHI) than in those with SHI. CONCLUSION Our findings suggest that Mongolia's OOP health expenses are associated with reduced essential expenditure on items such as durables, communication, transportation, rent, and food. The effect varies by household income level and SHI status, and the lowest-income families were most vulnerable. SHI in Mongolia may not protect households from large OOP health expenditures.
Collapse
Affiliation(s)
- Ochirbat Batbold
- Ach Medical University, Ulaanbaatar, Mongolia
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Medicine, Etugen University, Ulaanbaatar, Mongolia
| | - Tuvshin Banzragch
- Mongolian Institute of Certified Public Accountants, Ulaanbaatar, Mongolia
| | | | - Christy Pu
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
173
|
Amit AML, Pepito VCF, Dayrit MM. Advancing Universal Health Coverage in the Philippines through self-care interventions. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 26:100579. [PMID: 36105555 PMCID: PMC9465409 DOI: 10.1016/j.lanwpc.2022.100579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Arianna Maever L. Amit
- Center for Research and Innovation, School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines
- National Clinical Trials and Translation Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Veincent Christian F. Pepito
- Center for Research and Innovation, School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines
| | - Manuel M. Dayrit
- Center for Research and Innovation, School of Medicine and Public Health, Ateneo de Manila University, Pasig, Philippines
| |
Collapse
|
174
|
Moradinazar M, Rostami R, Armaghan N, Shakiba M, Rai A, Abbasi Azizi S, Shakiba E. Epidemiological Features of Spontaneous Abortion in the North Africa and the Middle East From 1990 to 2019: Results From the Global Burden of Disease Study 2019. J Family Reprod Health 2022; 16:183-191. [PMID: 36569256 PMCID: PMC9759432 DOI: 10.18502/jfrh.v16i3.10579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective: Spontaneous abortion is one of the most common problems which a woman may encounter during her pregnancy which is one of the most important causes of maternal death. Therefore, the aim of this study was to report the epidemiological features of spontaneous abortion in North Africa and the Middle East (NAME) countries. Materials and methods: The study population included 21 countries in the NAME region with a population of more than 600 million. The Global Burden of Disease (GBD) 2019 database was used. Incidence rates, the prevalence rates, death rates, the disability adjusted life years (DALYs) rates by age-standardized rate (ASR) per 100,000 people were measured. Also, the attributed burden to iron deficiency was reported. Results: In 2019, the highest prevalence 39.44 (95% CI, 24.58_ 59.26) and incidence 4794.16 (95% CI, 3491.77_ 6353.03) rates of spontaneous abortion were in Afghanistan. In 2019, the highest spontaneous abortion related-death 5.88 (95% CI, 3.23_ 8.97) and DALYs 339.12 (95% CI, 184.29_ 516.95) rates by ASR were in Yemen. In MENA, average prevalence (44.7 to 19.82) and incidence (5434.95 to 2409.61) rates have decreased by nearly 56%, and also average death (1990 4.51 to 2019 0.48) and DALYs (263.15 to 29.37) rates have decreased by nearly 89% between 1990 and 2019. The highest spontaneous abortion-related DALYs rate was attributed to iron deficiency. In 2019, Yemen (29%) had the highest attributed burden to iron deficiency. Conclusion: This study on 21 countries in the NAME region with a population of more than 600 million showed that average prevalence and incidence rates of spontaneous abortion have decreased by nearly 56%, and also average and the disability adjusted life years (DALYs) rates have decreased by nearly 89% between 1990 and 2019.
Collapse
Affiliation(s)
- Mehdi Moradinazar
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Rostami
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nazila Armaghan
- School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Shakiba
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amirreza Rai
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sogand Abbasi Azizi
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ebrahim Shakiba
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
175
|
Bajunirwe F, Semakula D, Izudi J. Career aspirations of specialty among medical students in sub-Saharan Africa: a systematic review and meta-analysis of data from two decades, 2000-2021. BMJ Open 2022; 12:e057020. [PMID: 36028276 PMCID: PMC9422889 DOI: 10.1136/bmjopen-2021-057020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To determine the distribution of career aspirations for the discipline of specialty among undergraduate medical students in sub-Saharan Africa (SSA). DESIGN We searched PubMed/MEDLINE, EMBASE Google Scholar and Google for studies published between 1 January 2000 and 31 June 2021. Two reviewers extracted data from eligible studies, with disagreements resolved through consensus with a third reviewer. The random effects model was used to pool proportions, presented with the corresponding 95% CI. Heterogeneity was assessed using Cochrane's (Q) test but quantified with I2 values. Sources of heterogeneity were checked using meta-regression analysis while publication bias was assessed using funnel plot and Egger's test. SETTING SSA. PARTICIPANTS Undergraduate medical students. OUTCOMES Primary outcome was pooled proportion of career aspirations for the discipline of medical specialty and the secondary outcome was reasons for the specialty selection. RESULTS We identified 789 citations but meta-analysed 32 studies, with an overall sample size of 8231 participants. The most popular career aspiration for the discipline of specialty was surgery (29.5%; 95% CI 25.0% to 34.2%), followed by internal medicine (17.3%, 95% CI 11.7% to 23.7%), and then obstetrics and gynaecology (15.0%, 95% CI 12.3% to 17.9%), and paediatrics (11.3%; 95% CI 9.6% to 13.2%). The less popular medical disciplines of specialty included public health, orthopaedics, ophthalmology, family medicine, pathology, anaesthesiology, dermatology, otolaryngology, psychiatry and emergency medicine. The reasons for the selection of a medical discipline for specialty related to mentor and peer influences, prospect for economic gains, personal factors, long-term career interests and goals and discipline-specific factors. CONCLUSION Surgery is the most preferred career aspiration for medical students in SSA, followed by internal medicine. The choices do not necessarily match the disease burden on the continent and medical schools should consider strengthening career counselling and mentoring in their curriculum. PROSPERO REGISTRATION NUMBER CRD42021260501.
Collapse
Affiliation(s)
- Francis Bajunirwe
- Community Health, Mbarara University of Science and Technology Faculty of Medicine, Mbarara, Uganda
| | - Daniel Semakula
- Africa Center for Systematic Reviews and Knowledge Translation, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jonathan Izudi
- Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
| |
Collapse
|
176
|
Li J, Akaliyski P, Heisig JP, Löbl S, Minkov M. Flexible societies excelled in saving lives in the first phase of the COVID-19 pandemic. Front Psychol 2022; 13:924385. [PMID: 36092034 PMCID: PMC9461707 DOI: 10.3389/fpsyg.2022.924385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Previous studies have shown that national cultural traits, such as collectivism–individualism and tightness–looseness, are associated with COVID-19 infection and mortality rates. However, although East Asian countries have outperformed other countries in containing COVID-19 infections and lowering mortality in the first pandemic waves, no studies to date have examined flexibility-monumentalism, a cultural trait that uniquely distinguishes East Asia from the rest of the world. Moreover, none of the previous studies have explored mechanisms underpinning the association between national culture and COVID-19 mortality. Aims Our study fills in these gaps by examining the association between flexibility-monumentalism and COVID-19 mortality, adjusting for important covariates and by analyzing mask wearing and fear of COVID-19 during the first weeks of the pandemic as plausible mechanisms underpinning this association. Methods We constructed and analyzed a dataset including 37 countries that have valid information on flexibility-monumentalism, COVID-19 deaths as of 31 October 2020 (before the start of vaccination campaigns), and relevant covariates including two other national cultural traits (individualism–collectivism and tightness–looseness) and other national characteristics (economic, political, demographic and health). Multiple linear regression with heteroscedasticity-consistent standard errors was used to assess the independent effect of flexibility-monumentalism on COVID-19 mortality. Mediation was assessed by examining the indirect effects of flexibility through mask wearing and fear of COVID-19 and determining the statistical significance through bootstrapping. Graphical and delete-one analysis was used to assess the robustness of the results. Results We found that flexibility was associated with a significant reduction in COVID-19 mortality as of 31 October 2020, independent of level of democracy, per capita GDP, urbanization, population density, supply of hospital beds, and median age of the population. This association with mortality is stronger and more robust than for two other prominent national cultural traits (individualism–collectivism and tightness–looseness). We also found tentative evidence that the effect of flexibility on COVID-19 mortality may be partially mediated through mask wearing in the first weeks of the pandemic.
