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Xi C, Shen JJ, Burston B, Upadhyay S, Zhou S. Epidemiological/Disease and Economic Burdens of Cervical Cancer in 2010-2014: Are Younger Women at Risk? Healthcare (Basel) 2023; 11:healthcare11010144. [PMID: 36611604 PMCID: PMC9818941 DOI: 10.3390/healthcare11010144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Cervical cancer is an important factor threatening women's health in China. This study examined the epidemiological and economic burden of cervical cancer among the medically insured population, which could provide data support for government departments to formulate policies. METHODS All new cases of cervical cancer under the Urban Employee Basic Medical Insurance (UEBMI) plan in a provincial capital city in eastern China from 2010 to 2014 were collected. The Cox proportional hazard model was used to analyze the factors affecting the survival rates for cervical cancer. Outpatient and hospitalization expenses were used to assess the direct economic burden, and the Potential Years of Life Loss (PYLL) and potential economic loss were calculated by the direct method to assess indirect burden. RESULTS During the observation period, there were 1115 new cases and 137 deaths. The incidence rate was 14.85/100,000 person years, the mortality was 1.82/100,000 person years, and the five-year survival rate was 75.3%. The age of onset was mainly concentrated in the 30-59 age group (82.9%) and the tendency was towards younger populations. The age of onset (HR = 1.037, 95% CI = 1.024-1.051), the frequency of hospitalization services (HR = 1.085, 95% CI = 1.061-1.109), and the average length of stay (ALOS) (HR = 1.020, 95% CI = 1.005-1.051) were the related factors affecting overall survival. Among the direct economic burden, the average outpatient cost was $4314, and the average hospitalization cost was $12,007. The average outpatient and hospitalization costs within 12 months after onset were $2871 and $8963, respectively. As for indirect burden, the average Potential Years of Life Loss (PYLL) was 27.95 years, and the average potential economic loss was $95,200. CONCLUSIONS The epidemiological and economic burden reported in the study was at a high level, and the onset age of cervical patients gradually became younger. The age of onset, the frequency of hospitalization services and the ALOS of cervical cancer patients should be given greater attention. Policymakers and researchers should focus on the trend of younger onset age of cervical cancer and the survival situation within 12 months after onset. Early intervention for cervical cancer patients, particularly younger women, may help reduce the burden of cervical cancer.
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Affiliation(s)
- Chuhao Xi
- Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China
| | - Jay J. Shen
- Department of Healthcare Administration and Policy School of Public Health, University of Nevada, Las Vegas, NV 89154, USA
| | - Betty Burston
- Department of Healthcare Administration and Policy School of Public Health, University of Nevada, Las Vegas, NV 89154, USA
| | - Soumya Upadhyay
- Department of Healthcare Administration and Policy School of Public Health, University of Nevada, Las Vegas, NV 89154, USA
| | - Shoujun Zhou
- Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China
- School of Health Policy & Management, Nanjing Medical University, Nanjing 211100, China
- Correspondence:
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Piazza MF, Amicizia D, Marchini F, Astengo M, Grammatico F, Battaglini A, Sticchi C, Paganino C, Lavieri R, Andreoli GB, Orsi A, Icardi G, Ansaldi F. Who Is at Higher Risk of SARS-CoV-2 Reinfection? Results from a Northern Region of Italy. Vaccines (Basel) 2022; 10:vaccines10111885. [PMID: 36366393 PMCID: PMC9692964 DOI: 10.3390/vaccines10111885] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022] Open
Abstract
The SARS-CoV-2 pandemic continues to spread worldwide, generating a high impact on healthcare systems. The aim of the study was to examine the epidemiological burden of SARS-CoV-2 reinfections and to identify potential related risk factors. A retrospective observational study was conducted in Liguria Region, combining data from National Vaccines Registry and Regional Chronic Condition Data Warehouse. In the study period (September 2021 to May 2022), 335,117 cases of SARS-CoV-2 infection were recorded in Liguria, of which 15,715 were reinfected once. During the Omicron phase (which predominated from 3 January 2022), the risk of reinfection was 4.89 times higher (p < 0.001) than during the Delta phase. Unvaccinated and vaccinated individuals with at least one dose for more than 120 days were at increased risk of reinfection compared with vaccinated individuals with at least one dose for ≤120 days, respectively (odds ratio (OR) of 1.26, p < 0.001; OR of 1.18, p < 0.001). Healthcare workers were more than twice as likely to be reinfected than non-healthcare workers (OR of 2.38, p < 0.001). Lower ORs were seen among people aged 60 to 79 years. Two doses or more of vaccination were found to be protective against the risk of reinfection rather than a single dose (mRNA vaccines: OR of 0.06, p < 0.0001, and OR of 0.1, p < 0.0001; vector vaccines: OR of 0.05, p < 0.0001). Patients with chronic renal failure, cardiovascular disease, bronchopneumopathy, neuropathy and autoimmune diseases were at increased risk of reinfection (OR of 1.38, p = 0.0003; OR of 1.09, p < 0.0296; OR of 1.14, p = 0.0056; OR of 1.78, p < 0.0001; OR of 1.18, p = 0.0205). Estimating the epidemiological burden of SARS-CoV-2 reinfections and the role played by risk factors in reinfections is relevant for identifying risk-based preventive strategies in a pandemic context characterized by a high circulation of the virus and a high rate of pathogen mutations.