Collapse
Affiliation(s)
- Jianghong Li
- President’s Research Group, WZB Berlin Social Science Center, Berlin, Germany
- Telethon KIDS Institute, Perth, Western Australia
- Faculty of Business and Law, Bankwest-Curtin Economics Centre, Curtin University, Perth, WA, Australia
- *Correspondence: Jianghong Li,
| | - Plamen Akaliyski
- Department of Social Sciences, Universidad Carlos III de Madrid, Madrid, Spain
- Graduate School of System Design and Management, Keio University, Tokyo, Japan
| | - Jan Paul Heisig
- Research Group “Health and Social Inequality”, WZB Berlin Social Science Center, Berlin, Germany
- Institute of Sociology, Freie Universität Berlin, Berlin, Germany
| | - Simon Löbl
- Research Group “Health and Social Inequality”, WZB Berlin Social Science Center, Berlin, Germany
| | - Michael Minkov
- Department of Business and Economics, Varna University of Management, Sofia, Bulgaria
- Department of Economics, Tartu University, Tartu, Estonia
| |
Collapse
|
177
|
Yakupu A, Zhang J, Dong W, Song F, Dong J, Lu S. The epidemiological characteristic and trends of burns globally. BMC Public Health 2022; 22:1596. [PMID: 35996116 PMCID: PMC9396832 DOI: 10.1186/s12889-022-13887-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Burns is a type of injury, caused by unintentional exposure to substances of high temperature, including hot liquid, solid, and objects radiating heat energy, placing a high burden not only on patients’ families but also on national healthcare systems globally. It is difficult for policymakers and clinicians to formulate targeted management strategies for burns because data on current epidemiological patterns worldwide are lacking. Methods Data on burns were obtained from the Global Burden of Disease (GBD) 2019 Study. The incidence, disability-adjusted life years (DALYs), and deaths of burns in 204 countries and regions from 1990 to 2019 were calculated and stratified by sex, age, geographical location, and sociodemographic index (SDI). The estimated annual percentage change (EAPC) of incidence, DALYs, and deaths was calculated to evaluate the temporal trends. All analyses were performed using R software, version 4.1.1, with 2-sided P-values < .05 indicating a statistically significant difference. Results A total of 8,378,122 new cases (95% UI, 6,531,887–10,363,109cases) of burns were identified globally in 2019, which is almost evenly split between men and women, and most of the new cases were concentrated in the 10–19-year age group. Besides, burns account for 111,292 deaths (95% UI, 132,392–88,188) globally in 2019, most of which were concentrated in those aged 1–4 years. The burden of burns measured in DALYs was 7,460,448.65 (95% UI, 5,794,505.89–9,478,717.81) in 2019, of which 67% and 33% could be attributed to YLLs and YLDs, respectively. The EAPC of incidence, DALYs, and deaths were negative, the age-standardized rate (ASR) of incidence, DALYs, and deaths were considered to be decreasing in most of the regions, and the EAPCs were negatively correlated with SDI levels, universal health coverage (UHC), and gross domestic product (GDP). Conclusion Globally, the age-standardized rates of burn incidence, DALYs, and mortality, as well as the number of burn DALYs and death cases will continuously decrease, but the number of new burn cases has an increasing tendency globally. In addition, the EAPCs of burns in incidence, DALYs, and deaths indicated that the burden of burns was considered to be decreasing in most of the regions. And from the relationship of EAPCs with SDI, UHC index, and GDP, indicate that prevention burns not only depend on health spending per capita but also depend on the education level per capita and healthcare system performance, but it does not mean higher health spending corresponds to higher UHC index, which needs high efficiency of translating health spending into individuals health gains. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13887-2.
Collapse
Affiliation(s)
- Aobuliaximu Yakupu
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Zhang
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Dong
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Song
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaoyun Dong
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai Burn Institute, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China.
| | - Shuliang Lu
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai Burn Institute, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China.
| |
Collapse
|
178
|
Endalamaw A, Gilks CF, Ambaw F, Assefa Y. Universality of universal health coverage: A scoping review. PLoS One 2022; 17:e0269507. [PMID: 35994455 PMCID: PMC9394787 DOI: 10.1371/journal.pone.0269507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/09/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The progress of Universal health coverage (UHC) is measured using tracer indicators of key interventions, which have been implemented in healthcare system. UHC is about population, comprehensive health services and financial coverage for equitable quality services and health outcome. There is dearth of evidence about the extent of the universality of UHC in terms of types of health services, its integrated definition (dimensions) and tracer indicators utilized in the measurement of UHC. Therefore, we mapped the existing literature to assess universality of UHC and summarize the challenges towards UHC. METHODS The checklist Preferred Reporting Items for Systematic reviews and Meta-analysis extension for Scoping Reviews was used. A systematic search was carried out in the Web of Science and PubMed databases. Hand searches were also conducted to find articles from Google Scholar, the World Bank Library, the World Health Organization Library, the United Nations Digital Library Collections, and Google. Article search date was between 20 October 2021 and 12 November 2021 and the most recent update was done on 03 March 2022. Articles on UHC coverage, financial risk protection, quality of care, and inequity were included. The Population, Concept, and Context framework was used to determine the eligibility of research questions. A stepwise approach was used to identify and select relevant studies, conduct data charting, collation and summarization, as well as report results. Simple descriptive statistics and narrative synthesis were used to present the findings. RESULTS Forty-seven papers were included in the final review. One-fourth of the articles (25.5%) were from the African region and 29.8% were from lower-middle-income countries. More than half of the articles (54.1%) followed a quantitative research approach. Of included articles, coverage was assessed by 53.2% of articles; financial risk protection by 27.7%, inequity by 25.5% and quality by 6.4% of the articles as the main research objectives or mentioned in result section. Most (42.5%) of articles investigated health promotion and 2.1% palliation and rehabilitation services. Policy and healthcare level and cross-cutting barriers of UHC were identified. Financing, leadership/governance, inequity, weak regulation and supervision mechanism, and poverty were most repeated policy level barriers. Poor quality health services and inadequate health workforce were the common barriers from health sector challenges. Lack of common understanding on UHC was frequently mentioned as a cross-cutting barrier. CONCLUSIONS The review showed that majority of the articles were from the African region. Methodologically, quantitative research design was more frequently used to investigate UHC. Palliation and rehabilitation health care services need attention in the monitoring and evaluation of UHC progress. It is also noteworthy to focus on quality and inequity of health services. The study implies that urgent action on the identified policy, health system and cross-cutting barriers is required to achieve UHC.
Collapse
Affiliation(s)
- Aklilu Endalamaw
- School of Public Health, The University of Queensland, Brisbane, Australia
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Charles F. Gilks
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Fentie Ambaw
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yibeltal Assefa
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| |
Collapse
|
179
|
Lin C, Cheng W, Liu X, Li H, Song Y. The global, regional, national burden of laryngeal cancer and its attributable risk factors (1990-2019) and predictions to 2035. Eur J Cancer Care (Engl) 2022; 31:e13689. [PMID: 35980023 DOI: 10.1111/ecc.13689] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/28/2022] [Accepted: 08/02/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVE We aim to report the incidence, mortality and disability-adjusted life years (DALYs) between 1990 and 2019 and provide predictions to 2035. METHODS We use estimates from Global Burden of Disease, Injuries and Risk Factors Study 2019 to analyse the incidence, mortality and DALYs. RESULTS In 2019, there were more than 209,149 incidence cases, with age-standardised rates (ASRs) of 2.5. Laryngeal cancer accounted for 123,356 death cases, with ASRs of 1.5. Laryngeal cancer was also responsible for 3.26 million (3,034,634 to 3,511,354) DALYs, with ASRs of 38.8 (36.1 to 41.8). In 2019, Central Europe had the highest age-standardised incidence rate. At the national level, the highest incidence rate was observed in Mongolia. Total number and rate were significantly higher among males than females across all age groups. DALYs were attributable to Alcohol use, Smoking, Occupational exposure to sulfuric acid and asbestos. The age-standardised incidence rates in seven GBD regions and 59 countries are projected to increase between 2019 and 2035. CONCLUSIONS Despite the current and predicted decline in age-standardised incidence globally, the absolute number of estimates continue to increase. Prevention programmes should concentrate on modifiable risk factors, especially among the males across all age groups.
Collapse
Affiliation(s)
- Changwei Lin
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Wenwei Cheng
- Medical Department, The Third Xiangya Hospital of Central South University, Changsha, China.,Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiajing Liu
- Graduate School of Guilin Medical University, Guilin, China
| | - Heqing Li
- Department of Otolaryngology-Head Neck Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yexun Song
- Department of Otolaryngology-Head Neck Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| |
Collapse
|
180
|
Patel V, Bhadada S, Mazumdar-Shaw K, Mukherji A, Khanna T, Kang G. A historic opportunity for universal health coverage in India. Lancet 2022; 400:475-477. [PMID: 35964597 DOI: 10.1016/s0140-6736(22)01395-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 10/15/2022]
Affiliation(s)
- Vikram Patel
- Harvard Medical School and Harvard T H Chan School of Public Health, Boston, MA 02115, USA; Sangath, Goa, India.
| | - Shubhangi Bhadada
- The Lakshmi Mittal and Family South Asia Institute, Harvard University, Cambridge, MA, USA
| | | | - Arnab Mukherji
- Center for Public Policy, IIM Bangalore, Bengaluru, India
| | - Tarun Khanna
- Harvard Business School and The Lakshmi Mittal and Family South Asia Institute, Harvard University, Cambridge, MA, USA
| | - Gagandeep Kang
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| |
Collapse
|
181
|
Luo Y, Wang M, Tian Y. Trends and age-period-cohort effects on incidence and mortality of asthma in Sichuan Province, China, 1990-2019. BMC Pulm Med 2022; 22:298. [PMID: 35922772 PMCID: PMC9351065 DOI: 10.1186/s12890-022-02059-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background The provinces in western China have undergone rapid urbanization and industrialization, particularly since the Chinese government launched the Great Western Development Strategy in 2000. We examined the time trends and contributions of age, period, and cohort effects to asthma incidence and mortality in Sichuan Province, a populous province in western China, from 1990 to 2019. Methods The data of Sichuan Province from 1990 to 2019 were extracted from the Global Burden of Disease study 2019. Trends and average annual percentage change were estimated using joinpoint regression. Age, period, and cohort effects were estimated using an age-period-cohort model with the intrinsic estimator method. Results In the latest period (2015–2019), the highest incidence of asthma was 2004.49/100,000 in children aged < 5 years, and the highest mortality rate was 22.04/100,000 for elderly people aged > 80 years. Age-standardized rates generally remained stable (95% confidence interval [CI] − 0.21, 0.11) for incidence and declined by 4.74% (95% CI − 5.09, − 4.39) for mortality over the last 30 years. After controlling for other effects, the age effect on asthma showed that the incidence rate ratio (RR) was highest in the < 5 years age group, and the mortality RR was highest in the > 80 years age group. The period effect on incidence and mortality decreased from 1990 to 2019, respectively. A cohort effect was found the incidence RR increased slowly from the early birth cohorts to the later birth cohorts, especially after the 2005 birth cohort, whereas the mortality RR continued to decline. Conclusions There was a significant effect of older age on the asthma mortality rate over the last 30 years, and the incidence rate in children aged < 5 years increased. The relative risk of asthma incidence in the later birth cohorts increased. Effective preventive measures and public health policies should be to protect children and elderly people from potentially harmful chronic diseases.
Collapse
Affiliation(s)
- Yu Luo
- Department of Obstetrics Nursing, West China Second University Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, 610000, Sichuan, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610000, Sichuan, China
| | - Mu Wang
- Outpatient Department, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, Sichuan, China
| | - Yumei Tian
- Department of Obstetrics Nursing, West China Second University Hospital, Sichuan University, Chengdu, China. .,West China School of Nursing, Sichuan University, Chengdu, 610000, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610000, Sichuan, China.
| |
Collapse
|
182
|
Abstract
IMPORTANCE Preterm birth complications are the leading cause of death in children younger than 5 years worldwide. Despite advancing knowledge of risk factors and mechanisms related to preterm labor, the preterm birth rate has risen in most industrialized countries. Moreover, the burden of neonatal preterm birth remains unclear across the world. OBJECTIVE To determine the trends in incidence and mortality of neonatal preterm birth at the global, regional, and national levels to quantify its burden from 1990 to 2019 using data from the 2019 Global Burden of Disease study. DESIGN, SETTING, AND PARTICIPANTS Annual incident cases, deaths, age-standardized incidence rates (ASIRs), and age-standardized mortality rates (ASMRs) of neonatal preterm birth between 1990 and 2019 were collected from the 2019 Global Burden of Disease study. The percentage of relative changes in incident cases and deaths as well as the estimated annual percentage changes (EAPCs) of ASIRs and ASMRs were calculated to quantify their temporal trends. Correlations of EAPC of ASIRs and ASMRs with sociodemographic index (SDI) and universal health coverage index were evaluated by Pearson correlation analyses. EXPOSURES Infants born alive before 37 completed weeks of gestation between 1990 and 2019. MAIN OUTCOMES AND MEASURES Incident cases, deaths, ASIRs, and ASMRs of neonatal preterm birth. RESULTS Globally, the incident cases of neonatal preterm birth decreased by 5.26% from 16.06 million in 1990 to 15.22 million in 2019, and the deaths decreased by 47.71% from 1.27 million in 1990 to 0.66 million in 2019. The overall ASIR (EAPC = -0.19 [95% CI, -0.27 to -0.11]) and ASMR (EAPC = -2.09 [95% CI, -1.99 to -2.20]) decreased in this period. The ASIR of neonatal preterm birth increased by a mean of 0.25% (95% CI, 0.13%-0.38%) in high-SDI regions from 1990 to 2019. The ASMR of neonatal preterm birth increased by a mean of 2.09% (95% CI, 1.99%-2.20%) in Southern Sub-Saharan Africa in this period. A positive correlation was observed between EAPC of ASIR and SDI or universal health coverage index in 2019, while a negative correlation was observed between EAPC in ASMR and SDI or universal health coverage index in 2019 at national levels. CONCLUSIONS AND RELEVANCE Preterm birth remains a crucial issue in children worldwide, with an increasing trend in ASIR in high-SDI regions and in ASMR in Southern Sub-Saharan Africa between 1990 to 2019. Efforts to reduce both the incidence and mortality of preterm births are essential.
Collapse
Affiliation(s)
- Guiying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
183
|
Liu J, Bai R, Chai Z, Cooper ME, Zimmet PZ, Zhang L. Low- and middle-income countries demonstrate rapid growth of type 2 diabetes: an analysis based on Global Burden of Disease 1990-2019 data. Diabetologia 2022; 65:1339-1352. [PMID: 35587275 PMCID: PMC9118183 DOI: 10.1007/s00125-022-05713-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/22/2022] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS The study aims to quantify the global trend of the disease burden of type 2 diabetes caused by various risks factors by country income tiers. METHODS Data on type 2 diabetes, including mortality and disability-adjusted life years (DALYs) during 1990-2019, were obtained from the Global Burden of Disease Study 2019. We analysed mortality and DALY rates and the population attributable fraction (PAF) in various risk factors of type 2 diabetes by country income tiers. RESULTS Globally, the age-standardised death rate (ASDR) attributable to type 2 diabetes increased from 16.7 (15.7, 17.5)/100,000 person-years in 1990 to 18.5 (17.2, 19.7)/100,000 person-years in 2019. Similarly, age-standardised DALY rates increased from 628.3 (537.2, 730.9)/100,000 person-years to 801.5 (670.6, 954.4)/100,000 person-years during 1990-2019. Lower-middle-income countries reported the largest increase in the average annual growth of ASDR (1.3%) and an age-standardised DALY rate (1.6%) of type 2 diabetes. The key PAF attributing to type 2 diabetes deaths/DALYs was high BMI in countries of all income tiers. With the exception of BMI, while in low- and lower-middle-income countries, risk factors attributable to type 2 diabetes-related deaths and DALYs are mostly environment-related, the risk factors in high-income countries are mostly lifestyle-related. CONCLUSIONS/INTERPRETATION Type 2 diabetes disease burden increased globally, but low- and middle-income countries showed the highest growth rate. A high BMI level remained the key contributing factor in all income tiers, but environmental and lifestyle-related factors contributed differently across income tiers. DATA AVAILABILITY To download the data used in these analyses, please visit the Global Health Data Exchange at http://ghdx.healthdata.org/gbd-2019 .