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Affiliation(s)
- Maria Francesca Piazza
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy
- Correspondence: ; Tel.: +39-010-548-4680
| | - Daniela Amicizia
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
| | - Francesca Marchini
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
| | - Matteo Astengo
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy
| | - Federico Grammatico
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
| | - Alberto Battaglini
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
| | - Camilla Sticchi
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy
| | - Chiara Paganino
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy
| | - Rosa Lavieri
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy
| | | | - Andrea Orsi
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
- Hygiene Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Giancarlo Icardi
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
- Hygiene Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Filippo Ansaldi
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
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Piazza MF, Amicizia D, Paganino C, Marchini F, Astengo M, Grammatico F, Trucchi C, Romairone P, Simonetti S, Sticchi C, Ansaldi F. Has Clinical and Epidemiological Varicella Burden Changed over Time in Children? Overview on Hospitalizations, Comorbidities and Costs from 2010 to 2017 in Italy. Vaccines (Basel) 2021; 9:1485. [PMID: 34960231 DOI: 10.3390/vaccines9121485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022] Open
Abstract
According to WHO estimates, varicella disease is responsible of a worldwide significant burden in terms of hospitalizations, complications, and deaths, with more than 90% of cases under 12 years old. This study aims at evaluating the clinical, epidemiological, and economic burden of varicella in Ligurian children, about comorbidities, organizational variables, and vaccination coverages from 2010 to 2017, in terms of Emergency Department accesses and hospitalizations. The overall hospitalization rate was 179.76 (per 100,000 inhab.), with a gradual but significant decline since 2015, when universal varicella vaccination was introduced in Liguria (p < 0.0001). The risk of being hospitalized for complicated varicella in subjects with at least one comorbidity was significantly higher than in subjects without comorbidities (p = 0.0016). The economic analysis showed higher costs in subjects with complicated varicella who were 0-3 years old. This age group showed higher costs also considering extra-hospital costs for both outpatient procedures and pharmaceutical costs (p < 0.0001). The results confirm the relevant burden of varicella, especially in the 0-3 age group and in children with comorbidities. Thus, vaccination with the achievement of adequate vaccination coverages is confirmed to be a necessary control strategy to reduce hospitalizations and associated complications with important economic benefits.
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Abstract
Diabetic retinopathy (DR) and age-related macular degeneration (AMD) comprise a significant socio-medical problem for Russia. The article presents an analysis aimed at identifying the prerequisites for further research on the socio-economic consequences of retinal pathology. Studying the epidemiological aspects of DR and AMD, as well as the conditions for receiving medical aid helped define the main approaches to assessing the economic burden of retinal diseases in Russia. It also revealed the problems associated with completeness of registration and accounting of patients, the disparity between the volume of medical aid required and funding, and between the required and provided assistance for patients with these pathologies in clinical practice. Analysis of the disease cost will allow not only to determine the socio-economic consequences of retinal diseases, but also to find further directions for improving the quality of medical care for patients with DR and AMD in order to reduce its economic cost for the state and society. Evidently, there is a need for comprehensive assessment of the total burden of retinal diseases in Russia that would serve as a basis for subsequent assessment of the economic effectiveness of prevention and treatment measures.
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Affiliation(s)
- O I Ivakhnenko
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,National Centre for Assessment of Health Technologies, Moscow, Russia
| | - V V Neroyev
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia.,A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - O V Zaytseva
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia.,A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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Sambala EZ, Mdolo A, Banda R, Phiri A, Wiyeh AB, Wiysonge CS. Burden of seasonal influenza in sub-Saharan Africa: a systematic review protocol. BMJ Open 2018; 8:e022949. [PMID: 30309991 PMCID: PMC6252638 DOI: 10.1136/bmjopen-2018-022949] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 08/26/2018] [Accepted: 08/31/2018] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Measures of epidemiological burdens are an important contribution to estimating disease severity and determining the at-risk populations for seasonal influenza. In the absence of these data, it is extremely difficult for policy-makers to decide on how to distribute limited resources. This systematic review will synthesise the literature on reported burden of seasonal influenza (eg, morbidity and mortality) in sub-Saharan Africa. METHOD AND ANALYSIS We will include published epidemiological studies that capture the burden estimation of seasonal influenza between 1 January 2000 and 31 August 2018. Studies that have reported disease burden estimates associated to influenza-like illness, acute respiratory illness, acute lower respiratory illness, severe acute respiratory illness and severe or very severe pneumonia using laboratory-confirmed influenza cases will be included. We will perform a multiple electronic database search in PubMed, Embase, African Journals Online, Cochrane, Web of science, CINAHL and Google scholar for eligible studies. The reference lists of relevant studies will also be hand-searched for potentially eligible studies. The titles and abstracts of identified records will be screened independently by two authors. The full-text articles of potentially eligible studies will be assessed independently by two authors. Discrepancies will be resolved by discussion, and by a third author if the first two authors fail to come to a consensus. The measures of the burden of influenza will be aggregated using a meta-analysis for homogeneous studies and narrative synthesis if the studies are heterogeneous. The strength of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION This systematic review will use publicly available data; and as such, no formal ethical review is required. Our findings will be published in a peer-reviewed journal and also disseminated through conferences and stakeholder meetings. PROSPERO REGISTRATION NUMBER CRD42017074091.
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Affiliation(s)
- Evanson Zondani Sambala
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Malawi Public Health Forum, Lilongwe, Malawi
| | - Aaron Mdolo
- Malawi Public Health Forum, Lilongwe, Malawi
- University Research Co., LLC - Centre for Human services (URC-CHS), Malawi Lab project, Lilongwe, Malawi
| | - Richard Banda
- Malawi Public Health Forum, Lilongwe, Malawi
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Alison B Wiyeh
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Centre for Evidence-Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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