Collapse
Affiliation(s)
- Jinli Liu
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Ruhai Bai
- School of Public Affairs, Nanjing University of Science and Technology, Nanjing, China
| | - Zhonglin Chai
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Mark E Cooper
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Paul Z Zimmet
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Lei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, VIC, Australia.
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
| |
Collapse
|
184
|
Kim S, Headley TY, Tozan Y. Universal healthcare coverage and health service delivery before and during the COVID-19 pandemic: A difference-in-difference study of childhood immunization coverage from 195 countries. PLoS Med 2022; 19:e1004060. [PMID: 35972985 PMCID: PMC9380914 DOI: 10.1371/journal.pmed.1004060] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/29/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several studies have indicated that universal health coverage (UHC) improves health service utilization and outcomes in countries. These studies, however, have primarily assessed UHC's peacetime impact, limiting our understanding of UHC's potential protective effects during public health crises such as the Coronavirus Disease 2019 (COVID-19) pandemic. We empirically explored whether countries' progress toward UHC is associated with differential COVID-19 impacts on childhood immunization coverage. METHODS AND FINDINGS Using a quasi-experimental difference-in-difference (DiD) methodology, we quantified the relationship between UHC and childhood immunization coverage before and during the COVID-19 pandemic. The analysis considered 195 World Health Organization (WHO) member states and their ability to provision 12 out of 14 childhood vaccines between 2010 and 2020 as an outcome. We used the 2019 UHC Service Coverage Index (UHC SCI) to divide countries into a "high UHC index" group (UHC SCI ≥80) and the rest. All analyses included potential confounders including the calendar year, countries' income group per the World Bank classification, countries' geographical region as defined by WHO, and countries' preparedness for an epidemic/pandemic as represented by the Global Health Security Index 2019. For robustness, we replicated the analysis using a lower cutoff value of 50 for the UHC index. A total of 20,230 country-year observations were included in the study. The DiD estimators indicated that countries with a high UHC index (UHC SCI ≥80, n = 35) had a 2.70% smaller reduction in childhood immunization coverage during the pandemic year of 2020 as compared to the countries with UHC index less than 80 (DiD coefficient 2.70; 95% CI: 0.75, 4.65; p-value = 0.007). This relationship, however, became statistically nonsignificant at the lower cutoff value of UHC SCI <50 (n = 60). The study's primary limitation was scarce data availability, which restricted our ability to account for confounders and to test our hypothesis for other relevant outcomes. CONCLUSIONS We observed that countries with greater progress toward UHC were associated with significantly smaller declines in childhood immunization coverage during the pandemic. This identified association may potentially provide support for the importance of UHC in building health system resilience. Our findings strongly suggest that policymakers should continue to advocate for achieving UHC in coming years.
Collapse
Affiliation(s)
- Sooyoung Kim
- School of Global Public Health, New York University, New York, New York, United States of America
| | | | - Yesim Tozan
- School of Global Public Health, New York University, New York, New York, United States of America
| |
Collapse
|
185
|
Ye X, Wang J, Zhong X, Qiu W, Yang S, He S, Lou L, Shen L. Association of sex with the global burden of vision impairment caused by neonatal preterm birth: An analysis from the global burden of disease study 2019. Front Public Health 2022; 10:938228. [PMID: 35968463 PMCID: PMC9363690 DOI: 10.3389/fpubh.2022.938228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/08/2022] [Indexed: 12/02/2022] Open
Abstract
Aims To investigate the sex-specific global burden of neonatal preterm birth (NPB) vision impairment by year, age, and socioeconomic status using years lived with disability (YLDs). Methods The global, regional, and national sex-specific YLD numbers, crude YLD rates, and age-standardized YLD rates of NPB-related moderate and severe vision loss and blindness were obtained from the Global Burden of Disease Study 2019. The Wilcoxon test and linear regression were used to investigate the relationship between sex difference in age-standardized YLD rates and the Human Development Index (HDI). Results Between 1990 and 2019, the gender disparity in age-standardized YLD rates for NPB-related vision impairment remained stable, increasing from 10.2 [95% uncertainty interval (UI) 6.7–14.6] to 10.4 (95% UI 6.9–15.0) for men and 10.3 (95% UI 6.8–14.7) to 10.7 (95% UI 7.2–15.1) for women, with women consistently having higher age-standardized YLD rates. Between the ages of 25 and 75, women had higher YLD rates than males, with the biggest disparity in the 60–64 age group. In 2019, sex difference in age-standardized YLD rates across 195 nations was statistically significant. Women had higher age-standardized YLD rates than men in both low (Z = −3.53, p < 0.001) and very high HDI countries (Z = −4.75, p < 0.001). Additionally, age-standardized YLD rates were found to be adversely associated with HDI (male: Standardized β = −0.435, female: Standardized β = −0.440; p < 0.001). Conclusion Despite advancements in worldwide NPB health care, sexual differences in NPB-related vision impairment burden showed little change. Female had higher burden than male, particularly in low and very high socioeconomic status countries.
Collapse
Affiliation(s)
- Xin Ye
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jun Wang
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiaxing Zhong
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Wangli Qiu
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Shangchao Yang
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Shucheng He
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lixia Lou
- Eye Center, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, China
- Lixia Lou
| | - Lijun Shen
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Lijun Shen
| |
Collapse
|
186
|
Awedew AF, Asefa Z, Belay WB. National Burden and Trend of Cancer in Ethiopia, 2010-2019: a systemic analysis for Global burden of disease study. Sci Rep 2022; 12:12736. [PMID: 35882895 PMCID: PMC9325704 DOI: 10.1038/s41598-022-17128-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 07/20/2022] [Indexed: 12/03/2022] Open
Abstract
Over the last two decades, we have tracked the national burden of cancer and its trends in Ethiopia, providing estimates of incidence, death, and disability adjusted life years. In Ethiopia, there were an estimated 53,560 (95% UI 52,480-55,540) new incident cases, 39,480 deaths (95% UI 32,640-46,440), and 1.42 million (95% UI 1.16-1.68) DALYs of cancer 2019. Cancer incidence, death, and DALYs counts increased by 32% (95% UI 11-55%), 29% (95% UI 12-44%), and 19% (95% UI - 2 to 44%) between 2010 to 2019, respectively, while age-standardised incidence, death, and DALYs rates increased by 5% (95% UI - 7 to 18%), 2% (95% UI - 9 to 14%), and - 2% (95% UI - 15 to 12%) respectively. In 2019, the leading incidence cases were leukemia, cervical cancer, breast cancer, colon and rectum cancer, and stomach cancer, while leukemia, breast cancer, cervical cancer, and stomach cancer were the most common killer cancers in Ethiopia. According to the findings of this study, tobacco-related cancers such as pancreatic, kidney, and lung cancer have increased in Ethiopian females over the last decade, while genitourinary cancer has increased in Ethiopian males. Another significant finding was that infection-related cancers, such as stomach cancer and Hodgkin lymphoma, have been rapidly declining over the last decade.
Collapse
Affiliation(s)
| | - Zelalem Asefa
- Department of Surgery, SoM, Addis Ababa University, Addis Ababa, Ethiopia
| | | |
Collapse
|
187
|
The global, regional and national burden of stomach cancer and its attributable risk factors from 1990 to 2019. Sci Rep 2022; 12:11542. [PMID: 35798837 PMCID: PMC9262989 DOI: 10.1038/s41598-022-15839-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/30/2022] [Indexed: 12/12/2022] Open
Abstract
We aimed to estimate the incidence, mortality, and disability-adjusted life-years (DALYs) of stomach cancer at the global, regional, and national levels. Stomach cancer resulted in 1.3 million (1.2-1.4 million) incident cases, 9.5 hundred thousand (8.7-10.4 hundred thousand) deaths, and 22.2 million (20.3-24.1 million) DALYs in 2019. The age-standardized incidence rate, death rate and DALY rate were 15.6 (14.1-17.2), 11.9 (10.8-12.8), and 268.4 (245.5-290.6) per 100,000 person-years, respectively. Between 1990 and 2019, the global age-standardized incidence rate, death rate, and DALY rate decreased by - 30.5% (- 36.7 to - 22.9), - 41.9% (- 47.2 to - 36.3), and - 45.6% (- 50.8 to - 39.8), respectively. In 2019, most of the global numbers of incidence, death and DALYs were higher among males than females. A considerable burden of stomach cancer was attributable to smoking and a high-sodium diet. Although the global age-standardized incidence and death rates have decreased, continued growth in absolute numbers in some regions, especially in East Asia, poses a major global public health challenge. To address this, public health responses should be tailored to fit each country's unique situation. Primary and secondary prevention strategies with increased effectiveness are required to reduce the incidence and mortality of stomach cancer, particularly in populations with a high disease burden.
Collapse
|
188
|
McCormick I, Mactaggart I, Resnikoff S, Muirhead D, Murthy GV, Silva JC, Bastawrous A, Stern J, Blanchet K, Wang N, Yusufu M, Cooper A, Gichangi M, Burton MJ, Ramke J. Eye health indicators for universal health coverage: results of a global expert prioritisation process. Br J Ophthalmol 2022; 106:893-901. [PMID: 33712481 PMCID: PMC9234411 DOI: 10.1136/bjophthalmol-2020-318481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION In its recent World Report on Vision, the WHO called for an updated approach to monitor eye health as part of universal health coverage (UHC). This project sought to develop a consensus among eye health experts from all world regions to produce a menu of indicators for countries to monitor eye health within UHC. METHODS We reviewed the literature to create a long-list of indicators aligned to the conceptual framework for monitoring outlined in WHO's World Report on Vision. We recruited a panel of 72 global eye health experts (40% women) to participate in a two-round, online prioritisation exercise. Two-hundred indicators were presented in Round 1 and participants prioritised each on a 4-point Likert scale. The highest-ranked 95 were presented in Round 2 and were (1) scored against four criteria (feasible, actionable, reliable and internationally comparable) and (2) ranked according to their suitability as a 'core' indicator for collection by all countries. The top 30 indicators ranked by these two parameters were then used as the basis for the steering group to develop a final menu. RESULTS The menu consists of 22 indicators, including 7 core indicators, that represent important concepts in eye health for 2020 and beyond, and are considered feasible, actionable, reliable and internationally comparable. CONCLUSION We believe this list can inform the development of new national eye health monitoring frameworks, monitor progress on key challenges to eye health and be considered in broader UHC monitoring indices at national and international levels.
Collapse
Affiliation(s)
- Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Debbie Muirhead
- The Fred Hollows Foundation Melbourne, Melbourne, Victoria, Australia
| | - G V Murthy
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- Indian Institutes of Public Health, Hyderabad, India
| | | | - Andrew Bastawrous
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Jude Stern
- International Agency for the Prevention of Blindness, London, UK
| | - Karl Blanchet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | | | - Michael Gichangi
- Ophthalmic Services Unit, Kenya Ministry of Health, Nairobi, Kenya
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- Moorfields Eye Hospital, London, UK
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
189
|
Wang K, Zhang Y, Wang Y, Liu J, Zhou P, Yuan Y, Yin Z, Mo S, Yu Y, Peng M. Secular trends in global burden of diabetes attributable to particulate matter pollution from 1990 to 2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:52844-52856. [PMID: 35277821 DOI: 10.1007/s11356-022-19510-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/25/2022] [Indexed: 06/14/2023]
Abstract
Increasing evidence suggests an association between fine particulate matter (PM2.5) exposure and type 2 diabetes mellitus. However, there is still a lack of comparative evaluation regarding diabetes burden due to ambient and indoor PM2.5 pollution at a global scale. This study attempts to provide a systematic and comprehensive profile for PM2.5-attributable burden of diabetes and its spatiotemporal trends, globally and regionally. Comparative estimates of diabetes attributable to ambient PM2.5 and household air pollution (HAP) from solid fuels for 204 countries and territories were derived from the Global Burden of Disease Study 2019. Globally, 292.5 (95% uncertainty interval: 207.1, 373.4) thousand deaths and 13.0 (9.1, 17.2) million disability-adjusted life years (DALYs) from diabetes were attributed to PM2.5 pollution in 2019, wherein more than two-thirds (67.3% deaths and 69.7% DALYs) were contributed by ambient PM2.5. Compared to 1990, age-standardized DALY rate (ASDR) in 2019 attributable to ambient PM2.5 increased by 85.9% (APC: 2.21% [2.15, 2.27]), while HAP-associated ASDR decreased by 37.9% (APC: - 1.66% [- 1.82, - 1.50]). We observed a negative correlation between SDI and APC in ASMR (rs = - 0.5, p < 0.001) and ASDR (rs = -0.4, p < 0.001) among 204 countries and territories. HAP-related diabetes experienced a sharp decline during 1990-2019, while global burden of diabetes attributable to ambient PM2.5 was rising rapidly. The elderly and people in low-SDI countries suffered from the greatest burden of diabetes due to PM2.5 pollution. More targeted interventions should be taken by governments to reduce PM2.5 exposure and related diabetes burden.
Collapse
Affiliation(s)
- Kai Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Yaqi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Jiaxin Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Peixuan Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Yang Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Zhouxin Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Shaocai Mo
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Yong Yu
- Department of Infection Control, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China
- School of Public Health, Hubei University of Medicine, Shiyan, 442000, China
| | - Minjin Peng
- Department of Infection Control, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China.
- School of Public Health, Hubei University of Medicine, Shiyan, 442000, China.
| |
Collapse
|
190
|
Clarsen B, Nylenna M, Klitkou ST, Vollset SE, Baravelli CM, Bølling AK, Aasvang GM, Sulo G, Naghavi M, Pasovic M, Asaduzzaman M, Bjørge T, Eggen AE, Eikemo TA, Ellingsen CL, Haaland ØA, Hailu A, Hassan S, Hay SI, Juliusson PB, Kisa A, Kisa S, Månsson J, Mekonnen T, Murray CJL, Norheim OF, Ottersen T, Sagoe D, Sripada K, Winkler AS, Knudsen AKS. Changes in life expectancy and disease burden in Norway, 1990–2019: an analysis of the Global Burden of Disease Study 2019. THE LANCET PUBLIC HEALTH 2022; 7:e593-e605. [PMID: 35779543 PMCID: PMC9253891 DOI: 10.1016/s2468-2667(22)00092-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 01/04/2023] Open
Abstract
Background Methods Findings Interpretation Funding
Collapse
|
191
|
Koyama S, Aida J, Mori Y, Okawa S, Odani S, Miyashiro I. COVID-19 Effects on Income and Dental Visits: A Cross-sectional Study. JDR Clin Trans Res 2022; 7:307-314. [PMID: 35533247 DOI: 10.1177/23800844221094479] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES In April 2020, the Japanese government declared a state of emergency owing to the outbreak of the novel coronavirus disease (COVID-19) pandemic, which resulted in reduced workforce and job losses. Furthermore, income is one of the most consistent predictors of dental visits. Therefore, this study examined the association between income changes and dental clinic visits during the COVID-19 state of emergency in Japan. METHODS An online, self-reported cross-sectional survey about health activities including dental visits during the first COVID-19 state of emergency was conducted in Osaka, Japan (June 23 to July 12, 2020). Among participants with toothaches, the assessment for the association between "refrained from visiting a dentist despite wanting treatment for toothache during the state of emergency (refrained treatment)" and income changes before and after the state of emergency using a multivariate Poisson regression model adjusted for sex, age, self-rated health, frequency of regular dental visits, and employment status. RESULTS Among 27,575 participants, 3,895 (14.1%) had toothaches, and 1,906 (6.9%) reported refrained treatment. Among people with decreased income (n = 8,152, 29.6% of overall participants), the proportions of the refrained treatment group were 8.0% (income decreased by 1%-49%), 9.9% (50%-99% decreased), and 9.1% (100% decreased). Among participants with toothache, after adjusting for all variables, compared with participants with no income change, we observed significantly higher prevalence ratios (PRs) for refrained treatment in those who experienced a decreased income owing to COVID-19 (1%-49% decrease: PR = 1.08; 95% confidence interval [CI], 1.005-1.17; 50%-99% decrease: PR = 1.18; 95% CI, 1.06-1.32; 100% decrease: PR = 1.18; 95% CI, 1.04-1.33). CONCLUSION Decreased income was associated with refrained dental treatment during the COVID-19 state of emergency in Osaka, Japan. The economic damage related to the COVID-19 pandemic could lead to oral health inequalities. KNOWLEDGE TRANSFER STATEMENT Our study found that individuals with decreased income owing to COVID-19 before and after the state of emergency showed significantly higher prevalence ratios for refraining from visiting a dentist despite wanting treatment for toothache. We believe that our study makes a significant contribution because it provides novel, basic data that economic damages related to the COVID-19 pandemic might expand to oral health inequalities.
Collapse
Affiliation(s)
- S Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - J Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Y Mori
- Department of Public Health and Medical Affairs, Osaka Prefectural Government, Chuo-ku, Osaka, Japan
| | - S Okawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - S Odani
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - I Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| |
Collapse
|
192
|
Haakenstad A, Irvine CMS, Knight M, Bintz C, Aravkin AY, Zheng P, Gupta V, Abrigo MRM, Abushouk AI, Adebayo OM, Agarwal G, Alahdab F, Al-Aly Z, Alam K, Alanzi TM, Alcalde-Rabanal JE, Alipour V, Alvis-Guzman N, Amit AML, Andrei CL, Andrei T, Antonio CAT, Arabloo J, Aremu O, Ayanore MA, Banach M, Bärnighausen TW, Barthelemy CM, Bayati M, Benzian H, Berman AE, Bienhoff K, Bijani A, Bikbov B, Biondi A, Boloor A, Busse R, Butt ZA, Cámera LA, Campos-Nonato IR, Cárdenas R, Carvalho F, Chansa C, Chattu SK, Chattu VK, Chu DT, Dai X, Dandona L, Dandona R, Dangel WJ, Daryani A, De Neve JW, Dhimal M, Dipeolu IO, Djalalinia S, Do HT, Doshi CP, Doshmangir L, Ehsani-Chimeh E, El Tantawi M, Fernandes E, Fischer F, Foigt NA, Fomenkov AA, Foroutan M, Fukumoto T, Fullman N, Gad MM, Ghadiri K, Ghafourifard M, Ghashghaee A, Glucksman T, Goudarzi H, Gupta RD, Hamadeh RR, Hamidi S, Haro JM, Hasanpoor E, Hay SI, Hegazy MI, Heibati B, Henry NJ, Hole MK, Hossain N, Househ M, Ilesanmi OS, Imani-Nasab MH, Irvani SSN, Islam SMS, Jahani MA, Joshi A, Kalhor R, Kayode GA, Khalid N, Khatab K, Kisa A, Kochhar S, Krishan K, Kuate Defo B, Lal DK, Lami FH, Larsson AO, Leasher JL, LeGrand KE, Lim LL, Mahotra NB, Majeed A, Maleki A, Manjunatha N, Massenburg BB, Mestrovic T, Mini GK, Mirica A, Mirrakhimov EM, Mohammad Y, Mohammed S, Mokdad AH, Morrison SD, Naghavi M, Ndwandwe DE, Negoi I, Negoi RI, Ngunjiri JW, Nguyen CT, Nigatu YT, Onwujekwe OE, Ortega-Altamirano DV, Otstavnov N, Otstavnov SS, Owolabi MO, Pakhare AP, Pepito VCF, Perico N, Pham HQ, Pigott DM, Pokhrel KN, Rabiee M, Rabiee N, Rahimi-Movaghar V, Rawaf DL, Rawaf S, Rawal L, Remuzzi G, Renzaho AMN, Resnikoff S, Rezaei N, Rezapour A, Rickard J, Roever L, Sahu M, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Seedat S, Senthilkumaran S, Serván-Mori E, Shaikh MA, Sheikh A, Silva DAS, Stein C, Stein DJ, Titova MV, Topp SM, Tovani-Palone MR, Ullah S, Unnikrishnan B, Vacante M, Valdez PR, Vasankari TJ, Venketasubramanian N, Vlassov V, Vos T, Yearwood JA, Yonemoto N, Younis MZ, Yu C, Zadey S, Zaman SB, Zerfu TA, Zhang ZJ, Ziapour A, Zodpey S, Lim SS, Murray CJL, Lozano R. Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2022; 399:2129-2154. [PMID: 35617980 PMCID: PMC9168805 DOI: 10.1016/s0140-6736(22)00532-3] [Citation(s) in RCA: 101] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/22/2022] [Accepted: 03/16/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 strategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous research has found substantial global disparities in HRH, the absence of comparable cross-national estimates of existing workforces has hindered efforts to quantify workforce requirements to meet health system goals. We aimed to use comparable and standardised data sources to estimate HRH densities globally, and to examine the relationship between a subset of HRH cadres and UHC effective coverage performance. METHODS Through the International Labour Organization and Global Health Data Exchange databases, we identified 1404 country-years of data from labour force surveys and 69 country-years of census data, with detailed microdata on health-related employment. From the WHO National Health Workforce Accounts, we identified 2950 country-years of data. We mapped data from all occupational coding systems to the International Standard Classification of Occupations 1988 (ISCO-88), allowing for standardised estimation of densities for 16 categories of health workers across the full time series. Using data from 1990 to 2019 for 196 of 204 countries and territories, covering seven Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) super-regions and 21 regions, we applied spatiotemporal Gaussian process regression (ST-GPR) to model HRH densities from 1990 to 2019 for all countries and territories. We used stochastic frontier meta-regression to model the relationship between the UHC effective coverage index and densities for the four categories of health workers enumerated in SDG indicator 3.c.1 pertaining to HRH: physicians, nurses and midwives, dentistry personnel, and pharmaceutical personnel. We identified minimum workforce density thresholds required to meet a specified target of 80 out of 100 on the UHC effective coverage index, and quantified national shortages with respect to those minimum thresholds. FINDINGS We estimated that, in 2019, the world had 104·0 million (95% uncertainty interval 83·5-128·0) health workers, including 12·8 million (9·7-16·6) physicians, 29·8 million (23·3-37·7) nurses and midwives, 4·6 million (3·6-6·0) dentistry personnel, and 5·2 million (4·0-6·7) pharmaceutical personnel. We calculated a global physician density of 16·7 (12·6-21·6) per 10 000 population, and a nurse and midwife density of 38·6 (30·1-48·8) per 10 000 population. We found the GBD super-regions of sub-Saharan Africa, south Asia, and north Africa and the Middle East had the lowest HRH densities. To reach 80 out of 100 on the UHC effective coverage index, we estimated that, per 10 000 population, at least 20·7 physicians, 70·6 nurses and midwives, 8·2 dentistry personnel, and 9·4 pharmaceutical personnel would be needed. In total, the 2019 national health workforces fell short of these minimum thresholds by 6·4 million physicians, 30·6 million nurses and midwives, 3·3 million dentistry personnel, and 2·9 million pharmaceutical personnel. INTERPRETATION Considerable expansion of the world's health workforce is needed to achieve high levels of UHC effective coverage. The largest shortages are in low-income settings, highlighting the need for increased financing and coordination to train, employ, and retain human resources in the health sector. Actual HRH shortages might be larger than estimated because minimum thresholds for each cadre of health workers are benchmarked on health systems that most efficiently translate human resources into UHC attainment. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
193
|
de Girolamo G, Stein DJ. Assessing effective treatment coverage for depression. THE LANCET REGIONAL HEALTH. EUROPE 2022; 17:100384. [PMID: 35494215 PMCID: PMC9039874 DOI: 10.1016/j.lanepe.2022.100384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Giovanni de Girolamo
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Unit of Epidemiological Psychiatry, Brescia, Italy
| | - Dan J. Stein
- South African Medical Council, Research Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
194
|
Fitzgerald R, Manguerra H, Arndt MB, Gardner WM, Chang YY, Zigler B, Taylor HJ, Bienhoff K, Smith DL, Murray CJL, Hay SI, Reiner RC, Kassebaum NJ. Current dichotomous metrics obscure trends in severe and extreme child growth failure. SCIENCE ADVANCES 2022; 8:eabm8954. [PMID: 35594349 PMCID: PMC9122330 DOI: 10.1126/sciadv.abm8954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/05/2022] [Indexed: 06/15/2023]
Abstract
Historically, the prevalence of child growth failure (CGF) has been tracked dichotomously as the proportion of children more than 2 SDs below the median of the World Health Organization growth standards. However, this conventional "thresholding" approach fails to recognize child growth as a spectrum and obscures trends in populations with the highest rates of CGF. Our analysis presents the first ever estimates of entire distributions of HAZ, WHZ, and WAZ for each of 204 countries and territories from 1990 to 2020 for children less than 5 years old by age group and sex. This approach reflects the continuous nature of CGF, allows us to more comprehensively assess shrinking or widening disparities over time, and reveals otherwise hidden trends that disproportionately affect the most vulnerable populations.
Collapse
Affiliation(s)
- Ryan Fitzgerald
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Helena Manguerra
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Michael B. Arndt
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - William M. Gardner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Ya-Yin Chang
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Bethany Zigler
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Heather Jean Taylor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kelly Bienhoff
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - David L. Smith
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Christopher J. L. Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert C. Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Nicholas J. Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| |
Collapse
|
195
|
Hoshi-Harada M, Aida J, Cooray U, Nakazawa N, Kondo K, Osaka K. Difference of income inequalities of denture use by co-payment rates: A JAGES cross-sectional study. Community Dent Oral Epidemiol 2022; 51:557-564. [PMID: 35569009 DOI: 10.1111/cdoe.12749] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/28/2022] [Accepted: 04/24/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Studies suggest that wearing dentures to restore missing teeth can have a positive impact on health status. However, income inequalities in denture wearing exist. The aim of this study was to investigate how differing co-payment rates under the current Japanese Universal Health Insurance Coverage System affect income inequalities in denture non-use among older adults with severe tooth loss. METHODS This cross-sectional study used data from the 2019 Japan Gerontological Evaluation Study (JAGES). Self-administered questionnaires were mailed to 345 356 independent people who did not receive long-term care insurance benefits and were aged ≥65 years. The dependent variable was denture non-use, and the independent variable was the equivalent annual household income. The Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were used with regression-based approaches to determine both absolute and relative inequalities in denture non-use by co-payment rates. The covariates were sex, age, years of education, number of teeth and comorbidities. RESULTS Of the 240 889 responses received (response rate =69.9%), we analysed 21 594 participants who fulfilled the inclusion criteria. The mean age was 72.8 years (standard deviation =4.1), and 57.6% were men. For 30 per cent, 20 per cent and 10 per cent co-payment rates, the percentages of people who did not use dentures and had severe tooth loss (≤9 teeth) were 18.3%, 13.3%, and 8.5%, respectively. All analyses confirmed significant inequalities in denture non-use. The lower the co-payment rate, the smaller the inequalities. SIIs for each co-payment rate were as follows: 30 per cent =13.35% (95% confidence interval [CI] = 9.61-17.09); 20 per cent =7.85% (95% CI = 4.88-10.81); and 10 per cent =4.85% (95% CI = 2.55-7.16). Inclusion of interaction term between income and co-payment rate significantly lowered the inequalities by co-payment rate in logistic regression analysis and SII. For RII, although the interaction was not statistically significant, a similar trend was observed. CONCLUSIONS Income inequalities in denture use existed among older adults with severe tooth loss in Japan, and the inequalities appeared to be greater when the co-payment rate was higher.
Collapse
Affiliation(s)
- Manami Hoshi-Harada
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Upul Cooray
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Noriko Nakazawa
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| |
Collapse
|
196
|
Vaivada T, Lassi ZS, Irfan O, Salam RA, Das JK, Oh C, Carducci B, Jain RP, Als D, Sharma N, Keats EC, Patton GC, Kruk ME, Black RE, Bhutta ZA. What can work and how? An overview of evidence-based interventions and delivery strategies to support health and human development from before conception to 20 years. Lancet 2022; 399:1810-1829. [PMID: 35489360 DOI: 10.1016/s0140-6736(21)02725-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 09/14/2021] [Accepted: 11/23/2021] [Indexed: 12/14/2022]
Abstract
Progress has been made globally in improving the coverage of key maternal, newborn, and early childhood interventions in low-income and middle-income countries, which has contributed to a decrease in child mortality and morbidity. However, inequities remain, and many children and adolescents are still not covered by life-saving and nurturing care interventions, despite their relatively low costs and high cost-effectiveness. This Series paper builds on a large body of work from the past two decades on evidence-based interventions and packages of care for survival, strategies for delivery, and platforms to reach the most vulnerable. We review the current evidence base on the effectiveness of a variety of essential and emerging interventions that can be delivered from before conception until age 20 years to help children and adolescents not only survive into adulthood, but also to grow and develop optimally, support their wellbeing, and help them reach their full developmental potential. Although scaling up evidence-based interventions in children younger than 5 years might have the greatest effect on reducing child mortality rates, we highlight interventions and evidence gaps for school-age children (5-9 years) and the transition from childhood to adolescence (10-19 years), including interventions to support mental health and positive development, and address unintentional injuries, neglected tropical diseases, and non-communicable diseases.
Collapse
Affiliation(s)
- Tyler Vaivada
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Zohra S Lassi
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, SA, Australia; Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Omar Irfan
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Christina Oh
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Bianca Carducci
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Reena P Jain
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Daina Als
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Naeha Sharma
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Emily C Keats
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Robert E Black
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, Johns Hopkins University, MD, USA
| | - Zulfiqar A Bhutta
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Centre of Excellence in Women and Child Health and Institute for Global Health and Development, The Aga Khan University, Karachi, Pakistan.
| |
Collapse
|
197
|
Singhal A, Nanda M, Sharma R, Jani C. The Burden of Chronic Kidney Disease in Asia, 1990-2019: Examination of Estimates from Global Burden of Disease 2019 Study. Nephrology (Carlton) 2022; 27:610-620. [PMID: 35506615 DOI: 10.1111/nep.14051] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/01/2022] [Accepted: 04/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chronic Kidney Disease (CKD) is a global public health issue, with Asia accounting for one of the highest CKD prevalence worldwide. This study examines the burden of CKD in Asian continent in the last three decades. DATA AND METHODS The estimates of age, sex and year wise burden of CKD for forty-nine countries in Asia for 1990 to 2019 were procured from the Global Burden of Disease 2019 study. FINDINGS In 2019, there were 9.8 million [9.0 - 10.6 million] new cases and 763,024 [696,050 - 823,829] deaths due to CKD in Asia. Between 1990 and 2019, CKD prevalence doubled from 202.4 million [186.5-219.1 million] to 431.2 [400.3-462.0 million]. Although age-standardized incidence rate (ASIR) of CKD increased from 170.6 [156.7 - 186.2] in 1990 to 206.3 [190.4 - 223.4] per 100,000 person-years in 2019, the age-standardized mortality rate (ASMR) witnessed a modest reduction from 18.4/100,000 [17.0 - 20.1] to 17.3/100,000 [15.7 - 18.7]. In 2019, the ASIR spanned from 141.9 /100,000 [126.2 - 159.2] in Tajikistan to 561.4/100,000 [524.6 - 598.6] in Saudi Arabia, and ASMR varied from 8.9/100,000 [7.2-9.8] in Japan to Saudi Arabia (52.9[42.8-63.1]). Between 1990 and 2019, absolute count of CKD incident cases, deaths, prevalent cases and DALYs increased 100% or more in 48/49, 32/49, 43/49 and 23/49 countries, respectively. INTERPRETATION CKD is widespread in the Asian region, with an alarming burden in resource-constrained countries. Strategies such as promoting awareness, screening among high-risk individuals, provision of cost-effective therapies, and increased healthcare coverage could help deal with the CKD epidemic in Asia.
Collapse
Affiliation(s)
- Aashima Singhal
- University School of Management and Entrepreneurship; Delhi Technological University, New Delhi, India
| | - Mehak Nanda
- University School of Management and Entrepreneurship; Delhi Technological University, New Delhi, India
| | - Rajesh Sharma
- University School of Management and Entrepreneurship; Delhi Technological University, New Delhi, India
| | - Chinmay Jani
- Mount Auburn Hospital, Cambridge, MA, USA.,Harvard Medical School, Boston, MA, USA
| |
Collapse
|
198
|
Abou Jaoude GJ, Garcia Baena I, Nguhiu P, Siroka A, Palmer T, Goscé L, Allel K, Sinanovic E, Skordis J, Haghparast-Bidgoli H. National tuberculosis spending efficiency and its associated factors in 121 low-income and middle-income countries, 2010–19: a data envelopment and stochastic frontier analysis. THE LANCET GLOBAL HEALTH 2022; 10:e649-e660. [PMID: 35427522 PMCID: PMC9023749 DOI: 10.1016/s2214-109x(22)00085-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/25/2022] [Accepted: 02/21/2022] [Indexed: 12/12/2022] Open
Abstract
Background Maximising the efficiency of national tuberculosis programmes is key to improving service coverage, outcomes, and progress towards End TB targets. We aimed to determine the overall efficiency of tuberculosis spending and investigate associated factors in 121 low-income and middle-income countries between 2010 and 2019. Methods In this data envelopment and stochastic frontier analysis, we used data from the WHO Global TB report series on tuberculosis spending as the input and treatment coverage as the output to estimate tuberculosis spending efficiency. We investigated associations between 25 independent variables and overall efficiency. Findings We estimated global tuberculosis spending efficiency to be between 73·8% (95% CI 71·2–76·3) and 87·7% (84·9–90·6) in 2019, depending on the analytical method used. This estimate suggests that existing global tuberculosis treatment coverage could be increased by between 12·3% (95% CI 9·4–15·1) and 26·2% (23·7–28·8) for the same amount of spending. Efficiency has improved over the study period, mainly since 2015, but a substantial difference of 70·7–72·1 percentage points between the most and least efficient countries still exists. We found a consistent significant association between efficiency and current health expenditure as a share of gross domestic product, out-of-pocket spending on health, and some Sustainable Development Goal (SDG) indicators such as universal health coverage. Interpretation To improve efficiency, treatment coverage will need to be increased, particularly in the least efficient contexts where this might require additional spending. However, progress towards global End TB targets is slow even in the most efficient countries. Variables associated with TB spending efficiency suggest efficiency is complimented by commitments to improving health-care access that is free at the point of use and wider progress towards the SDGs. These findings support calls for additional investment in tuberculosis care. Funding None.
Collapse
Affiliation(s)
| | | | - Peter Nguhiu
- Kenya Medical Research Institute (KEMRI) Wellcome Trust, Nairobi, Kenya
| | | | - Tom Palmer
- Institute for Global Health, University College London, London, UK
| | - Lara Goscé
- Institute for Global Health, University College London, London, UK
| | - Kasim Allel
- Institute for Global Health, University College London, London, UK; Department of Disease Control, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Edina Sinanovic
- Health Economics Unit, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Jolene Skordis
- Institute for Global Health, University College London, London, UK
| | | |
Collapse
|
199
|
Health inequalities among Russian-born immigrant women in Finland: longitudinal analysis on cervical cancer incidence and participation to screening. J Migr Health 2022; 6:100117. [PMID: 35712528 PMCID: PMC9194839 DOI: 10.1016/j.jmh.2022.100117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/12/2022] [Accepted: 05/25/2022] [Indexed: 11/22/2022] Open
Abstract
Research has documented both lower and higher cancer incidence among migrants. Evidence among the large Russian-born migrant population, however, is scarce. We examined cervical cancer incidence and screening participation among Russian-born immigrant women in Finland, a country with complete cancer registration and universal public health care including organized cancer screening. Our study population included all the women that resided in Finland during 1970–2017 and was formed linking individual-level data from four nationwide registries. The linked data sets on cancer and cancer screening were analysed separately using different statistical models. Russian-born immigrant women had increased (+62%) incidence of cervical cancer compared to the general Finnish female population, and they participated in cervical cancer screening slightly less than other women. Our findings showed no consistent transition pattern in cancer incidence or screening participation rate with duration of stay. Potential explanations for the observed differences include institutional and behavioural factors. Cervical cancer is one of the most preventable cancers, and cancer screening can both prevent and reduce incidence and mortality of cervical cancer. Efforts should be made to encourage migrant populations to participate in cervical screening.
Collapse
|
200
|
Gangannagaripalli J, Albagli A, Myers SN, Whittaker S, Joseph A, Clarke A, Matkin L, Alonso J, Byock I, van den Berg M, Canfield C, Chaplin J, Dapueto J, de Almedia Fleck MP, Sidey-Gibbons C, Hazelzet J, Hess R, Immonen K, Joyner S, Katz C, Kerrigan C, Lam C, Lunn J, McKenzie F, Roeves A, Stowell C, Switaj T, Tinsley M, Zimlichman E, Valderas JM. A Standard Set of Value-Based Patient-Centered Outcomes and Measures of Overall Health in Adults. THE PATIENT 2022; 15:341-351. [PMID: 34719774 PMCID: PMC9095515 DOI: 10.1007/s40271-021-00554-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/26/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The definition of population-specific outcomes is an essential precondition for the implementation of value-based health care. We developed a minimum standard outcome set for overall adult health (OAH) to facilitate the implementation of value-based health care in tracking, comparing, and improving overall health care outcomes of adults across multiple conditions, which would be of particular relevance for primary care and public health populations. METHODS The International Consortium for Health Outcomes Measurement (ICHOM) convened an international panel (patients, clinicians, and topic experts). Following the development of a conceptual framework, a modified Delphi method (supported by public consultations) was implemented to identify, in sequence, the relevant domains, the best instruments for measuring them, the timing of measurement, and the relevant adjustment variables. FINDINGS Outcomes were identified in relation to overall health status and the domains of physical, mental, and social health. Three instruments covering these domains were identified: PROMIS Scale v1.2-Global Health (10 items), WHO Wellbeing Index (5 items), and the WHO Disability Assessment Schedule 2.0 (12 items). Case-mix variables included a range of sociodemographic and biometric measures. Yearly measurement was proposed for all outcomes and most case-mix variables. INTERPRETATION The ICHOM OAH Standard Set has been developed through consensus-based methods based on predefined criteria following high standards for the identification and selection of high-quality measures The involvements of a wide range of stakeholders supports the acceptability of the set, which is readily available for use and feasibility testing in clinical settings.
Collapse
Affiliation(s)
- Jaheeda Gangannagaripalli
- Health Services and Policy Research Group, University of Exeter Medical School, SJ02, Smeall Building, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Andrea Albagli
- International Consortium for Health Outcomes Measurement, Boston, MA, USA
| | - Stacie N Myers
- International Consortium for Health Outcomes Measurement, Boston, MA, USA
| | - Sarah Whittaker
- International Consortium for Health Outcomes Measurement, Boston, MA, USA
| | - Andria Joseph
- International Consortium for Health Outcomes Measurement, Boston, MA, USA
| | - Anna Clarke
- International Consortium for Health Outcomes Measurement, Boston, MA, USA
| | - Lucy Matkin
- International Consortium for Health Outcomes Measurement, Boston, MA, USA
| | - Jordi Alonso
- IMIM Hospital del Mar Medical Research Institute, CIBERESP, Pompeu Fabra University (UPF), Barcelona, Spain
| | | | | | | | | | - Juan Dapueto
- Universidad de la Republica, Montevideo, Uruguay
| | | | | | - Jan Hazelzet
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | | | | | - Catherine Katz
- Australian Commission for Safety and Quality in Health Care, Sydney, NSW, Australia
| | - Carolyn Kerrigan
- Dartmouth-Hitchcock Medical Centre, The Dartmouth Institute, Lebanon, NH, USA
| | - Cindy Lam
- University of Hong Kong, Hong Kong, China
| | - Joanne Lunn
- We Help Ourselves (WHOS), Sydney, NSW, Australia
| | | | - Alastair Roeves
- Bwrdd Iechyd Prifysgol Bae Abertawe Swansea Bay, University Health Board, Wales, UK
| | | | | | | | | | - Jose M Valderas
- Health Services and Policy Research Group, University of Exeter Medical School, SJ02, Smeall Building, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK.
- International Society for Quality of Life Research, Milwaukee, WI, USA.
| |
Collapse
|